• Dosage of Hydrochlorothiazide Excellium in details
• Hydrochlorothiazide Excellium interactions
• Hydrochlorothiazide Excellium reviews

Dosage of Hydrochlorothiazide Excellium in details

Hydrochlorothiazide Excellium Dosage

Applies to the following strength(s): 25 mg; 50 mg; 100 mg; 50 mg/5 mL; 12.5 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

• Edema
• Hypertension
• Nephrocalcinosis
• Osteoporosis
• Diabetes Insipidus

Usual Pediatric Dose for:

• Edema
• Hypertension

Additional dosage information:

• Renal Dose Adjustments
• Liver Dose Adjustments
• Dose Adjustments
• Precautions
• Dialysis
• Other Comments

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

Renal Dose Adjustments

CrCl less than 30 mL/min: Not recommended; thiazide diuretics are considered ineffective below this level.

Liver Dose Adjustments

Thiazides should be used with caution in patients with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma.

Dose Adjustments

Many patients with edema respond to intermittent therapy by giving doses on alternate days or 3 to 5 days/week. Patients usually do not require more than 50 mg/day when combined with other antihypertensives.

Precautions

There are no well-controlled clinical trials in pediatric patients. Information on dosing in this age group is supported by evidence from empiric use in pediatric patients and published literature regarding the treatment of hypertension in children.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Periodic monitoring of electrolytes is recommended, particularly in elderly patients and in patients receiving a high dose.

Hydrochlorothiazide Excellium doses should be administered in the morning; if patients are on a twice daily dosing schedule, the second dose should be given before 6 PM.

If Hydrochlorothiazide Excellium is used concomitantly with other antihypertensive agents, the dose of the latter may need to be reduced so as to minimize the risk of an excessive fall in blood pressure.

Diuretics, including Hydrochlorothiazide Excellium, should be discontinued for 2 to 3 days before the start of angiotensin converting enzyme (ACE) inhibitor therapy so as to reduce the risk of first dose hypotension.

More about Hydrochlorothiazide Excellium

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• Dosage Information
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Consumer resources

• HCTZ
• Hydrochlorothiazide Excellium
• Hydrochlorothiazide Excellium capsules
• Hydrochlorothiazide Excellium solution
• Hydrochlorothiazide Excellium (Advanced Reading)

• Other brands: Hydrochlorothiazide Excellium, Aquazide H

Professional resources

• Hydrochlorothiazide Excellium (AHFS Monograph)
• More (4) »

Related treatment guides

• High Blood Pressure
• Diabetes Insipidus
• Osteoporosis
• Edema
• Nephrocalcinosis

What other drugs will affect Hydrochlorothiazide Excellium?

Tell your doctor if you regularly use other medicines that make you light-headed (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to the side effects of Hydrochlorothiazide Excellium.

Tell your doctor about all other medicines you use, especially:

• lithium (Eskalith, Lithobid);

• digoxin (Lanoxin);

• cholestyramine (Prevalite, Questran) or colestipol (Colestid);

• steroids (prednisone and others);

• other blood pressure medications;

• NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others; or

• insulin or oral diabetes medication.

This list is not complete and other drugs may interact with Hydrochlorothiazide Excellium. 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.

Hydrochlorothiazide Excellium interactions

CAPTOPRIL

Potassium sparing diuretics or potassium supplements: ACE inhibitors attenuate diuretic induced potassium loss. Potassium sparing diuretics (e.g. spironolactone, triamterene or amiloride), potassium supplements, or potassium-containing salt substitutes may lead to significant increases in serum potassium. If concomitant use is indicated because of demonstrated hypokalaemia they should be used with caution and with frequent monitoring of serum potassium.

Diuretics (thiazide or loop diuretics): Prior treatment with high dose diuretics may result in volume depletion and a risk of hypotension when initiating therapy with captopril. The hypotensive effects can be reduced by discontinuation of the diuretic, by increasing volume or salt intake or by initiating therapy with a low dose of captopril. However, no clinically significant drug interactions have been found in specific studies with Hydrochlorothiazide Excellium or furosemide.

