Select a medication above to begin.
Inzirqo
hydrochlorothiazide
Adult Dosing .
Dosage forms: SUSP: 10 mg per mL
HTN
- [12.5-50 mg PO qd]
- Start: 12.5-25 mg PO qd; Max: 50 mg/day
edema, adjunct tx
- [25-100 mg PO qd]
- Alt: may be dosed qod or 3-5x/wk; Info: in heart failure pts, start 25 mg PO qd-bid, max 200 mg/day
renal dosing
- [see below]
- CrCl <10: avoid use; anuria: contraindicated
- HD/PD: avoid use
hepatic dosing
- [see below]
- hepatic impairment/progressive hepatic dz: not defined, caution advised
Peds Dosing .
- Dosage forms: SUSP: 10 mg per mL
HTN
- [<6 mo]
- Dose: 1-3 mg/kg/day PO divided bid; Max: 37.5 mg/day
- [6 mo-2 yo]
- Dose: 1-2 mg/kg/day PO divided qd-bid; Max: 37.5 mg/day
- [2-12 yo]
- Dose: 1-2 mg/kg/day PO divided qd-bid; Max: 100 mg/day
edema, adjunct tx
- [<6 mo]
- Dose: 1-3 mg/kg/day PO divided bid; Max: 37.5 mg/day
- [6 mo-2 yo]
- Dose: 1-2 mg/kg/day PO divided qd-bid; Max: 37.5 mg/day
- [2-12 yo]
- Dose: 1-2 mg/kg/day PO divided qd-bid; Max: 100 mg/day
bronchopulmonary dysplasia (off-label)
- [<24 mo]
- Dose: 2-4 mg/kg/day PO divided bid
renal dosing
- [see below]
- CrCl <10: avoid use; anuria: contraindicated
- HD/PD: avoid use
hepatic dosing
- [see below]
- hepatic impairment/progressive hepatic dz: not defined, caution advised
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- breastfeeding (>50 mg/day dose)
- anuria
- CrCl <10
- neonatal jaundice
- avoid: sun exposure
- avoid: UV light exposure, artificial
- caution: hypersensitivity to sulfonamides
- caution: elderly pts
- caution: White pts (incr. risk of skin CA w/ >50,000 mg cumulative dose)
- caution: renal impairment
- caution: hepatic impairment
- caution: hepatic dz, progressive
- caution: electrolyte abnormalities
- caution: volume depletion
- caution: diabetes mellitus
- caution: seizure disorder
- caution: HTN, gestational
- caution: SLE
- caution: gout hx
- caution: pancreatitis hx
Drug Interactions .
Overview
hydrochlorothiazide
thiazide diuretic
- affected by altered gastrointestinal motility
- antihypertensive agent
- binds to anion exchange resin/polymer
- decreases renal perfusion/fxn
- diuretic
- hypercalcemia
- hyperglycemic effects
- hyperuricemic effects
- hypokalemia
- hypomagnesemia
- hyponatremia
- photosensitivity
- urine alkalinizer
Contraindicated
- dofetilide
- isocarboxazid
- methenamine
Avoid/Use Alternative
- aldesleukin
- amikacin
- aminolevulinic acid topical
- aripiprazole lauroxil
- chlorothiazide
- chlorthalidone
- clofarabine
- hydrochlorothiazide
- indapamide
- iomeprol
- lofexidine
- mannitol
- metolazone
- porfimer
- sulfamethoxazole
Monitor/Modify Tx
- abaloparatide
- abiraterone acetate
- acarbose
- acetazolamide
- acyclovir
- adefovir dipivoxil
- albuterol
- albuterol inhaled
- alfentanil
- alfuzosin
- allopurinol
- almotriptan
- aloe
- alogliptin
- amantadine
- amifostine
- amikacin inhaled
- amiloride
- amitriptyline
- amoxapine
- amphetamine
- amphotericin
- anthrax immune globulin
- apomorphine
- apraclonidine ophthalmic
- arformoterol inhaled
- aripiprazole bimonthly injection
- aripiprazole monthly injection
- aripiprazole oral
- armodafinil
- arsenic trioxide
- articaine
- asciminib
- asenapine
- asparaginase
- aspirin
- atogepant
- atomoxetine
- atropine ophthalmic
- auranofin
- avanafil
- axitinib
- azilsartan medoxomil
- balsalazide
- benazepril
- benzphetamine
- berberine
- betamethasone
- betaxolol ophthalmic
- bethanechol
- bevacizumab
- bexagliflozin
