i THYE a
Adjunctive therapy in treatment of edema and
Hypersensitivity to polythiazide or any other sulfonamide-derived drugs;
anuria; renal decompensation; pregnancy
Avoid in severe renal disease (ineffective). Electrolyte disturbances
(hypokalemia, hypochloremic alkalosis, hyponatremia) can occur. Use with caution
in severe hepatic dysfunction; hepatic encephalopathy can be caused by
electrolyte disturbances. Gout can be precipitate in certain patients with a
history of gout, a familial predisposition to gout, or chronic renal failure.
Cautious use in diabetics; may see a change in glucose control. Hypersensitivity
reactions can occur. Can cause SLE exacerbation or activation. Use with caution
in patients with moderate or high cholesterol concentrations. Photosensitization
may occur. Correct hypokalemia before initiating therapy.
1% to 10%: Hypokalemia
<1% (Limited to important or life-threatening symptoms): Hypotension,
drowsiness, photosensitivity, rash, fluid and electrolyte imbalances
(hypocalcemia, hypomagnesemia, hyponatremia), hyperglycemia, nausea, vomiting,
anorexia, polyuria, rarely blood dyscrasias, hepatitis, prerenal azotemia,
Angiotensin-converting enzyme inhibitors: Increased hypotension if
aggressively diuresed with a thiazide diuretic.
Beta-blockers increase hyperglycemic effects in Type 2 diabetes mellitus.
Cyclosporine and thiazides can increase the risk of gout or renal toxicity;
avoid concurrent use.
Digoxin toxicity can be exacerbated if a thiazide induces hypokalemia or
Lithium toxicity can occur by reducing renal excretion of lithium; monitor
lithium concentration and adjust as needed.
Neuromuscular blocking agents can prolong blockade; monitor serum potassium
and neuromuscular status.
NSAIDs can decrease the efficacy of thiazides reducing the diuretic and
The diuretic mechanism of action of the thiazides is primarily inhibition of
sodium, chloride, and water reabsorption in the renal distal tubules, thereby
producing diuresis with a resultant reduction in plasma volume. The
antihypertensive mechanism of action of the thiazides is unknown. It is known
that doses of thiazides produce greater reductions in blood pressure than
equivalent diuretic doses of loop diuretics (eg, furosemide). There has been
speculation that the thiazides may have some influence on vascular tone mediated
through sodium depletion, but this remains to be proven.
Onset of diuretic effect: Within ~2 hours
Duration: 24-48 hours
Hypertension: 2-4 mg/day
Thiazide diuretics are effective first-line therapeutic agents in the
management of hypertension and have proven to be of benefit in terms of
cardiovascular outcome. They may act synergistically to lower blood pressure
when combined with an ACE inhibitor or beta-blocker. The initial concern about
thiazide diuretic-induced hypokalemia, glucose intolerance, and lipid profiles
does not appear to be of substantial clinical consequence in the treatment of
hypertension. The benefits of this class of agents in the treatment of
hypertension is established and compares well with other first-line therapeutic
|Mental Health: Effects
on Mental Status|
May cause drowsiness
Effects on Psychiatric
May decrease lithium clearance resulting in an increase in serum lithium
levels and potential lithium toxicity; monitor serum lithium
|Dental Health: Local
No information available to require special precautions
Effects on Dental Treatment|
No effects or complications reported
May be taken with food or milk; take early in day to avoid nocturia; take the
last dose of multiple doses no later than 6 PM unless instructed otherwise. A
few people who take this medication become more sensitive to sunlight and may
experience skin rash, redness, itching, or severe sunburn, especially if sun
block SPF greater than or equal to 15 is not used on exposed skin
Monitor blood pressure, fluids, weight loss, serum
Tablet: 1 mg, 2 mg, 4 mg
Copyright © 1978-2000 Lexi-Comp Inc. All Rights Reserved