Other antihypertensive agents: captopril has been safely co-administered with other commonly used anti-hypertensive agents (e.g. beta-blockers and long-acting calcium channel blockers). Concomitant use of these agents may increase the hypotensive effects of captopril. Nitroglycerine and other nitrates, or other vasodilators, should be used with caution.

Treatments of acute myocardial infarction: Captopril may be used concomitantly with acetylsalicylic acid (at cardiological doses), thrombolytics, beta-blockers and/or nitrates in patients with myocardial infarction.

Tricyclic antidepressants/Antipsychotics: ACE inhibitors may enhance the hypotensive effects of certain tricyclic antidepressants and antipsychotics. Postural hypotension may occur.

Allopurinol, procainamide, cytostatic or immuno-suppressant agents: Concomitant administration with ACE inhibitors may lead to an increased risk of leucopenia, especially when the latter are used at higher than currently recommended doses.

Sympathomimetics: may reduce the antihypertensive effects of ACE inhibitors; patients should be carefully monitored.

Antidiabetics: Pharmacological studies have shown that ACE inhibitors, including captopril, can potentiate the blood glucose-reducing effects of insulin and oral antidiabetics, such as sulphonylurea, in diabetics. Should this very rare interaction occur, it may be necessary to reduce the dose of the antidiabetic during simultaneous treatment with ACE inhibitors.

Hydrochlorothiazide Excellium

Amphotericin B (parenteral), carbenoxolone, corticosteroids, corticotropin (ACTH) or stimulant laxatives: Hydrochlorothiazide Excellium may intensify electrolyte imbalance, particularly hypokalaemia.

Calcium salts: Increased serum calcium levels due to decreased excretion may occur when administered concurrently with thiazide diuretics.

Cardiac glycosides: Enhanced possibility of digitalis toxicity associated with thiazide induced hypokalaemia.

Cholestyramine resin and colestipol: may delay or decrease absorption of Hydrochlorothiazide Excellium. Sulphonamide diuretics should be taken at least one hour before or four to six hours after these medications.

Nondepolarising muscle relaxants (e.g. tubocurarine chloride): effects of these agents may be potentiated by Hydrochlorothiazide Excellium.

Drugs associated with torsades de pointes: Because of the risk of hypokalaemia, caution should be used when Hydrochlorothiazide Excellium is coadministered with drugs associated with torsades de pointes, e.g. some anti-arrhythmics, some antipsychotics and other drugs known to induce torsades de pointes.

CAPTOPRIL/Hydrochlorothiazide Excellium COMBINATION

Lithium: Reversible increases in serum lithium concentrations and toxicity have been reported during concomitant administration of lithium with ACE inhibitors. Concomitant use of thiazide diuretics may increase the risk of lithium toxicity and enhance the already increased risk of lithium toxicity with ACE inhibitors. The combination of captopril and Hydrochlorothiazide Excellium with lithium is therefore not recommended and careful monitoring of serum lithium levels should be performed if the combination proves necessary.

Non-steroidal anti-inflammatory medicinal products: It has been described that non-steroidal anti-inflammatory medicinal products (NSAIDs) and ACE inhibitors exert an additive effect on the increase in serum potassium, whereas renal function may decrease. These effects are, in principle, reversible. Rarely, acute renal failure may occur, particularly in patients with compromised renal function such as the elderly or dehydrated. Chronic administration of NSAIDs may reduce the antihypertensive effect of an ACE inhibitor. The administration of NSAIDs may reduce the diuretic, natriuretic and antihypertensive effects of thiazide diuretics.

Clinical Chemistry

Captopril may cause a false-positive urine test for acetone. Hydrochlorothiazide Excellium may cause diagnostic interference of the bentiromide test. Thiazides may decrease serum PBI (Protein Bound Iodine) levels without signs of thyroid disturbance.

References

1. DailyMed. "AMLODIPINE BESYLATE; HYDROCHLOROTHIAZIDE; OLMESARTAN MEDOXOMIL: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
2. FDA/SPL Indexing Data. "0J48LPH2TH: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
3. MeSH. "Diuretics". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).

Reviews

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Information checked by Dr. Sachin Kumar, MD Pharmacology