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thiazide diuretic
Increases the elimination of water and salt by the kidneys and lowers blood pressure. This molecule appears in 2,485 of the medicines we have indexed.
We do not make a formula for this treatment. Talk to your doctor or pharmacist about this active ingredient.
See the detailsBy the Layer Nutrition editorial teamHow the atlas classifies the 664 molecules
It is a medicine in the “thiazide diuretic (antihypertensive)” category. Diuretics help the kidneys remove water and salt, which lowers blood pressure and relieves edema.
In practice: Increases the elimination of water and salt by the kidneys and lowers blood pressure. It is generally taken over the long term, with regular follow-up, and it is not stopped on one’s own initiative.
These names come from the public registers of 32 countries: the ANSM for France, the AEMPS for Spain, the AIFA for Italy, the HPRA for Ireland, Swissmedic for Switzerland, and the European Medicines Agency for the others.
Most widespread
No name matches.
The atlas gives each molecule one of these three answers. Most call for nothing.
On hydrochlorothiazide, the kidney eliminates more potassium and magnesium through the urine. Diet is the first lever for rebuilding these two minerals, and the easiest one to keep up day after day.
Potassium is concentrated in vegetables and fruit: potato, sweet potato, spinach, lentils, beans, avocado, dried apricot, and banana. Magnesium comes mainly from green leafy vegetables, nuts such as almonds and walnuts, pumpkin seeds, whole grains, and dark chocolate.
Several of these foods provide both at once: spinach, lentils, beans, pumpkin seeds. Spreading them across your meals covers a good share of your needs, on top of your treatment. Orange juice and dried fruit such as raisins and prunes easily round out the potassium intake.
Hydrochlorothiazide belongs to the family of thiazide diuretics. It acts on the kidney, at the level of the distal convoluted tubule, where it selectively inhibits the sodium-chloride cotransporter known as NCC. This transporter is the main entry point for sodium on the apical membrane of the cells in that region. By blocking it, the drug prevents the reabsorption of sodium at this part of the nephron.
When sodium is no longer reabsorbed, it passes into the urine, carrying chloride and water along with it. Diuresis increases, the circulating blood volume falls, and blood pressure drops. The pharmacological effect begins about 2 hours after the dose, reaches its peak around 4 hours, and lasts from 6 to 12 hours. The elimination half-life of the drug ranges from about 5.6 to 15 hours.
The main indication is essential arterial hypertension, which the drug treats alone or in combination with other antihypertensive agents. By lowering the blood volume and then relaxing the resistance of the vessels, it brings blood pressure back toward lower values. This is one of the reasons for its long-standing place in the maintenance treatment of hypertension.
It is also used to reduce edema, these accumulations of water and salt in the tissues, related to heart failure, to the use of corticosteroids, to a nephrotic syndrome, or to estrogen therapy. The drug is contraindicated in cases of anuria, that is to say an absence of urine production, and in cases of known hypersensitivity to the product.
It is generally taken early in the day. Because it makes you urinate more, a morning dose limits the need to get up during the night, which is called nocturia. In hypertension, the usual starting dose ranges from 12.5 to 25 mg once a day, and the treatment is usually taken once or twice a day depending on the prescription.
Consistency is key. The drug controls blood pressure as long as it is taken, it does not cure it: you must therefore continue even when feeling well, and never stop it on your own initiative. The doctor may combine it with a low-salt diet, which reinforces the effect on blood pressure. Any change in dose requires medical advice.
By changing the way the kidney works, the thiazide alters the handling of several minerals. The sodium it prevents from being reabsorbed reaches farther along the nephron, where it is partly exchanged for potassium: potassium then passes more into the urine, which can lower its concentration in the blood, a hypokalemia. Magnesium follows a similar movement, and its urinary elimination also increases, hence a possible hypomagnesemia.
