Basic Hydrochlorothiazide Information

• INN (International Nonproprietary Name): Hydrochlorothiazide
• Brand Names Available in Canada: Hydro-Diuril, Diuril
• ATC Code: C03AA03
• Forms & Dosages: Tablets 12.5 mg, 25 mg, 50 mg
• Manufacturers in Canada: Teva, Apotex, Sun Pharmaceuticals
• Registration Status in Canada: Approved
• OTC / Rx Classification: Prescription Only Medicine

Latest Research Highlights

Recent studies are spotlighting the efficacy of hydrochlorothiazide (HCTZ) as a treatment for hypertension, while reinforcing its essential role in preventing cardiovascular events. In Canada, the Canadian Hypertension Education Program (CHEP) guidelines have emphasized the drug’s effectiveness, either when used alone or in combination with other medications like amlodipine or valsartan. A notable trial conducted in 2022 revealed that patients treated with HCTZ experienced statistically significant reductions in blood pressure compared to those receiving a placebo. These findings underline HCTZ's ongoing relevance in clinical settings. Data gathered from various Canadian clinical trials has reaffirmed hydrochlorothiazide’s role as a safe and effective option for blood pressure management. This aligns with the findings of a recent meta-analysis from 2023, which focused on its impact specifically among the elderly. The analysis highlighted a meaningful reduction in hospital admissions for older adults, provided that electrolyte levels are monitored closely. The table below outlines key research findings, featuring patient demographics, dosing regimens, and notable outcomes which reinforce the clinical benefits of hydrochlorothiazide:

Study Year	Patient Demographics	Dosing Regimen	Outcomes
2022	Adults, mean age 60	12.5-25 mg	Significant reduction in blood pressure
2023	Older adults, aged 65+	25-50 mg	Reduced hospital admissions, monitored electrolytes

This data reinforces the importance of incorporating hydrochlorothiazide into hypertension management strategies across Canada. As healthcare providers look for effective ways to control high blood pressure and its related risks, HCTZ continues to be a mainstay in treatment protocols. In conclusion, this collective body of research affirms the effectiveness of hydrochlorothiazide, solidifying its position in Canadian clinical practice. Monitoring remains a critical aspect of care, especially for populations who may experience unique electrolyte fluctuations, underscoring the need for personalized treatment approaches.

Clinical Effectiveness in Canada

Hydrochlorothiazide has become a staple in Canadian medicine, highlighted by its presence in Health Canada's drug monographs. The Drug Identification Number (DIN)—like 02115554 for Hydro-Diuril 25 mg—signals its approved status within the medical community. The integration of evidence-based guidelines into practice is crucial, as outlined by the Canada Blood Pressure guidelines. For patients dealing with hypertension, the standard initial dose typically commences at 12.5 mg, adjusting as necessary based on the individual's response and tolerance. Studies reveal that HCTZ effectively helps to mitigate long-term risks related to stroke and heart failure, particularly significant in older populations, a key demographic in community pharmacies. The following summarizes provincial health plans covering HCTZ, including coverage limits and eligibility requirements:

• Ontario Drug Benefit: Covers HCTZ with no age restrictions for eligible patients.
• Québec: Generally included in the public prescription drug insurance plan.
• British Columbia: Part of the PharmaCare program, with coverage based on income assessments.
• Nova Scotia: Available through the Nova Scotia Pharmacare program for seniors and low-income patients.

These details underscore the drug’s accessibility and highlight a commitment to supporting patient health throughout the nation. As prescribing practices evolve and new data emerges, hydrochlorothiazide remains a vital component in the management of hypertension in Canada.

Indications & Expanded Uses

Hydrochlorothiazide is primarily targeted for the management of hypertension and for treating edema caused by conditions like heart failure, hepatic cirrhosis, and particular renal-related issues. The standard daily dosage for adults begins at 12.5 mg, often adjusted to between 25 mg and 50 mg according to patient-specific needs. In addition to its approved uses, off-label indications have gained attention, particularly regarding its benefits for nephrolithiasis. Clinical evidence supports its effectiveness in helping to prevent the recurrence of calcium-based kidney stones, especially in patients previously diagnosed with nephrolithiasis. The following table compares approved uses against off-label indications for hydrochlorothiazide, along with key clinical studies that back these applications:

Indication Type	Description	Clinical Studies
Approved Uses	Hypertension, Edema	Canada Blood Pressure guidelines
Off-label	Nephrolithiasis	Clinical research supporting calcium stone recurrence reduction

Canadian prescribers are advised to tailor dosages considering various demographic factors within their patient population. This includes recognizing that Indigenous groups may possess different genetic susceptibilities, which can inform the approach to hypertension management. In summary, hydrochlorothiazide’s versatility extends throughout its use cases, reinforcing the importance of personalized treatment strategies. As clinical research continually evolves, healthcare providers can stay informed to optimize therapeutic outcomes for individuals in diverse settings.

