Hydrochlorothiazide
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222860604
2008-07-01T13:44:43Z
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{{Drugbox
| IUPAC_name = 6-chloro-3,4-dihydro-2H-<BR>1,2,4-benzothiadiazine-<BR>7-sulfonamide 1,1-dioxide
| image = Hydrochlorothiazide-2D-skeletal.png
| image2 = Hydrochlorothiazide-from-xtal-3D-balls.png
| width=200px
| CAS_number=58-93-5
| ATC_prefix=C03
| ATC_suffix=AA03
| ATC_supplemental=
| PubChem=3639
| DrugBank=
| C=7 | H=8 |Cl=1 | N=3 | O=4 | S=2
| molecular_weight = 297.742
| smiles = Clc1cc2NCNS(=O)(=O)c2cc1S(=O)(=O)N
| bioavailability= Variably absorbed from GI tract
| metabolism = does not undergo significant metabolism (>95% excreted unchanged in urine)<ref>{{cite journal |author=Beermann B, Groschinsky-Grind M, Rosén A.|title=Absorption, metabolism, and excretion of hydrochlorothiazide |journal=Clin Pharmacol Ther |volume=19 |issue=5 (Pt 1) |pages=531–7 |year=1976}}</ref>
| elimination_half-life=5.6-14.8 hours
| excretion = Primarily excreted unchanged in urine
| pregnancy_category = B (D if used to treat pregnancy-induced hypertension)
| legal_status = Rx-only
| routes_of_administration= Oral (capsules, tablets, oral solution)
}}
'''Hydrochlorothiazide''', sometimes abbreviated '''HCT''', '''HCTZ''', or '''HZT''' is a popular [[diuretic]] drug of the [[thiazide]] class that acts by inhibiting the [[kidney]]s' ability to retain water. This reduces the volume of the [[blood]], decreasing blood return to the heart and thus [[cardiac output]] and, by other mechanisms, is believed to lower [[peripheral vascular resistance]]. Hydrochlorothiazide is sold both as a [[generic drug]] and under a large number of brand names, including: '''Apo-Hydro''', '''Aquazide H''', '''Dichlotride''', '''Hydrodiuril''', '''HydroSaluric''', '''Microzide''', '''Oretic'''.
== Activity ==
Hydrochlorothiazide belongs to the [[thiazide]] class of [[Diuretic|diuretics]], acting on the [[kidneys]] to reduce [[sodium]] (Na) reabsorption in the [[distal convoluted tubule]]. This increases the [[osmolarity]] in the lumen, causing less water to be reabsorbed by the [[collecting duct]]s. This leads to increased urinary output.
== Indications ==
HCT is often used in the treatment of [[hypertension]], congestive [[heart failure]], symptomatic [[edema]] and the prevention of [[kidney stone]]s. It is effective for nephrogenic [[diabetes insipidus]] (paradoxical effect, which decreases urine formation) and is also sometimes used for [[hypercalciuria]] and [[Dent's Disease]].
[[Hypokalemia]], an occasional side-effect, can be usually prevented by [[potassium]] supplements or combining hydrochlorothiazide with a [[potassium-sparing diuretic]].
Thiazides are also used in the treatment of [[osteoporosis]]. Thiazides decrease mineral bone loss by promoting calcium retention in the kidney, and by directly stimulating [[osteoblast]] differentiation and bone mineral formation.<ref name="pmid17656470">{{cite journal |author=Dvorak MM, De Joussineau C, Carter DH, ''et al'' |title=Thiazide diuretics directly induce osteoblast differentiation and mineralized nodule formation by interacting with a sodium chloride co-transporter in bone |journal=J. Am. Soc. Nephrol. |volume=18 |issue=9 |pages=2509–16 |year=2007 |pmid=17656470 |doi=10.1681/ASN.2007030348 |url=http://jasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=17656470}}</ref>
== Side effects ==
* [[Hypokalemia]]
* [[Hypomagnesemia]]
* [[Hyperuricemia]] and [[gout]]
* [[Hyperglycemia|High blood sugar]]
* [[Hypercalcemia]]
* [[Headache]]
* [[Nausea]]/[[vomit]]ing
==External links==
* [http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682571.html NIH medlineplus druginfo]
==References==
{{Reflist}}
{{Antihypertensives and diuretics}}
[[Category:Thiazides]]
[[de:Hydrochlorothiazid]]
[[hr:Hidroklorotiazid]]
[[hu:Hidroklorotiazid]]
[[nl:Hydrochloorthiazide]]
[[ja:ヒドロクロロチアジド]]
[[no:Hydroklortiazid]]
[[nn:Hydroklortiazid]]
[[pl:Hydrochlorotiazyd]]
[[pt:Hidroclorotiazida]]