Microzide (Oral)

Hydrochlorothiazide is used by itself or with other medicines to treat high blood pressure (hypertension). High blood pressure makes the heart and arteries work harder. If it lasts a long time, the heart and arteries may not work properly. This can harm the blood vessels in the brain, heart, and kidneys, leading to a stroke, heart failure, or kidney failure. High blood pressure may also raise the risk of heart attacks. Controlling blood pressure may help lower the chance of these problems.

Hydrochlorothiazide is also used to treat fluid retention (edema) caused by congestive heart failure, severe liver disease (cirrhosis), kidney disease, or the use of a steroid or hormone medicine.

Hydrochlorothiazide is a thiazide diuretic (water pill). It helps reduce the amount of water in the body by increasing urine flow. It may also be used for other conditions as your doctor decides.

This medicine is available only with your doctor's prescription.

It is very important for your doctor to check your progress at regular visits to ensure this medicine is working properly. Blood and urine tests may be needed to look for unwanted effects.

Contact your doctor immediately if you experience seizures, decreased urine, drowsiness, dry mouth, excessive thirst, increased heart rate or pulse, muscle pains or cramps, nausea or vomiting, or unusual tiredness or weakness. These may be signs of a condition called hypokalemia or potassium loss.

Contact your doctor right away if you have blurred vision, difficulty reading, eye pain, or any other change in vision during or after treatment. This could indicate a serious eye problem. Your doctor will want you to see an ophthalmologist (eye doctor) for an eye exam.

This medicine may cause some people to feel dizzy. Do not drive, operate machinery, or do anything else that could be dangerous if you feel dizzy or not alert.

Alcohol, narcotic pain relievers, or sleeping pills can make you feel more lightheaded, dizzy, or faint when taken with this medicine. Inform your doctor if you are drinking alcohol or using pain relievers or sleeping pills.

Before any medical tests, inform the doctor in charge that you are taking this medicine. The results of some tests (for example, tests for parathyroid function) may be affected by this medicine.

This medicine may increase your risk of developing skin cancer (for example, non-melanoma skin cancer). Avoid sun exposure. Use sunscreen when you are outdoors. Avoid sunlamps and tanning beds. Discuss any concerns about this risk with your doctor.

Do not take other medicines unless you have talked about them with your doctor. This includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, as they may raise your blood pressure.

In deciding to use a medicine, you and your doctor need to weigh the risks against the benefits. For this medicine, consider the following:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know about any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

There have not been enough studies to determine how age affects the use of hydrochlorothiazide capsules or tablets in children. Safety and effectiveness have not been established.

Geriatric

Current studies have not found any specific problems in older adults that would limit the use of hydrochlorothiazide capsules. However, older patients are more likely to have liver, kidney, or heart issues due to aging, which may require a dose adjustment for those taking hydrochlorothiazide capsules.

There is no information available about how age affects the use of hydrochlorothiazide tablets in older patients. However, older patients are more likely to have liver, kidney, or heart issues due to aging, which may require a dose adjustment for those taking hydrochlorothiazide tablets.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before using this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while others may be used together even if there is a risk of interaction. In these cases, your doctor may adjust the dose or take other precautions. It is very important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions are based on their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Dofetilide

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acarbose
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Albiglutide
• Albuterol
• Alogliptin
• Amphetamine
• Amtolmetin Guacil
• Arsenic Trioxide
• Aspirin
• Benzphetamine
• Bromfenac
• Bromocriptine
• Bufexamac
• Buprenorphine
• Canagliflozin
• Celecoxib
• Chlorpropamide
• Choline Salicylate
• Clonixin
• Codeine
• Dapagliflozin
• Deslanoside
• Desmopressin
• Dexibuprofen
• Dexketoprofen
• Dextroamphetamine
• Diclofenac
• Diflunisal
• Digitalis
• Digitoxin
• Digoxin
• Dipyrone
• Droperidol
• Droxicam
• Dulaglutide
• Empagliflozin
• Etodolac
• Etofenamate
• Etoricoxib
• Exenatide
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Flecainide
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Formoterol
• Glimepiride
• Glipizide
• Glyburide
• Ibuprofen
• Indomethacin
• Insulin
• Insulin Aspart, Recombinant
• Insulin Bovine
• Insulin Degludec
• Insulin Detemir
• Insulin Glulisine
• Ketanserin
• Ketoprofen
• Ketorolac
• Levomethadyl
• Linagliptin
• Liraglutide
• Lisdexamfetamine
• Lithium
• Lixisenatide
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Methamphetamine
• Methotrexate
• Metildigoxin
• Miglitol
• Morniflumate
• Nabumetone
• Naproxen
• Nateglinide
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Ouabain
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Phenylbutazone
• Piketoprofen
• Pioglitazone
• Piroxicam
• Porfimer
• Pramlintide
• Proglumetacin
• Propyphenazone
• Proquazone
• Proscillaridin
• Repaglinide
• Rofecoxib
• Rosiglitazone
• Salicylic Acid
• Salsalate
• Saxagliptin
• Sitagliptin
• Sodium Salicylate
• Sotalol
• Sulindac
• Tapentadol
• Tenoxicam
• Tiaprofenic Acid
• Tolazamide
• Tolbutamide
• Tolfenamic Acid
• Tolmetin
• Topiramate
• Valdecoxib
• Vildagliptin