Composition & Brand Landscape

Hydrochlorothiazide, a thiazide diuretic, remains a staple in hypertension management and is consistently available across various formulations. In Canada, this effective diuretic is primarily provided as oral tablets, coming in strengths of 12.5 mg, 25 mg, and 50 mg. Brand names such as Hydro-Diuril and Diuril are well recognized in Canadian pharmacies, ensuring the drug’s strong market presence.

Moreover, hydrochlorothiazide often features in combination therapies, typically partnered with medications like amlodipine or irbesartan. This dual approach not only enhances therapeutic efficacy but also broadens treatment options for patients facing hypertension. The availability of generic alternatives plays a crucial role in providing cost-effective solutions while ensuring therapeutic effectiveness. Generic brands, including Teva-Hydrochlorothiazide and PMS-Hydrochlorothiazide, are frequently prescribed, allowing patients to benefit from the essential properties of the drug at a lower price point.

Brand Name	Formulation	DIN
Hydro-Diuril	25 mg, 50 mg	02290557
Diuril	12.5 mg, 25 mg	00454662
Teva-Hydrochlorothiazide	25 mg	02261017
PMS-Hydrochlorothiazide	12.5 mg, 25 mg	02019433

The Canadian pharmacy landscape reflects a commitment to bilingualism, ensuring all labeling meets both English and French requirements. This practice not only complies with regulations but also respects the linguistic diversity of the Canadian population.

Contraindications & Special Precautions

Hydrochlorothiazide is not suitable for everyone. Patients with known hypersensitivity to sulfonamide-derived medications, those experiencing anuria, and individuals with severe renal or hepatic impairment should avoid this medication. Health Canada emphasizes the need for special awareness regarding adverse effects, especially among vulnerable populations, including the elderly and Indigenous communities, who may have unique metabolic responses.

Regular monitoring for electrolytes such as potassium and sodium is vital given the diuretic nature of hydrochlorothiazide. Its effects can notably affect conditions such as diabetes mellitus and gout, potentially worsening blood sugar and uric acid levels.

• Absolute Contraindications:
  • Hypersensitivity to Hydrochlorothiazide or sulfonamide drugs
  • Anuria
  • Severe renal or hepatic impairment
• Relative Contraindications:
  • Diabetes mellitus
  • Gout
  • Moderate renal insufficiency
  • Moderate liver dysfunction

Educating both healthcare providers and patients about these risks forms a cornerstone of patient-centered care, ensuring informed decision-making in hydrochlorothiazide therapy.

Dosage Guidelines

Standard dosing for hydrochlorothiazide in adults generally starts at 12.5 mg daily. Adjustments are made based on the individual’s response to the medication, with optimal dosages tailored to achieve effective blood pressure reduction while considering tolerability. For children, the usual dosing is between 1-2 mg/kg/day, with maximum daily limits taken into account. Elderly patients are advised to start with lower doses for safety, maintaining ongoing evaluations of blood pressure and electrolyte levels.

Population	Starting Dose	Max Dose
Adults	12.5 mg daily	100 mg daily
Children	1–2 mg/kg/day	37.5 mg daily
Elderly	12.5 mg daily	Titrated as needed

Canadian healthcare guidelines focus heavily on the necessity of regular monitoring for safety and efficacy, particularly during dosage adjustments and in cases of renal or hepatic impairment.

Interactions Overview

Hydrochlorothiazide is known to interact with various medications and dietary factors prevalent in Canadian lifestyles. For instance, when taken alongside digitalis, the risk of toxicity increases due to lower potassium levels. Non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the drug's antihypertensive effects, while alcohol could worsen dehydration and electrolyte loss caused by HCTZ.

Grapefruit is another dietary consideration, as it may affect the metabolism of hydrochlorothiazide, altering its therapeutic efficacy.

• Common Drug Interactions:
  • Digitalis
  • NSAIDs
  • Lithium
• Dietary Considerations:
  • Avoid alcohol consumption
  • Be cautious with grapefruit intake
• Health Canada Recommendations:
  • Routine monitoring for potential interactions
  • Education on lifestyle modifications

Such factors are especially essential for patients in rural areas, where healthcare access can be limited. Insightful discussions about these interactions can lead to better patient outcomes and adherence to prescribed therapy.

Cultural Perceptions & Patient Habits

Cultural attitudes towards medications can significantly impact patient adherence to hydrochlorothiazide regimens. Many Canadians embrace universal healthcare principles, placing a strong emphasis on preventive care approaches. This includes regular screenings and effective medication management for chronic conditions such as hypertension.

Online discussions, especially on platforms like Reddit Canada, provide insights into patient experiences, where concerns about side effects, particularly electrolyte imbalances and weight changes, frequently surface. These conversations illustrate the importance of community support in addressing anxieties surrounding treatment.

