Hydrochlorothiazide (HCTZ)

Hydrochlorothiazide Brand Names

Esidrix | Ezide | HydroDIURIL | Microzide | Oretic | Zide

What is Hydrochlorothiazide

Hydrochlorothiazide (HCTZ) is a thiazide diuretic used in the management of edema and hypertension.

In hypertension, thiazide diuretics are often used as initial therapy, either alone or in combination with other agents.

Unlike the loop diuretics, their efficacy is diminished in patients with renal insufficiency.

Hydrochlorothiazide also has been used to treat diabetes insipidus and hypercalciuria, although these are not FDA-approved indications.

Hydrochlorothiazide was approved by the FDA in 1959.

Indications

  1. ascites
  2. diabetes insipidus
  3. edema
  4. heart failure
  5. hypercalciuria
  6. hypertension
  7. nephrolithiasis
  8. nephrotic syndrome
  9. premenstrual syndrome (PMS)
  10. renal calculus

Side Effects

  1. abdominal pain
  2. agranulocytosis
  3. alopecia
  4. anaphylactoid reactions
  5. anorexia
  6. aplastic anemia
  7. azotemia
  8. blurred vision
  9. constipation
  10. diarrhea
  11. dizziness
  12. erythema multiforme
  13. exfoliative dermatitis
  14. fever
  15. glycosuria
  16. gout
  17. headache
  18. hemolytic anemia
  19. hypercalcemia
  20. hypercholesterolemia
  21. hyperglycemia
  22. hypertriglyceridemia
  23. hyperuricemia
  24. hypochloremia
  25. hypokalemia
  26. hypomagnesemia
  27. hyponatremia
  28. hypotension
  29. impotence (erectile dysfunction)
  30. interstitial nephritis
  31. jaundice
  32. leukopenia
  33. metabolic alkalosis
  34. muscle cramps
  35. myopia
  36. nausea
  37. ocular hypertension
  38. orthostatic hypotension
  39. pancreatitis
  40. paresthesias
  41. photosensitivity
  42. pneumonitis
  43. polyuria
  44. pulmonary edema
  45. purpura
  46. rash
  47. renal failure (unspecified)
  48. restlessness
  49. sialadenitis
  50. Stevens-Johnson syndrome
  51. syncope
  52. thrombocytopenia
  53. toxic epidermal necrolysis
  54. urticaria
  55. vasculitis
  56. vertigo
  57. vomiting
  58. weakness
  59. xanthopsia

Monitoring Parameters

  • blood glucose
  • blood pressure
  • serum calcium
  • serum creatinine/BUN
  • serum electrolytes
  • serum magnesium

Contraindications

  • anuria
  • asthma
  • breast-feeding
  • diabetes mellitus
  • electrolyte imbalance
  • geriatric
  • gout
  • hepatic disease
  • hypercalcemia
  • hyperglycemia
  • hyperuricemia
  • hypochloremia
  • hypokalemia
  • hypomagnesemia
  • hyponatremia
  • hypotension
  • hypovolemia
  • jaundice
  • metabolic alkalosis
  • neonates
  • orthostatic hypotension
  • pancreatitis
  • penicillin hypersensitivity
  • preeclampsia
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • sulfonamide hypersensitivity
  • sunlight (UV) exposure
  • sympathectomy
  • syncope
  • systemic lupus erythematosus (SLE)
  • thiazide diuretic hypersensitivity

