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Acuren (Hydrochlorothiazide)
Therapeutic Group: Cardiovascular » Anti Hypertensive » Diuretic
Presentation

Acuren 25: Each tablet contains Hydrochlorothiazide BP 25 mg.

Acuren 50: Each tablet contains Hydrochlorothiazide BP 50 mg.

Descriptions
Hydrochlorothiazide is a novel diuretic which affects the distal renal tubular mechanism of electrolyte reabsorption. Hydrochlorothiazide increases excretion of sodium and chloride in approximately equivalent amounts. The mechanism of the antihypertensive effect of thiazides is unknown. Hydrochlorothiazide does not usually affect normal blood pressure.
Indications
Hydrochlorothiazide is indicated in –

• Edema associated with congestive heart failure, hepatic cirrohosis, various forms of renal dysfunction and corticosteroid and estrogen therapy

• Management of hypertension either as the sole therapeutic agent or to enhance the effectiveness of other antihypertensive drugs in the more severe form of hypertension

• Management of diabetes insipidus

• Management of proximal renal tubular acidosis

• Idiopathic hypercalciuria and calcium nephrolithiasis, osteoporosis and exercise induced hyperkalemia

Dosage & Administration
Adults
For Edema: The usual adult dosage is 25 to 100 mg daily as a single or divided dose.
For Control of Hypertension: The usual initial dose in adults is 25 mg daily given as a single dose. The dose may be increased to 50 mg daily, given as a single or two divided doses. Doses above 50 mg are often associated with marked reductions in serum potassium. In some patients (especially the elderly) an initial dose of 12.5 mg daily may be sufficient.

Infants and children
For diuresis and for control of hypertension: The usual pediatric dosage is 1 to 2 mg per kg body weight per day in single or two divided doses, not to exceed 37.5 mg per day in infants up to 2 years of age or 100 mg per day in children 2 to 12 years of age. In infants less than 6 months of age, doses up to 3 mg per kg body weight per day in two divided doses may be required.
Side Effects
Generally, Hydrochlorothiazide is well tolerated. However, a few side effects may occur like weakness, restlessness, dizziness, headache, fever, diarrhea, vomiting, sialadenitis, cramping, constipation, gastric irritation, nausea, anorexia, and hypotension. In rare case hyperglycemia, glycosuria, hyperuricemia and muscle spasm may occur.
Precautions
Thiazides should be used with caution in patients with severe renal disease, impaired hepatic function or progressive liver disease and gout.
Contraindications
Hydrochlorothiazide is contraindicated to the patients of anuria and those who are sensitive to hydrochlorothiazide or to other sulfonamide-derived drugs. Therapy is not to be initiated in diabetes mellitus.
Use in Pregnancy & Lactation
Pregnancy: Evidence of fetal risk in hydrochlorothiazide therapy is found, but it is indicated if benefits outweigh risks. Thiazides are indicated in pregnancy when edema is due to pathologic causes.
Lactation: Neonatal side effects have been seen incase of hydrochlorothiazide therapy and therefore it is not recommended.
Drug Interaction
Alcohol, Barbiturates, or Narcotics: Potentiation of orthostatic hypotension may occur.
Antidiabetic Drugs (oral agents and insulin): Thiazides can impair control of diabetes mellitus by diet and antidiabetic Drugs.
Antihypertensive Drugs: Additive effect or potentiation.
Overdose
The most common signs and symptoms observed are those caused by electrolyte depletion (hypokalemia, hypochloremia, hyponatremia) and dehydration resulting from excessive diuresis. Rarely, autoimmune hemolytic anemia and other hypersensitivity reactions may complicate the picture.
In the event of over dosage, symptomatic and supportive measures should be employed. Emesis should be induced or gastric lavage performed. Correct dehydration, electrolyte imbalance, hepatic coma and hypotension by established procedures. Hemodialysis can be used successfully to treat severe intoxication.
Commercial Packaging
Acuren 25: Each box contains 10 blister strips of 10 tablets.
Acuren 50: Each box contains 10 blister strips of 10 tablets.
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