- bismuth subsalicylate
- bortezomib
- botulism immune globulin
- brexpiprazole
- brigatinib
- brimonidine ophthalmic
- brimonidine topical
- bromocriptine
- budesonide
- bumetanide
- bupivacaine
- bupivacaine liposomal
- buprenorphine
- bupropion
- butalbital
- butorphanol
- cabergoline
- cabozantinib
- caffeine
- caffeine citrate
- calcipotriene topical
- calcitriol
- calcitriol topical
- calcium acetate
- calcium carbonate
- calcium chloride
- calcium citrate
- calcium gluconate
- canagliflozin
- candesartan cilexetil
- cannabis
- capecitabine
- captopril
- carbamazepine
- carboplatin
- carfilzomib
- cariprazine
- carteolol ophthalmic
- celecoxib
- cetuximab
- chloroprocaine
- chlorpromazine
- cholecalciferol (vitamin D3)
- cholestyramine
- cidofovir
- cilostazol
- cisplatin
- citalopram
- clindamycin
- clomipramine
- clonidine
- clozapine
- cocaine
- codeine
- coenzyme Q-10
- colesevelam
- colestipol
- colistimethate
- copanlisib
- corticotropin
- cortisone
- creatine
- crizotinib
- cyclophosphamide
- cyclosporine
- cytomegalovirus immune globulin
- danazol
- dapagliflozin
- darbepoetin alfa
- decitabine
- deferasirox
- deferoxamine
- deflazacort
- denileukin diftitox
- desflurane
- desipramine
- desmopressin
- desvenlafaxine
- dexamethasone
- dexlansoprazole
- dexmedetomidine
- dexmedetomidine injection
- dexmethylphenidate
- dextroamphetamine
- diazoxide
- dichlorphenamide
- diclofenac
- diclofenac topical
- diethylpropion
- diflunisal
- digoxin
- dihydrocodeine
- dihydroergotamine
- dinutuximab
- dipyridamole
- doxapram
- doxazosin
- doxepin
- doxercalciferol
- dronabinol
- droxidopa
- dulaglutide
- duloxetine
- eletriptan
- emapalumab
- empagliflozin
- enalapril
- enalaprilat
- entacapone
- entrectinib
- enzalutamide
- ephedra
- ephedrine injection
- ephedrine oral
- epinephrine
- epinephrine inhaled
- epoetin alfa
- epoprostenol
- eptinezumab
- erenumab
- ergocalciferol (vitamin D2)
- ergotamine
- ertugliflozin
- escitalopram
- esketamine
- eslicarbazepine acetate
- esomeprazole
- estetrol (contraceptive)
- estradiol (contraceptive)
- ethacrynic acid
- ethanol
- ethinyl estradiol (contraceptive)
- etodolac
- etrasimod
- exenatide
- fenfluramine
- fenoprofen
- fentanyl
- ferumoxytol
- fingolimod
- flaxseed
- flibanserin
- flucytosine
- fludrocortisone
- fluoxetine
- fluphenazine
- flurbiprofen
- fluvoxamine
- formoterol inhaled
- foscarnet
- foslevodopa
- fostamatinib
- fremanezumab
- frovatriptan
- fruquintinib
- furosemide
- galcanezumab
- ganciclovir
- garlic
- gentamicin
- gilteritinib
- glimepiride
- glipizide
- glyburide
- guanfacine
- haloperidol
- hoodia
- hydralazine
- hydrocodone
- hydrocortisone
- hydromorphone
- ibrutinib
- ibuprofen
- ibuprofen lysine
- ifosfamide
- iloperidone
- iloprost
- iloprost inhaled
- imipramine
- immune globulin
- indomethacin
- insulin
- iohexol
- iopamidol
- irbesartan
- iron sucrose
- isoflurane
- isoproterenol
- isosorbide dinitrate
- isosorbide mononitrate
- ketamine
- ketoprofen
- ketorolac
- landiolol
- lanreotide
- lansoprazole
- leflunomide
- lenalidomide
- lenvatinib
- levalbuterol inhaled
- levobunolol ophthalmic
- levodopa
- levomilnacipran
- levorphanol
- levothyroxine
- licorice
- lidocaine
- linagliptin
- linezolid
- liothyronine
- liraglutide
- lisdexamfetamine
- lisinopril
- lithium
- lorlatinib
- losartan
- loxapine
- lubiprostone
- lumacaftor/ivacaftor
- lumateperone
- lurasidone
- luspatercept
- lutetium Lu 177 vipivotide tetraxetan
- magnesium citrate