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both drugs may be the best option for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aminolevulinic Acid
• Bepridil
• Carbamazepine
• Cholestyramine
• Ginkgo
• Gossypol
• Licorice

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around mealtime or with certain foods due to possible interactions. Using alcohol or tobacco with certain medicines may also cause interactions. Discuss with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Other medical issues may affect how you can use this medicine. Make sure to inform your doctor if you have any other medical problems, especially:

• Anuria (unable to urinate) or
• Sulfa drug allergy (e.g., sulfamethoxazole/trimethoprim, Bactrim®, Septra®)—Should not be used in patients with these conditions.

• Asthma or
• Diabetes or
• Electrolyte imbalance (e.g., high calcium or low magnesium, potassium, sodium in the body) or
• Glaucoma, angle-closure or
• Gout or
• Hypercholesterolemia (high cholesterol in the blood) or
• Hyperuricemia (high uric acid in the blood) or
• Hypoglycemia (low blood sugar) or
• Liver disease or
• Myopia (nearsightedness) or
• Systemic lupus erythematosus (SLE)—Use with caution. This may worsen these conditions.

• Kidney disease—Use with caution. The effects may be stronger because the medicine is removed from the body more slowly.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do, they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

• Back, leg, or stomach pains
• black, tarry stools
• bleeding gums
• blistering, peeling, or loosening of the skin
• bloating
• blood in the urine or stools
• blue lips and fingernails
• blurred vision
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• chest pain or tightness
• chills
• clay-colored stools
• cloudy urine
• cold sweats
• confusion
• constipation
• cough or hoarseness
• coughing that sometimes produces a pink frothy sputum
• coughing up blood
• cracks in the skin
• darkened urine
• decrease in urine-concentrating ability
• decreased frequency or amount of urine
• diarrhea
• difficult, fast, or noisy breathing
• difficulty with swallowing
• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position
• dry mouth
• fast or irregular heartbeat
• fever
• flushed, dry skin
• fruit-like breath odor
• general body swelling
• general feeling of discomfort or illness
• greatly decreased frequency of urination or amount of urine
• headache
• hives, itching, rash
• increased hunger
• increased sweating
• increased thirst
• increased urination
• indigestion
• joint pain, stiffness, or swelling
• loss of appetite
• loss of heat from the body
• lower back or side pain
• muscle cramps or pain
• nausea or vomiting
• nosebleeds
• numbness, tingling, pain, or weakness in the hands or feet
• painful or difficult urination
• pains in the stomach or side, possibly radiating to the back
• pale skin
• persistent non-healing sore
• pink growth
• pinpoint red spots on the skin
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• red, irritated eyes
• red skin lesions, often with a purple center
• red, swollen skin
• reddish patch or irritated area
• redness, soreness, or scaly skin
• seizures
• shiny bump
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• sores, welting, or blisters
• swelling of the face, fingers, legs, ankles, feet, or lower legs
• swollen or painful glands
• tenderness of salivary glands
• thickening of bronchial secretions
• trembling
• trouble breathing
• unpleasant breath odor
• unusual bleeding or bruising
• unusual tiredness or weakness
• unusual weight loss
• vomiting of blood
• weakness and heaviness of the legs
• weight gain
• white, yellow or waxy scar-like area
• yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

• Cramping
• decreased interest in sexual intercourse
• difficulty having a bowel movement (stool)
• feeling of constant movement of self or surroundings
• hair loss or thinning of the hair
• inability to have or keep an erection
• increased sensitivity of the skin to sunlight
• loss in sexual ability, desire, drive, or performance
• muscle spasm
• redness or other discoloration of the skin
• restlessness
• sensation of spinning
• severe sunburn
• weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Aquazide H
• Hydrocot
• Microzide
• Zide

Available Dosage Forms:

• Capsule
• Tablet

Therapeutic Class: Cardiovascular Agent

Pharmacologic Class: Diuretic

Chemical Class: Thiazide

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt) or potassium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to receive it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For fluid retention (edema):For oral dosage form (tablets): Adults—The usual dose is 25 to 100 milligrams (mg) daily as a single or divided dose. Your doctor may want you to take this dose every other day or on 3 to 5 days each week. Children—Dose is based on body weight and must be determined by your doctor.
• For high blood pressure: For oral dosage form (capsule): Adults—At first, 12.5 milligrams (mg) or one capsule once a day. Your doctor may want you to take this alone or together with other blood pressure medicines. Your doctor may increase your dose as needed. However, the dose is usually not more than 50 mg per day. Children—Use and dose must be determined by your doctor. For oral dosage form (tablets): Adults—At first, 25 milligrams (mg) once a day. Your doctor may increase your dose as needed and may be taken as a single dose or divided into two doses. Children—Dose is based on body weight and must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

• What is the best time of day to take blood pressure medication?
• How long does hydrochlorothiazide stay in your system?
• Should you use a diuretic with diazoxide?