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Hypothiazide, 20 pcs., 25 mg, tablets

During long-term treatment, it is necessary to carefully monitor the clinical symptoms of water-electrolyte imbalance, primarily in patients at high risk: patients with diseases of the cardiovascular system and impaired liver function; in case of severe vomiting or when signs of water and electrolyte imbalance appear, such as dry mouth, thirst, weakness, lethargy, drowsiness, anxiety, muscle pain or cramps, muscle weakness, hypotension, oliguria, tachycardia, gastrointestinal complaints.

Hypokalemia can be avoided by using potassium-containing drugs or foods rich in potassium (fruits, vegetables), especially in the case of increased potassium loss (increased diuresis, prolonged treatment) or concomitant treatment with digitalis glycosides or corticosteroid drugs.

Thiazides have been shown to increase urinary excretion of magnesium; this may lead to hypomagnesemia.

With reduced renal function, monitoring of creatinine clearance is necessary. In patients with impaired renal function, the drug may cause azotemia, and cumulative effects may develop. If renal dysfunction is obvious, discontinuation of the drug should be considered when oliguria occurs.

In patients with impaired liver function or with progressive liver diseases, thiazides are prescribed with caution, since a slight change in water and electrolyte balance, as well as serum ammonium levels, can cause hepatic coma.

In cases of severe cerebral and coronary sclerosis, the administration of the drug requires special caution.

Treatment with thiazide drugs may impair glucose tolerance. During a long course of treatment for manifest and latent diabetes mellitus, systematic monitoring of carbohydrate metabolism is necessary; It may be necessary to change the dose of hypoglycemic drugs. Increased monitoring of patients with impaired uric acid metabolism is required.

Alcohol, barbiturates, and narcotic analgesics enhance the orthostatic hypotensive effect of thiazide diuretics.

With long-term therapy, in rare cases, pathological changes in the parathyroid glands were observed, accompanied by hypercalcemia and hypophosphatemia. Thiazides can reduce the amount of iodine bound to serum proteins without causing signs of thyroid dysfunction.

In patients suffering from lactose intolerance, gastrointestinal complaints may occur due to the presence of lactose in the tablets: Hypothiazide® 25 mg tablets contain 63 mg of lactose, Hypothiazide® 100 mg - 39 mg of lactose.

Impact on the ability to drive a car and perform work that requires increased attention.

In the initial stage of using the drug (the duration of this period is determined individually), it is forbidden to drive a car or perform work that requires increased attention.

Side effects

Metabolism:

hyponatremia;
hypercalcemia;
hypokalemia;
hypochloremic alkalosis;
glucosuria;
hyperglycemia;
hyperuricemia;
hypomagnesemia.

Hypotnatremia is manifested by muscle cramps , fatigue, convulsions, confusion, excessive excitability, and lethargy . With hypochloremic alkalosis , nausea, weakness, vomiting, muscle pain and cramps, various types of heart rhythm disturbances , thirst, dry mouth, changes in the psyche and mood are noted. hepatic encephalopathy (up to hepatic coma can develop . A decrease in sugar tolerance can cause an exacerbation, a manifestation of a latent form of diabetes mellitus, which is manifested in a biochemical analysis by hyperglycemia .

Digestive tract:

constipation;
anorexia;
cholestatic jaundice;
cholecystitis;
diarrhea syndrome;
pancreatitis;
sialadenitis.

The cardiovascular system:

arrhythmia;
vasculitis;
orthostatic hypotension.

Peripheral nervous system, central nervous system:

headache;
temporary blurred vision;
dizziness;
paresthesia.

Allergic responses:

respiratory distress syndrome ( edema of non-cardiogenic origin, pneumonitis ).