- magnesium salicylate
- magnesium sulfate
- maraviroc
- meclofenamate
- mefenamic acid
- meloxicam
- meperidine
- mepivacaine
- mesalamine
- mesalamine rectal
- metformin
- methadone
- methamphetamine
- methazolamide
- methohexital
- methotrexate
- methoxy polyethylene glycol-epoetin beta
- methylene blue injection
- methylergonovine
- methylphenidate
- methylprednisolone
- methyltestosterone
- metoclopramide
- midazolam
- midodrine
- mifepristone
- miglitol
- milnacipran
- milrinone
- mirabegron
- mirtazapine
- mitomycin
- modafinil
- moexipril
- molindone
- morphine
- motixafortide
- nabumetone
- nalbuphine
- naphazoline ophthalmic
- naproxen
- naratriptan
- nateglinide
- nattokinase
- naxitamab
- necitumumab
- neomycin
- niacin (vitamin B3)
- nilotinib
- niraparib
- nitric oxide
- nitrite
- nitroglycerin
- nitroprusside
- nortriptyline
- nusinersen
- obinutuzumab
- olanzapine
- oliceridine
- olmesartan medoxomil
- olodaterol inhaled
- olsalazine
- omeprazole
- opicapone
- opium
- osilodrostat
- oxaliplatin
- oxaprozin
- oxazepam
- oxcarbazepine
- oxycodone
- oxymetazoline nasal
- oxymetazoline ophthalmic
- oxymetazoline topical
- oxymorphone
- oxytocin
- ozanimod
- paliperidone
- palopegteriparatide
- pamidronate
- panitumumab
- pantoprazole
- paricalcitol
- paromomycin
- paroxetine
- patiromer
- pazopanib
- pegloticase
- pemetrexed
- penicillamine
- pentamidine
- pentazocine
- pentobarbital
- pentostatin
- pentoxifylline
- perindopril
- perphenazine
- pexidartinib
- phendimetrazine
- phenelzine
- phenobarbital
- phentermine
- phenylephrine
- phenylephrine injection
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- pioglitazone
- piroxicam
- plazomicin
- polyethylene glycol
- polyethylene glycol/electrolytes
- polymyxin B
- ponatinib
- ponesimod
- posaconazole
- pralsetinib
- pramipexole
- pramlintide
- prazosin
- prednisolone
- prednisone
- primidone
- probenecid
- procarbazine
- prochlorperazine
- promethazine
- propafenone
- propofol
- protriptyline
- pseudoephedrine
- quetiapine
- quinapril
- quinidine (antiarrhythmic)
- quinidine (CYP2D6 inhibitor)
- quinine
- rabeprazole
- ramipril
- ramucirumab
- rasagiline
- rasburicase
- regorafenib
- remifentanil
- remimazolam
- repaglinide
- Rho(D) immune globulin
- rimegepant
- riociguat
- ripretinib
- risperidone
- rituximab
- rizatriptan
- romidepsin
- ropeginterferon alfa-2b
- ropinirole
- ropivacaine
- rosiglitazone
- rotigotine transdermal
- sacituzumab govitecan
- sacubitril
- safinamide
- salmeterol inhaled
- salsalate
- saxagliptin
- selegiline
- selegiline transdermal
- selinexor
- selpercatinib
- semaglutide
- sertraline
- sevoflurane
- sildenafil
- silodosin
- siponimod
- sirolimus
- sirolimus albumin-bound
- sitagliptin
- sodium benzoate
- sodium ferric gluconate complex
- sodium phenylacetate
- sodium phenylbutyrate
- sodium polystyrene sulfonate
- sodium thiosulfate
- sorafenib
- sotagliflozin
- sotalol
- sparsentan
- spironolactone
- streptomycin
- streptozocin
- sufentanil
- sulfate bowel prep
- sulindac
- sumatriptan
- sunitinib
- tacrolimus
- tadalafil
- tafasitamab
- tagraxofusp
- tamsulosin
- tapentadol
- taurine
- telavancin
- telmisartan
- temsirolimus
- tenofovir alafenamide
- tenofovir disoproxil
- terazosin
- terbutaline
- teriflunomide
- teriparatide
- testosterone
- tetrahydrozoline ophthalmic
- thalidomide
- thioridazine
- thiothixene
- thyroid
- timolol ophthalmic
- tiopronin
- tirzepatide
- tivozanib
- tizanidine