Access to medications like hydrochlorothiazide often varies in Canada, especially between urban and rural areas. Patients living in urban environments generally have easier access to pharmacies, whereas those in rural regions face logistical challenges that can hinder timely medication access. Community health initiatives play a crucial role in bridging these gaps, often providing local pharmacy collaborations to improve service delivery.

City	Region	Delivery Time
Toronto	Ontario	5–7 days
Vancouver	British Columbia	5–7 days
Montreal	Quebec	5–7 days
Calgary	Alberta	5–7 days
Ottawa	Ontario	5–7 days
Edmonton	Alberta	5–7 days
Quebec City	Quebec	5–7 days
Winnipeg	Manitoba	5–7 days
Hamilton	Ontario	5–9 days
Kitchener	Ontario	5–9 days
Halifax	Nova Scotia	5–9 days
Regina	Saskatchewan	5–9 days
Victoria	British Columbia	5–9 days
London	Ontario	5–9 days

This understanding of cultural perceptions emphasizes the importance of fostering community health programs that support the social determinants of health, ultimately promoting better adherence and positive health outcomes for individuals prescribed hydrochlorothiazide.

Availability & Pricing Patterns

Hydrochlorothiazide is readily accessible in Canada through major pharmacy chains such as Shoppers Drug Mart, Rexall, Jean Coutu, and London Drugs. Regulated pricing mechanisms ensure that costs for hydrochlorothiazide are generally lower than those found in the United States, making it more accessible for populations reliant on public health insurance plans.

With the rise of online pharmacies, Canadian patients have additional options for obtaining hydrochlorothiazide. However, these online pharmacies are often subject to provincial pharmacy regulations, which can affect the availability of medications. Price comparisons typically show that hydrochlorothiazide remains affordable, further supporting sustained adherence among patients in community pharmacies.

Pharmacy Name	Price (CAD)	US Price Comparison
Shoppers Drug Mart	$10.00	$20.00
Rexall	$11.00	$19.50
Jean Coutu	$9.50	$18.00
London Drugs	$10.50	$22.00

Pharmacists are essential in guiding patients through the pricing landscape, helping them to identify affordable options and available generic alternatives, ultimately reducing out-of-pocket expenses associated with hydrochlorothiazide.

Comparable Medicines and Preferences

When prescribing hydrochlorothiazide, healthcare professionals often evaluate it against alternative diuretics like chlorthalidone and furosemide. The choice depends on the patient's unique circumstances, including any existing co-morbid conditions and previous treatment outcomes.

Canadian pharmacies typically offer comparison checklists that highlight the distinctions between hydrochlorothiazide and its alternatives, such as effectiveness in lowering blood pressure, risks of electrolyte imbalances, and patient preferences for dosing frequency. Chlorthalidone, for instance, is recognized for its longer action, yet hydrochlorothiazide remains a popular option due to its established safety profile.

Diuretic	Pros	Cons
Hydrochlorothiazide	Widely used, well-established safety	Possible electrolyte imbalance
Chlorthalidone	Longer duration of action	Less commonly prescribed
Furosemide	Effective in heart failure	May cause more electrolyte issues

Enhancing patient education about these options encourages meaningful discussions with healthcare providers, empowering them to take active roles in managing their hypertension treatment plans.

FAQ Section

What is hydrochlorothiazide used for?
Hydrochlorothiazide is primarily indicated for treating hypertension and managing fluid retention linked to heart conditions.

What should I do if I miss a dose?
Take the missed dose immediately unless it's almost time for the next dose; avoid doubling up.

What are common side effects of hydrochlorothiazide?
Common side effects may include dizziness, electrolyte imbalance, and gastrointestinal upset. It's crucial to inform a healthcare provider of any severe symptoms.

Can hydrochlorothiazide cause weight gain?
Although not typical, some patients may notice weight fluctuations. Consulting a healthcare professional is advisable if concerns arise.

Is hydrochlorothiazide safe to take with other medications?
Always discuss current medications with a healthcare provider, as some combinations may necessitate monitoring for interactions.

Guidelines for Proper Use

Pharmacists are pivotal in delivering thorough advice pertaining to the use of hydrochlorothiazide. Key guidelines include:

• Ensuring adherence to prescribed dosages
• Regularly monitoring for side effects
• Promoting lifestyle changes, such as a reduction in dietary sodium and an increase in potassium intake through food sources

Provincial health authorities recommend that patients on hydrochlorothiazide attend regular follow-ups to reassess both blood pressure and electrolyte levels periodically. Educating patients about the timing of the medication is essential too—whether taken with or without food, as this can optimize therapeutic effects.

Ultimately, the comprehensive guidance delivered by pharmacists enhances the effectiveness of hydrochlorothiazide therapy and empowers patients to proactively manage their health. Prioritizing monitoring and patient self-management will significantly contribute to improved health outcomes.