Other negative reactions:

development of interstitial nephritis ;
changes in the functioning of the renal system;
potency disorder.

pharmachologic effect

Diuretic. The principle of action of thiazide diuretics is based on increasing diuresis through suppressing the reabsorption of Na and Cl ions in the initial sections of the tubules of the renal system, which causes increased excretion of Na, Cl ions and water. of electrolytes (Mg, K, etc.) increases

Maximum therapeutic dosages of thiazide duretics provide approximately the same natriuretic/diuretic effect. Diuresis and natriuresis are recorded after 2 hours, and the maximum effect appears after 4 hours. Thiazide diuretics are able to suppress carbonic anhydrase activity due to increased excretion of bicarbonate ions. This effect is weakly expressed and has virtually no effect on urine pH. Hydrochlorothiazide is characterized by a hypotensive effect . The active substance has no effect on normal blood pressure

Hypothiazide analogs

Level 4 ATC code matches:
Dichlorothiazide

Hydrochlorothiazide

Structural analogues:

Hydrochlorothiazide-SAR;
Hydrochlorothiazide.

Medicines with similar pharmacological effects (diuretics):

Veroshpiron;
Diuver;
Indapamide;
Torasemide;
Arifon;
Spironolactone;
Inspra;
Lasix;
Furosemide.

Indications for use of Hypothiazide

What are Hypothiazide tablets for? The medication is prescribed for edema syndrome of various origins:

portal hypertension;
chronic renal failure;
nephrotic syndrome;
taking corticosteroids;
acute glomerulonerfit ;
premenstrual tension syndrome;
chronic course of heart failure.

Indications for use of Hypothiazide:

control for polyuria ( diabetes insipidus , nephrogenic diabetes );
arterial hypertension (in combination with other antihypertensive drugs, in monotherapy);
prevention of stone formation in the urinary system in predisposed patients (reducing the risk of hypercalciuria ).

Hypothiazide price, where to buy

The cost of the medication is relatively low and varies within small ranges depending on the amount of the active substance, pharmacy chain, and region. The average price of Hypothiazide in Russia is 100 rubles.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

ZdravCity

Hypothiazide tablets 100 mg 20 pcs.Chinoin
RUB 121 order
Hypothiazide tablets 25 mg 20 pcs.Chinoin
93 RUR order

Pharmacy Dialogue

Hypothiazide (tablet 100 mg No. 20)Chinoin
114 RUR order
Hypothiazide tablets 25 mg No. 20Chinoin
81 RUR order
Hypothiazide tablets 100 mg No. 20Chinoin
116 RUR order

Pharmacy24

Hypothiazide 25 mg N20 tablets Quinoin Pharmaceutical and Chemical Products Plant Private Co. Ltd., Ugorshchina
48 UAH.order
Hypothiazide 100 mg No. 20 tablets Quinoin Pharmaceutical and Chemical Products Plant Private Co. Ltd., Ugorshchina
75 UAH order

PaniPharmacy

Hypothiazide tablets Hypothiazide tablets. 100 mg No. 20 Hungary, Chinoin
93 UAH order
Hypothiazide tablets Hypothiazide tablets. 25 mg No. 20 Hungary, Chinoin
53 UAH order

Hypothiazide during pregnancy (and lactation)

The active component Hydrochlorothiazide is contraindicated during pregnancy in the first trimester. It is permissible to prescribe the medication in the 2nd and 3rd trimesters in cases where the possible benefit to the mother significantly exceeds the expected risk to the health of the fetus. The active substance can pass the placental barrier. Newborns may develop thrombocytopenia , jaundice and other consequences. The active component is released during lactation , which may require interruption of breastfeeding if it is necessary to take a diuretic.