- tobramycin
- tobramycin inhaled
- tolcapone
- tolmetin
- topiramate
- torsemide
- tramadol
- trametinib
- trandolapril
- tranylcypromine
- trastuzumab
- trazodone
- treprostinil
- triamcinolone
- triamterene
- trifluoperazine
- trimipramine
- ubrogepant
- vaccinia immune globulin
- vadadustat
- valacyclovir
- valganciclovir
- valsartan
- vamorolone
- vancomycin
- vandetanib
- vardenafil
- vasopressin
- venlafaxine
- vilanterol inhaled
- vilazodone
- viloxazine
- voclosporin
- vonoprazan
- vortioxetine
- vosoritide
- willow bark
- yohimbe
- zavegepant
- ziprasidone
- ziv-aflibercept
- zoledronic acid
- zolmitriptan
- zonisamide
Caution Advised
- acitretin
- aclidinium inhaled
- atropine
- belladonna alkaloids
- benztropine
- brompheniramine
- carbinoxamine
- chlophedianol
- chlorpheniramine
- clemastine
- clidinium
- cyclobenzaprine
- cyproheptadine
- darifenacin
- dexbrompheniramine
- dexchlorpheniramine
- dicyclomine
- dimenhydrinate
- diphenhydramine
- disopyramide
- doxepin topical
- doxylamine
- fesoterodine
- flavoxate
- glycopyrrolate
- glycopyrronium topical
- homatropine
- hydroxyzine
- hyoscyamine
- icosapent ethyl
- ipratropium inhaled
- meclizine
- methoxsalen
- methscopolamine
- orphenadrine
- oxybutynin
- pheniramine
- pimozide
- pyrilamine
- scopolamine
- sofpironium topical
- solifenacin
- tiotropium inhaled
- tolterodine
- trihexyphenidyl
- triprolidine
- trospium
- verteporfin
Adverse Reactions .
Serious Reactions
- hypokalemia, severe
- electrolyte imbalance
- arrhythmia
- cholestatic jaundice
- pancreatitis
- anaphylaxis
- necrotizing angiitis
- erythema multiforme
- Stevens-Johnson syndrome
- exfoliative dermatitis
- toxic epidermal necrolysis
- photosensitivity
- non-melanoma skin CA
- renal failure
- interstitial nephritis
- aplastic anemia
- agranulocytosis
- leukopenia
- hemolytic anemia
- thrombocytopenia
- SLE exacerbation
- glaucoma, acute angle-closure
Common Reactions
- hypokalemia
- hypochloremia
- hyponatremia
- hypomagnesemia
- hypercalcemia
- hyperuricemia
- hyperglycemia
- hyperlipidemia
- hypotension, orthostatic
- dizziness
- anorexia
- diarrhea
- abdominal pain
- headache
- weakness
- muscle cramps
- photosensitivity
- rash
- sexual dysfxn
- blurred vision
Safety/Monitoring .
Monitoring Parameters
BUN/Cr; electrolytes at baseline, then periodically; dermatologic exams if incr. skin CA risk
Look/Sound-Alike Drug Names
hydroCHLOROthiazide confused with: hydrALAZINE; hydrocortisone; hydroxychloroquine; hydroxyurea; hydrOXYzine; Maxzide
Pregnancy/Lactation .
Pregnancy
Clinical Summary
may use during pregnancy if on chronic tx before conception, otherwise weigh risk/benefit; no known risk of teratogenicity based on human data; possible risk of decr. placental perfusion and neonatal adverse effects, incl. hypoglycemia, thrombocytopenia, and electrolyte abnormalities, based on limited or conflicting human data; risks not observed if chronic use before conception
Lactation
Clinical Summary
avoid use if dose >50 mg/day, otherwise may use while breastfeeding; no known risk of infant harm based on limited human data and drug properties; decr. milk production w/ high-dose use based on limited human data
Pharmacology .
Metabolism: none; CYP450: none
Excretion: urine (>61% unchanged); Half-life: 5.6-14.8h
Subclass: Diuretics, Thiazides
Mechanism of Action
inhibits distal convoluted tubule sodium and chloride reabsorption
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.