Type of Drug:

Diuretics or “water pills.”

How the Drug Works:

Thiazides and related diuretics reduce water in the body and increase urine flow.

Uses:

To treat high blood pressure, either alone or in combination with other high blood pressure medications.

To treat edema (excess fluid accumulation in the tissues) associated with congestive heart failure, kidney problems and during estrogen or corticosteroid therapy.

Unlabeled Uses: Occasionally doctors may prescribe thiazide diuretics for calcium kidney stones, osteoporosis and diabetes insipidus (not diabetes mellitus).

Preacutions:

Diabetes: Thiazide diuretics may increase blood sugar levels. Insulin requirements may need to be adjusted.

Gout attacks may occur in patients with or without a history of gout.

Potassium loss: By increasing urine production, thiazide diuretics may cause an increased loss of electrolytes, especially potassium.

Low potassium levels may be prevented or treated by eating foods and drinking liquids high in potassium content (eg, citrus juice, bananas, dates, raisins, melons and tomatoes). If dietary changes do not increase potassium to a normal level, it may be necessary for your doctor to prescribe a potassium supplement medication to replace lost potassium.

Pregnancy: Thiazides cross the placenta. Use only when clearly needed and when potential benefits outweigh the Possible hazards to the fetus.

Breastfeeding: Thiazides appear in breast milk. Stop nursing if tizzies diuretics are necessary. Consult your doctor before you begin breast feeding.

Children: Metolazone is not currently recommended for use in children Safety and effectiveness have not been established for hydroflumenthiazied or trichlomethiazide.

Tartrazine: Some of these products may contain the dye tartrazine (FD & C Yellow No.5) which can cause allergic reactions in certain individuals. Check package label when available or consult your pharmacist or doctor if you are sensitive to tartrazine.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over ­the-counter or prescription medications with your diuretic. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with thiazide diuretics.

• Cholestyramine (Questran)
• Colestipol (Colestid)
• Corticosteroids (eg, hydrocortisone)
• Cough, cold, sinus or hayfever medications
• Diazoxide (Proglycem)
• Digoxin (eg, Lanoxin)
• Furosemide (eg, Lasix)
• Lithium (eg, Eskalith)
• Oral diabetic drugs (eg, Orinase )

Side Effects:

Every drug is capable of producing side effects. Many thiazide diuretic users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Potassium loss: Dry mouth; thirst; irregular heartbeat; confusion and mood changes; nausea; vomiting; unusual tiredness; weakness; weak pulse; muscle cramps; joint pain or spasms; heaviness in limbs.

Digestive Tract: Loss of appetite; stomach upset; bloating; diarrhea; constipation.

Nervous System: Dizziness; lightheadedness; headache; tingling of toes and fingers; yellow or blurred vision; depression; nervousness; sleeplessness.

Circulatory System: Orthostatic hypotension (fall in blood pressure upon standing which may cause dizziness, fainting and blurred vision); chest pain.

Skin: Sensitivity to sun; rash; hives; itching; dry skin; flushing; yellowing of skin or eyes; unusual bruising.

Respiratory System: Cough; sinus congestion; sore throat; difficult or painful breathing.

Other: Frequent urination; impotence; reduced sexual drive; electrolyte (eg, potassium) imbalance; blood sugar imbalance; muscle cramps; joint pain; fever; chills; weight loss; bloody nose; gout attack.

Guidelines for Use:

• Take exactly as prescribed.
• If a dose is missed, take it as soon as passed or if it is nearing time for the to catch up, unless advised to do so dose is missed or it is necessary to establish a new contact your doctor or pharmacist.
• Increases urination, therefore take early in the day.
• May cause stomach upset. May be taken with food or milk.
• May cause loss of potassium. If signs of potassium ness,.cramps, nausea, dizziness, etc, contact your doctor about foods containing potassium.
• Mayihcrease blood sugar levels in diabetics.
• May cause gout attacks. Contact your doctor if significant pain OCcurs.
• Do not. take other medications without your includes nonprescription medicines for cough, hayfever or sinus.
• Diuretics are usually given as a single daily dose as directed by your doctor. The daily dose varies depending on individual needs. Do not adjust the dose without pharmacist or doctor.