Interaction

Taking antihypertensive medications may require adjustment of the Hypothiazide dosage regimen, because drugs can potentiate each other's effects. Increased lithium toxicity and decreased renal clearance when treated with lithium salts . Hypomagnesemia and hypokalemia that occur during the use of diuretics can enhance the toxic effect of digitalis, which must be taken into account when taking Digoxin and other cardiac glycosides . The risk of developing arrhythmia associated with hypokalemia increases significantly when taking Amiodarone . Hyperglycemia and a decrease in the effectiveness of oral forms of hypoglycemic medications when taking Hypothiazide. Potassium excretion increases when taking corticosteroid medications . NSAIDs can reduce the effectiveness of diuretics and suppress the hypotensive effect of thiazides. It is possible to enhance the effectiveness of muscle relaxants (non-depolarizing forms). The hypotensive orthostatic effect is significantly enhanced by the use of barbiturates , ethanol , and opioid analgesics . Cholestyramine can reduce the absorption rate of Hypothiazide. The risk of toxic effects from Amantadine increases because Hydrochlorothiazide reduces its clearance, increasing the plasma . Temporary withdrawal of the thiazide diuretic is required before conducting tests characterizing the functional state of the parathyroid glands.

Overdose

The clinical picture of overdose is manifested due to a sharp loss of electrolytes and fluid, which is manifested by the following symptoms:

paresthesia;
dizziness;
drop in blood pressure;
spasms in the calf muscles;
hypokalemia;
alkalosis;
hypochloremia;
confusion;
severe weakness, apathy;
tachycardia;
oliguria;
increased concentration of urea nitrogen (more pronounced in patients with pathology of the renal system);
hyponatremia;
anuria (as a result of hemoconcentration);
polyuria;
nausea;
shock;
vomit.

It is recommended to artificially induce vomiting, gastric lavage, and administer Activated Carbon or other drugs with an enterosorbing effect. In case of shock and a drop in blood pressure, measures are taken to compensate for the volume of circulating blood and electrolytes (Na, K). Monitoring of indicators of the state of water and electrolyte balance (particular attention is paid to the level of potassium in the blood) and the functioning of the renal system (until all indicators are normalized) is mandatory. A specific antidote has not been developed.

Contraindications

Main contraindications to the use of Hydrochlorothiazide:

Addison's disease;
severe insufficiency of the hepatic system;
anuria;
severe renal failure;
difficult to control diabetes mellitus ;
individual hypersensitivity;
age limit - up to three years (relevant for solid dosage form);
refractory hyponatremia (decrease in NA level), hypokalemia, hypercalcemia;
intolerance to sulfonamides.

Relative contraindications:

lactose intolerance;
hypokalemia;
taking cardiac glycosides (for example, Digoxin );
gout;
cirrhotic lesion of the hepatic system;
IHD;
hypercalcemia;
hyponatremia;
elderly age.

Reviews about Hypothiazide

The medication is often prescribed for diseases of the heart and vascular system, accompanied by edema syndrome. Patients note a mild diuretic effect of the drug if the dosages specified by the doctor are observed. The edema syndrome is relieved gradually, without washing away the necessary microelements from the body.

Reviews about Hypothiazide for weight loss are mixed. Weight does indeed decrease, but only due to lost fluid. The kilograms return after water enters the body. The medication does not have any effect on fat and muscle tissue, so the use of Hypothiazide for weight loss is inappropriate, and in some cases can be harmful to health (loss of microelements, dehydration, etc.)

Pharmacodynamics and pharmacokinetics

Suction, distribution

The active substance, although not complete, is very quickly absorbed from the gastrointestinal tract (the effect lasts 6-12 hours). The maximum concentration is recorded after 1.5-2.5 hours when taking 100 mg of the active substance. At a plasma of 2 mcg/ml, the most pronounced diuretic effect is observed (4 hours after taking the tablet). Protein binding rate is 40%. The active component hydrochlorothiazide is able to penetrate into breast milk and can easily pass the placental barrier .

Removal

The active substance is excreted unchanged by the renal system through filtration and secretion . The T1\2 indicator with a normally functioning renal system is 6.4 hours.

Pharmacokinetics of a special category of patients

With CC less than 30 ml per minute, T1/2 (half-life) is 20.7 hours. With moderate pathology of the renal system, this figure is 11.5 hours.