The drug can also lower blood sodium, a hyponatremia more pronounced in older people and those with a low intake, and raise blood calcium, a hypercalcemia. Potassium and magnesium remain the two minerals to watch closely. The extent of the decline depends on the dose, and laboratory monitoring keeps it in check. Diet remains the simplest way to rebuild these reserves.
The treatment can modestly raise fasting blood glucose, a dose-related effect that warrants monitoring in people with diabetes. It can also increase the level of uric acid in the blood and trigger gout attacks, especially during the first weeks and in a dose-dependent way. Finally, modest and dose-dependent rises in total cholesterol and triglycerides are observed.
Rarer effects also exist. Cases of acute myopia and secondary angle-closure glaucoma have been reported, typically in the days following the start of treatment. In addition, the FDA has flagged a slight increase in the risk of non-melanoma skin cancer, in particular squamous cell carcinoma, especially in fair-skinned people.
Several combinations call for caution. With lithium, diuretics reduce its renal elimination and greatly increase the risk of toxicity: the combination is not recommended. The induced hypokalemia can exaggerate the heart’s response to the toxic effects of digitalis agents such as digoxin. Nonsteroidal anti-inflammatory drugs can dampen the diuretic and antihypertensive effect. In people with diabetes, the dose of the antidiabetic drug may need to be adjusted, and corticosteroids intensify the loss of potassium. Cholestyramine and colestipol reduce the digestive absorption of the drug, by up to 85 % and 43 % respectively, which requires spacing out the doses.
Monitoring frames all of this. It includes measuring sodium, potassium, calcium, and magnesium at the start and then at regular intervals, fasting blood glucose in people with diabetes, surveillance of kidney and liver function, and looking for signs of gout during the first weeks. This laboratory framework makes it possible to adjust the dose and to spot an imbalance early.
Beyond the plate, a single isolated nutrient can be worth discussing, to confirm with your doctor or pharmacist. Here is which one and in which form.
Magnesium is a mineral involved in many enzymatic reactions. Supplements differ mainly by their salt: organic forms such as bisglycinate and citrate are better tolerated digestively and better absorbed than oxide.
Preferred formbisglycinate or citrate rather than oxide
To be confirmed with your doctor or pharmacist.
Type the name written on the box. The atlas gives you its answer.
For example Panadol, Doliprane or paracetamol.
Hydrochlorothiazide is a thiazide diuretic prescribed for high blood pressure and certain types of edema. The package leaflet notably lists dizziness, a drop in blood pressure at the start of treatment and possible electrolyte imbalances. For the full list and what applies to you, refer to the package leaflet and speak with your doctor or pharmacist.
The package leaflet flags interactions with certain NSAIDs, lithium, corticosteroids, other diuretics and antidiabetic medicines, which can alter tolerance or your mineral salt balance. Report all your treatments, including over-the-counter ones, to your doctor or pharmacist before combining anything.
Hydrochlorothiazide is not recommended during pregnancy and the package leaflet indicates a contraindication in the second and third trimesters. If you are pregnant, planning to be or breastfeeding, do not stop anything on your own and consult your doctor promptly.
If you miss a dose, the package leaflet advises against doubling the next one. Stopping a treatment for high blood pressure is not a decision to make alone, as your blood pressure may rise again. Any change should be discussed with your doctor or pharmacist.
Pharmacological literature describes that thiazide diuretics increase urinary elimination of potassium and, to a lesser degree, magnesium. This is why medical follow-up often includes a blood test for these minerals. This blood test, and the interpretation that follows from it, are the responsibility of your doctor.
Depending on your blood test results, the active most often considered is magnesium, in a well-tolerated form such as bisglycinate. Potassium, on the other hand, is monitored by blood test and managed with your doctor, never on your own. It is better to stick to a single active ingredient rather than a complex.
These answers draw on the patient leaflet and on the published literature. For any question about your medicine, the patient leaflet and your doctor or pharmacist are the reference.
We will write to you the day your formula becomes available.