Side Effects of Microzide (hydrochlorothiazide)

Microzide(hydrochlorothiazide) is a diuretic used to treat excessive fluid accumulation and swelling (edema) of the body caused byheart failure,cirrhosis, chronickidney failure,corticosteroidmedications, and nephrotic syndrome. It also is used alone or in conjunction with other官网地址bwinlowering medications to treathigh blood pressure.

Microzide can be used to treat calcium-containing肾结石because it decreases the amount of calcium excreted by the kidneys in the urine and thus decreases the amount of calcium in urine to form stones. Although Microzide is approved for treating edema incirrhosisof theliver, it is rarely used because of the availability of other diuretics that are more effective.

Common side effects of Microzide include

• weakness,
• low blood pressure,
• light sensitivity (rashcaused by sunlight),
• impotence,
• nausea, and
• abdominal pain.

Serious side effects of Microzide include

• electrolytedisturbances,
• pancreatitis,
• yellowing skin and eyes (jaundice), and
• life-threateningallergic reaction(anaphylaxis).

Drug interactionsof Microzide includelithium, because Microzide reduces the elimination of lithium by the kidneys and can lead to lithium toxicity.

• Nonsteroidal anti-inflammatorydrugs(NSAIDs),例如,ibuprofen, may reduce the blood pressure lowering effects of Microzide.
• Bloodsugarlevels can be elevated by Microzide, necessitating adjustment in the doses of medications that are used for treatingdiabetes.
• Combining Microzide withcorticosteroidsmay increase the risk for low levels of blood potassium and otherelectrolytes.
• Low blood potassium (hypokalemia) can increase the toxicity ofdigoxin.Cholestyramineandcolestipolbind to Microzide and reduce its absorption from the gastrointestinal tract by 43% to 85%.

There are no adequate studies of Microzide inpregnantwomen.Thiazide diureticsmay increase the risk of fetal orneonatal jaundice, low platelet levels, and possibly other adverse reactions that have occurred in adults.

Microzide is excreted inbreast milk. Intense diuresis using Microzide may reduce the production of breast milk. Otherwise Microzide is considered safe to use duringbreastfeeding如果所需的母亲。请咨询你的医生性能试验ore breastfeeding.

Side effects of hydrochlorothiazide include

• weakness,
• low blood pressure,
• light sensitivity (rashcaused by sunlight),
• impotence,
• nausea, and
• abdominal pain.

More serious side effects include

• electrolyte disturbances,
• pancreatitis,
• jaundice, and
• anaphylaxis (a life-threateningallergicreaction).

Patients allergic to sulfa may also be allergic to hydrochlorothiazide because of the similarity in the chemical structure of the medications.

Hydrochlorothiazide can aggravate kidney dysfunction and is used with caution in patients withkidney disease. Hydrochlorothiazide can lower blood potassium, sodium, and magnesium levels.Low potassiumand magnesium levels can lead to abnormalities inheartrhythm, especially in patients already taking digoxin (Lanoxin). During hydrochlorothiazide treatment, supplementation with potassium is common to prevent low potassium levels.

Blood uric acid levels can increase during hydrochlorothiazide treatment, and this elevation may cause an episode of acutegoutin some individuals. Thiazide diuretics may increase bloodsugar(glucose) levels and precipitatediabetes.

The adverse reactions associated with hydrochlorothiazide have been shown to be dose related. In controlledclinical trials, the adverse events reported with doses of 12.5 mg hydrochlorothiazide once daily were comparable toplacebo. The following adverse reactions have been reported for doses of hydrochlorothiazide 25 mg and greater and, within each category, are listed in the order of decreasing severity.

• Body as a whole: Weakness.
• Cardiovascular:Hypotensionincludingorthostatic hypotension(may be aggravated byalcohol,barbiturates, narcotics or antihypertensive drugs).
• Digestive:Pancreatitis,jaundice(intrahepatic cholestatic jaundice),diarrhea,vomiting, sialadenitis, cramping,constipation, gastric irritation,nausea,anorexia.
• Hematologic:Aplastic anemia,agranulocytosis,leukopenia,hemolytic anemia,thrombocytopenia.
• Hypersensitivity: Anaphylactic reactions, necrotizingangiitis(vasculitisand cutaneousvasculitis), respiratory distress including pneumonitis andpulmonary edema,photosensitivity,fever,urticaria,rash,purpura.
• Metabolic: Electrolyte imbalance (seePRECAUTIONS),hyperglycemia, glycosuria,hyperuricemia.
• Musculoskeletal:Muscle spasm.
• Nervous System/Psychiatric:Vertigo,paresthesia,dizziness,headache, restlessness.
• Renal:Renal failure, renal dysfunction, interstitial nephritis (see警告).
• Skin:Erythema multiformeincludingStevens-Johnson syndrome, exfoliativedermatitisincluding toxic epidermal necrolysis,alopecia.
• Special Senses: Transientblurred vision,xanthopsia.
• Urogenital:Impotence.

Whenever adverse reactions are moderate or severe, thiazide dosage should be reduced or therapy withdrawn.

When given concurrently the following drugs may interact with thiazide diuretics:

• Alcohol, barbiturates, or narcotics:potentiation oforthostatic hypotensionmay occur.
• Antidiabetic drugs:(oral agents andinsulin) dosage adjustment of the antidiabetic drug may be required.
• 其他antihypertensive drugs:additive effect or potentiation.
• Cholestyramine and colestipol resins: Cholestyramine and colestipol resins bind the hydrochlorothiazide and reduce its absorption from thegastrointestinal tractby up to 85 and 43 percent, respectively.
• Corticosteroid, ACTH:intensified electrolyte depletion, particularlyhypokalemia.
• Pressor amines (e.g., norepinephrine):possible decreased response to pressor amines but not sufficient to preclude their use.
• Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine):possible increased responsiveness to themuscle relaxant.
• Lithium:generally should not be given with diuretics.Diureticagents reduce the renal clearance of lithium and greatly increase the risk of lithium toxicity. Refer to the package insert for lithium preparations before use of such preparations with MICROZIDE (hydrochlorothiazide capsule) .
• 非甾体抗炎药物s:In some patients, the administration of a non-steroidal anti-inflammatory agent can reduce the diuretic,natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics. When MICROZIDE (hydrochlorothiazide capsule) and non-steroidal anti-inflammatory agents are used concomitantly, the patients should be observed closely to determine if the desired effect of the diuretic is obtained.

Drug/Laboratory Test Interactions

• Thiazidesshould be discontinued before carrying out tests for parathyroid function.