Interactions

  • Acarbose
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Acetazolamide
  • Acetohexamide
  • Aclidinium; Formoterol
  • Acrivastine; Pseudoephedrine
  • Albiglutide
  • Albuterol
  • Albuterol; Ipratropium
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Alendronate; Cholecalciferol
  • Alfentanil
  • Allopurinol
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alpha-glucosidase Inhibitors
  • Alprostadil
  • Amifostine
  • Aminolevulinic Acid
  • Amiodarone
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphetamine; Dextroamphetamine Salts
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Amyl Nitrite
  • Angiotensin-converting enzyme inhibitors
  • Anticholinergics
  • Apomorphine
  • Apraclonidine
  • Arformoterol
  • Aripiprazole
  • Arsenic Trioxide
  • Articaine; Epinephrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Atracurium
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Baclofen
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Benzhydrocodone; Acetaminophen
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzphetamine
  • Benztropine
  • Beta-agonists
  • Bortezomib
  • Bosentan
  • Brexpiprazole
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Budesonide; Formoterol
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Cabergoline
  • Calcium
  • Calcium Phosphate, Supersaturated
  • Calcium; Vitamin D
  • Canagliflozin
  • Canagliflozin; Metformin
  • Captopril
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cardiac glycosides
  • Cariprazine
  • Celecoxib
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chlordiazepoxide; Clidinium
  • Chloroprocaine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpropamide
  • Cholestyramine
  • Cidofovir
  • Cisapride
  • Cisatracurium
  • Citalopram
  • Clindamycin; Tretinoin
  • Clozapine
  • Co-Enzyme Q10, Ubiquinone
  • Cocaine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colchicine; Probenecid
  • Colestipol
  • Conivaptan
  • Corticosteroids
  • Cosyntropin
  • Cyclophosphamide
  • Dapagliflozin
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Desloratadine; Pseudoephedrine
  • Desvenlafaxine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexlansoprazole
  • Dexmethylphenidate
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Quinidine
  • Diazoxide
  • Dichlorphenamide
  • Diclofenac
  • Diclofenac; Misoprostol
  • Dicyclomine
  • Diethylpropion
  • Diflunisal
  • Digitoxin
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Dobutamine
  • Dofetilide
  • Dolasetron
  • Donepezil; Memantine
  • Dopamine
  • Doxacurium
  • Droperidol
  • Dulaglutide
  • Duloxetine
  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Enflurane
  • Ephedrine
  • Epinephrine
  • Ergocalciferol, Vitamin D2
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Escitalopram
  • Esomeprazole
  • Esomeprazole; Naproxen
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Ethanol
  • Etodolac
  • Etomidate
  • Exenatide
  • Famotidine; Ibuprofen
  • Fenoprofen
  • Fentanyl
  • Fexofenadine; Pseudoephedrine
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Flavoxate
  • Fluconazole
  • Fluocinolone; Hydroquinone; Tretinoin
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Flurbiprofen
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Fluvoxamine
  • Formoterol
  • Formoterol; Mometasone
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fospropofol
  • Gallium Ga 68 Dotatate
  • General anesthetics
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Granisetron
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Halobetasol; Tazarotene
  • Halofantrine
  • Haloperidol
  • Halothane
  • Homatropine; Hydrocodone
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hyoscyamine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen
  • Ibuprofen lysine
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Icosapent ethyl
  • Iloperidone
  • Inamrinone
  • Incretin Mimetics
  • Indacaterol
  • Indacaterol; Glycopyrrolate
  • Indomethacin
  • Inotersen
  • Insulin Degludec; Liraglutide
  • Insulin Glargine; Lixisenatide
  • Insulins
  • Intravenous Lipid Emulsions
  • Isocarboxazid
  • Isoflurane
  • Isoproterenol
  • Isosorbide Dinitrate, ISDN
  • Isosorbide Mononitrate
  • Ketamine
  • Ketoprofen
  • Ketorolac
  • Lansoprazole
  • Lansoprazole; Naproxen
  • Lesinurad; Allopurinol
  • Levalbuterol
  • Levodopa
  • Levomethadyl
  • Levomilnacipran
  • Levorphanol
  • Linagliptin
  • Linagliptin; Metformin
  • Liraglutide
  • Lisdexamfetamine
  • Lisinopril
  • Lithium
  • Lixisenatide
  • Loop diuretics
  • Loratadine; Pseudoephedrine
  • Lovastatin; Niacin
  • Lurasidone
  • Magnesium Salts
  • Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
  • Mannitol
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meglitinides
  • Meloxicam
  • Memantine
  • Mepenzolate
  • Meperidine
  • Meperidine; Promethazine
  • Mequinol; Tretinoin
  • Mestranol; Norethindrone
  • Metaproterenol
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methadone
  • Methamphetamine
  • Methazolamide
  • Methenamine
  • Methenamine; Sodium Acid Phosphate
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methotrexate
  • Methoxsalen
  • Methscopolamine
  • Methylphenidate
  • Metoclopramide
  • Midodrine
  • Miglitol
  • Milnacipran
  • Milrinone
  • Mirtazapine
  • Mivacurium
  • Moexipril
  • Morphine
  • Morphine; Naltrexone
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nateglinide
  • Nefazodone
  • Nesiritide, BNP
  • Neuromuscular blockers
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Nitrates
  • Nitroglycerin
  • Nitroprusside
  • Nonsteroidal antiinflammatory drugs
  • Norepinephrine
  • Octreotide
  • Olanzapine
  • Olodaterol
  • Omeprazole
  • Omeprazole; Amoxicillin; Rifabutin
  • Omeprazole; Sodium Bicarbonate
  • Ondansetron
  • Oprelvekin, rh-IL-11
  • Oxaprozin
  • Oxybutynin
  • Oxycodone
  • Oxymetazoline
  • Oxymorphone
  • Paliperidone
  • Pancuronium
  • Pantoprazole
  • Paroxetine
  • Pasireotide
  • Pentamidine
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentoxifylline
  • Perindopril
  • Perindopril; Amlodipine
  • Phendimetrazine
  • Phenelzine
  • Phenothiazines
  • Phentermine
  • Phentermine; Topiramate
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Photosensitizing agents (topical)
  • Pimozide
  • Pioglitazone
  • Pirbuterol
  • Piroxicam
  • Polycarbophil
  • Polyethylene Glycol; Electrolytes
  • Polyethylene Glycol; Electrolytes; Ascorbic Acid
  • Porfimer
  • Pramlintide
  • Prazosin
  • Prilocaine; Epinephrine
  • Probenecid
  • Procainamide
  • Procaine
  • Propantheline
  • Propofol
  • Pseudoephedrine
  • Quetiapine
  • Quinapril
  • Quinidine
  • Rabeprazole
  • Ramipril
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  • Risperidone
  • Rocuronium
  • Rofecoxib
  • Rosiglitazone
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  • Salmeterol
  • Saxagliptin
  • Scopolamine
  • Selegiline
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  • Serotonin norepinephrine reuptake inhibitors
  • Sertraline
  • Sevoflurane
  • Silodosin
  • Simvastatin; Sitagliptin
  • Sitagliptin
  • Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Solifenacin
  • Streptozocin
  • Succinylcholine
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  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
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  • Vitamin D
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  • Vorinostat
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  • Ziconotide
  • Ziprasidone
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