Hydrochlorothiazide, abbreviated HCTZ, is a thiazide diuretic used for the treatment of mild to moderate high blood pressure. It may also be used for the treatment of water accumulation in the body in patients who have congestive heart failure and nephritic syndrome. The medication prevents the reabsorption of sodium back into the body, leading to an increase in the release of sodium and water. The action of HCTZ is able to lower blood pressure and release accumulated water from the body. The drug may cause side effects, but the patient can discuss any concerns with a physician.
Low Blood Pressure
According to the Drug Information Handbook, up to 10 percent of people may experience this side effect. The patient may feel dizzy or lightheaded. Patients may also develop orthostatic hypotension, which is a drop in the blood pressure due to sitting or standing too quickly. The patient should use caution when moving from lying position to sitting or standing. If the patient experiences a feeling of faint, he should contact a physician.
Hypokalemia
Hypokalemia, a low potassium level, may occur in about 5 percent of patients using HCTZ. "Basic and Clinical Pharmacology" explains that the medication increases the delivery of salt and water to the kidney and also enhances the release of potassium. A small decrease in the level of potassium doesn't produce any symptoms; however, a large drop in potassium levels can be life-threatening. Symptoms of dangerously low levels of potassium include irregular heartbeats, muscle spasms and muscle pain or weakness. The patient should seek medical care immediately if she develops these symptoms.
Increased Uric Acid
HCTZ increases reabsorption of uric acid, leading to an increase in uric acid level in the body. This may produce attacks of gout, a form of arthritis in which uric acid builds up in the joints. Patients with a previous history of gout are at risk for developing an attack, but those with no previous history aren't likely to develop an attack, states "Pharmacotherapy: A Pathophysiologic Approach." Patients who develop gout may be treated with allopurinol and continue with HCTZ therapy.
Hyperglycemia
Hyperglycemia, an increase in blood sugar levels, can occur in patients on HCTZ. This side effect is due to inadequate release of insulin and decreased utilization of blood sugar. "Basic and Clinical Pharmacology" says hyperglycemia may reverse partially with the correction of hypokalemia.
Increased Cholesterol
HCTZ may increase LDL, which is the "bad" cholesterol. These levels may return to normal after long-term use of the medication. The patient should keep all doctor appointments to ensure he's monitored properly.
References
- "Drug Information Handbook"; Charles F. Lacy, Lora L. Armstrong, et al.; 2009
- "Basic and Clinical Pharmacology"; Bertram G. Katzung; 2007
- "Pharmacotherapy: A Pathophysiologic Approach"; Josep T. Dipiro, Robert L. Talbert, et al.; 2008
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