Category:

• Diuruetic

Description:

• Antihypertensive, thiazide diuretic

Indications:

• Edema associated with CHF, hepatic cirrhosis, corticosteroid and estrogen therapy

• Hypertension

Contraindications:

• Anuria

• Renal decompensation

Precautions:

• Pregnancy category D; 1^st trimester may increase risk of congenital defects; use in later trimesters does not seem to carry this risk

• Hypokalemia, renal disease, hepatic disease, gout

• COPD, lupus erythematosus, diabetes mellitus

• Children, vomiting, diarrhea, hyperlipidemia

Adverse Reactions (Side Effects):

• CNS: depression, dizziness, drowsiness, fatigue, paresthesia, weakness, headache

• CV: irregular pulse, orthostatic hypotension, palpitations, volume depletion

• EENT: blurred vision

• GI: anorexia, constipation, cramps, diarrhea, nausea, pancreatitis, vomiting

• GU: frequency, decreased libido, impotence

• HEME: agranulocytosis, aplastic anemia, hemolytic anemia, leukopenia, neutropenia, thrombocytopenia

• METAB: hypercalcemia, hyperglycemia, hyperuricemia, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, increased creatinine, BUN

• SKIN: fever, photosensitivity, purpupa, rash, urticaria

Dosage:

Administered orally (tablet, solution)

• Adult:   PO 12.5-50mg daily, max 200mg daily; doses >50 mg/day generally not recommended due to increased incidence of hypokalemia and other metabolic disturbances

• Child:   PO (<6 months) 2-3.3 mg/kg/day in 2 divided doses; (>6 months) 2 mg/kg/day in 2 divided doses

Drug interactions:

• Antidiabetics: thiazide diuretics tend to increase blood glucose, may increase dosage requirements of antidiabetic drugs

• Digitalis glycosides: diuretic-induced hypokalemia may increase risk of digitalis toxicity

Special considerations:

• May cause gout attacks

• May cause sensitivity to sunlight

• Take early in day due to increased urination