Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Hydrochlorothiazide is used to treat high blood pressure (hypertension).

Hydrochlorothiazide is also used to treat fluid retention (edema) in people with congestive heart failure, cirrhosis of the liver, or kidney disorders, or edema caused by taking steroids or estrogen.

You should not use hydrochlorothiazide if you are unable to urinate.

Before using hydrochlorothiazide, tell your doctor if you have liver disease, kidney disease, glaucoma, asthma or allergies, gout, diabetes, or if you are allergic to sulfa drugs or penicillin.

Avoid drinking alcohol, which can increase some of the side effects of hydrochlorothiazide .

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

There are many other drugs that can interact with hydrochlorothiazide. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

If you are being treated for high blood pressure, keep using hydrochlorothiazide even if you feel fine. High blood pressure often has no symptoms.

Before taking this medicine

You should not use hydrochlorothiazide if you are allergic to it, or if you are unable to urinate.

To make sure hydrochlorothiazide is safe for you, tell your doctor if you have ever had:

• kidney disease;

• liver disease;

• gout;

• glaucoma;

• low levels of potassium or sodium in your blood;

• high levels of calcium in your blood;

• a parathyroid gland disorder;

• diabetes; or

• an allergy to sulfa drugs or penicillin.

Tell your doctor if you are pregnant or plan to become pregnant. If you take hydrochlorothiazide during pregnancy, your newborn baby may develop jaundice or other problems.

You should not breastfeed while using this medicine.

Hydrochlorothiazide is not approved for use by anyone younger than 18 years old.

Take hydrochlorothiazide exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking hydrochlorothiazide, which can lead to severely low blood pressure or a serious electrolyte imbalance.

Your blood pressure will need to be checked often. Your blood and urine may be tested if you have been vomiting or are dehydrated.

If you need surgery, tell your surgeon you currently use this medicine. You may need to stop for a short time.

Keep using hydrochlorothiazide as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Store at room temperature away from moisture, heat, and freezing. Keep the bottle tightly closed when not in use.

Usual Adult Dose for Edema:

Usual dose: 25 mg to 100 mg orally once or twice daily

Comments:
-Some patients respond to intermittent therapy, (i.e., administration on alternate days or on 3 to 5 days each week). Excessive response and undesirable electrolyte imbalance are less likely to occur with intermittent dosing.

Usual Adult Dose for Hypertension:

Initial dose: 25 mg orally once daily
Maintenance dose: May increase to 50 mg orally daily, as a single or 2 divided doses

Comments:
-Patients usually do not require doses in excess of 50 mg daily when used concomitantly with other antihypertensive agents.

Usual Adult Dose for Nephrocalcinosis:

Initial: 25 mg orally once daily
Maintenance dose: May increase to 50 mg twice daily

Usual Adult Dose for Osteoporosis:

Initial: 25 mg orally once daily
Maintenance dose: May increase to 50 mg daily

Usual Adult Dose for Diabetes Insipidus:

Initial: 50 mg orally once daily
Maintenance dose: May increase to 100 mg orally daily

Usual Pediatric Dose for Edema:

Less than 6 months: Up to 3 mg/kg/day (up to 1.5 mg/pound) orally in 2 divided doses

Less than 2 years: 1 to 2 mg/kg/day (0.5 to 1 mg/pound) orally daily as a single dose or in 2 divided doses
Maximum dose 37.5 mg per day

2 to 12 years: 1 to 2 mg/kg/day (0.5 to 1 mg/pound) orally daily as a single dose or in 2 divided doses
Maximum dose 100 mg per day

Usual Pediatric Dose for Hypertension:

Less than 6 months: Up to 3 mg/kg/day (up to 1.5 mg/pound) orally in 2 divided doses

Less than 2 years: 1 to 2 mg/kg/day (0.5 to 1 mg/pound) orally daily as a single dose or in 2 divided doses
Maximum dose 37.5 mg per day

2 to 12 years: 1 to 2 mg/kg/day (0.5 to 1 mg/pound) orally daily as a single dose or in 2 divided doses
Maximum dose 100 mg per day

You should not use hydrochlorothiazide if you are allergic to it, or if you are unable to urinate.

To make sure hydrochlorothiazide is safe for you, tell your doctor if you have ever had:

• kidney disease;

• liver disease;

• gout;

• glaucoma;

• low levels of potassium or sodium in your blood;

• high levels of calcium in your blood;

• a parathyroid gland disorder;

• diabetes; or

• an allergy to sulfa drugs or penicillin.

Tell your doctor if you are pregnant or plan to become pregnant. If you take hydrochlorothiazide during pregnancy, your newborn baby may develop jaundice or other problems.

You should not breastfeed while using this medicine.

Hydrochlorothiazide is not approved for use by anyone younger than 18 years old.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include nausea, dizziness, dry mouth, thirst, and muscle pain or weakness.

Keep this medicine in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not allow the liquid or capsules to freeze.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

If your doctor prescribes a low-salt or low-sodium diet, or to eat or drink increased amounts of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice) in your diet, follow these instructions carefully.

Hydrochlorothiazide may increase your risk of skin cancer. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Your doctor may want you to have skin examinations on a regular basis.

Drinking alcohol with hydrochlorothiazide can cause side effects.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Get emergency medical help if you have signs of an allergic reaction to hydrochlorothiazide (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Call your doctor at once if you have:

• a light-headed feeling;

• eye pain, vision problems;

• jaundice (yellowing of the skin or eyes);

• pale skin, easy bruising, unusual bleeding (nose, mouth, vagina, or rectum);

• shortness of breath, wheezing, cough with foamy mucus, chest pain;

• dehydration symptoms - feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin; or

• signs of an electrolyte imbalance - increased thirst or urination, confusion, vomiting, constipation, muscle pain, leg cramps, bone pain, lack of energy, irregular heartbeats, tingly feeling.

Common hydrochlorothiazide side effects may include:

• weakness;

• feeling like you might pass out;

• severe pain in your upper stomach spreading to your back, nausea and vomiting;

• fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath; or

• electrolyte imbalance.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Taking hydrochlorothiazide with other drugs that make you light-headed can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your other medicines, especially:

• cholestyramine, colestipol;

• insulin or oral diabetes medicine;

• lithium;

• other blood pressure medications;

• steroid medicine; or

• NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect hydrochlorothiazide, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly, and blood tests should be done occasionally.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking hydrochlorothiazide.

Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Hydrochlorothiazide starts to work after about two hours. You’ll probably notice the full effects around four hours after taking it.

Let your doctor know if you experience any severe or unusual side effects while using this medicine.

Your dosage of hydrochlorothiazide will depend on your medical condition, age, and other factors.

A typical starting dose for adults with high blood pressure is 25 milligrams (mg), once a day. This may be increased to 50 mg a day if needed.

Hydrochlorothiazide may be used “off-label” to treat or prevent other medical conditions, including:

• Kidney stones
• Diabetes insipidus (a condition that develops from an imbalance of bodily fluids)
• Osteoporosis

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