Various health problems are responsible for edema, wherein the tissues retain fluids. For instance, patients with renal problems, complications in the liver and heart problems are likely to end up fluid retention in the body. Similarly, certain medications with estrogen or corticosteroids are also known to cause edema. The condition is treated with diuretics and Hydrochlorothiazide is one among the commonly used medications for treating the condition. By virtue of the mechanism of action and the intended results, side effects of hydrochlorothiazide are experienced by patients. Here is a detailed look at the adverse effects and the best methods o mitigating or managing the condition.

Drug overview and side effects of hydrochlorothiazide

Belonging to the class of thiazide diuretics, the medication is typically used for treating edema apart from hypertension in patients. The most popular medications are often the combination formulations of hydrochlorothiazide and angiotensin converting enzyme inhibitors. The drug has been in use for more than six decades since FDA approval in 1959. The major conditions treated by the drug either alone or in combination with other formulations include cirrhosis, renal failure, heart failure, and hypertension apart from damage to the kidneys that filter waste and fluids from the blood.

Before we look at the side effects of hydrochlorothiazide it is time to look at the mechanism of action of the drug to understand how it works and the resultant effects. The medication works by primarily inhibiting the reabsorption of water and sodium. Consequently, more urine is passed by patients on the medication, thereby retaining lesser fluids in the tissues. The medication has a wide therapeutic window, which effectively means that the dosage can be increased considerably without apprehensions of dosage related effects. Sodium is typically reabsorbed and pushed to create a layer that in turn promotes increased intake of water. The medication works by inhibiting the carrier, which in turn has an impact on the layer thereby inhibiting fluid reabsorption.

How is overdose treated?

In addition to the side effects of hydrochlorothiazide it is necessary to have measures in place to effectively treat overdose of the medication. Despite its relatively wide therapeutic index, overdose of the medication may result in complications such as hyponatremia, and hypokalemia. Patients who have been diagnosed as having an overdose of the medication are typically administered supportive, symptomatic treatment. For instance, fluids and electrolytes are administered to help support patients with known overdose. Similarly, vasopressors are used for treating low blood pressure as a result of the overdose. In certain cases wherever patients exhibit symptoms of impaired breathing or difficulty in breathing, oxygen is administered.

Commonly experienced side effects of hydrochlorothiazide

The side effects of hydrochlorothiazide can be broadly classified into two different categories – common and rare. Side effects that a re relatively common are known to be less severe in nature whereas side effects that are rare are known to be severe in nature. Common side effects include lesser chloride levels resulting in lower acid base problems. Patients are likely to end up with reduced potassium levels in the blood. Additionally, there is also a possibility of patients having lowered blood pressure levels/less sodium levels in the blood. Other side effects include reduced libido/lack of interest in sexual activities, sudden onset of diarrhea, abnormal decrease in appetite, low blood pressure, unexplained nausea and/or vomiting sensation. Individuals are likely to feel drained of energy and feel dizzy at times. The possibility of experiencing cramps in the stomach are high, and patients may also experience low blood pressure – known as orthostatic hypotension.

Side effects that are less serious in nature but common include constipation, and a sudden increase in the triglyceride levels in the blood. Additionally, patients may also end up with high levels of cholesterol as a result of the medication. Certain side effects of hydrochlorothiazide are unusual in nature. For instance, patients may experience a pricking sensation wherein the individual feels multiple needles and pins being forced on the skin. Certain patients are known to turn nervous for no particular reason, and sometimes experience a sudden spinning feeling. Fever is another possible adverse effect of the medication. As a result of the bilirubin, patients may experience vision that is yellowed apart from blurred vision. Spasms of the muscles and an inflammation of the salivary glands are another possibility, associated with the medication.

Side effects that are rare and relatively severe in nature

The following side effects of hydrochlorothiazide are rare in nature and could result in serious manifestations. Patients may end up with impaired functioning of the kidneys, and have high levels of blood sugar. Another side effect of the medication is a possibility of patients having lower levels of magnesium in the blood. Patients are also known to experience allergic reactions in a condition that is medically known as anaphylaxis. Other allergies include the Steven-Johnson Syndrome that refers to a condition wherein the skin begins to blister and peel. A similar condition, known as toxic epidermal necrolysis is also a possible side effect of the medication. A small section of patients are also known to end up with high bilirubin levels that is attributed to the blockage of the bile duct. The possibility of kidney related complications are higher, with patients being exposed to possible interstitial nephritis.

Among the side effects of hydrochlorothiazide there is cause for concern in certain issues, such as excessive levels of uric acid in the blood which is known to result in gout. This joint disorder can have an impact on routine. Similarly, there is also the possibility of lung inflammation, that is medically known as interstitial pneumonitis as a result of the medication. Pancreatic inflammation is another possibility associated with the medication. Patients may sometimes have decreased blood platelet count, while experiencing a sudden increase in the blood calcium levels. A small percentage of patients are also known to end up with inflammation of the blood vessels, liver, and parathyroid gland. An abnormal reduction in the white blood cell count is a possibility and this could result in neutrophils. A similar condition is the low blood count as a result of adverse impact of the medication on the bone marrow.

Among the side effects of hydrochlorothiazide that impact routine, patients may suddenly end up with vision related problems. For instance, nearsightedness is a possibility, while patients may also have secondary angle-closure glaucoma. Another blood disorder that has been reported among patients is hemolytic anemia, wherein patients end up with red blood cells that burst. Cancer of the skin is one of the possible side effects of the medication, and has been reported among a section of patients.

Drug interactions that trigger side effects of hydrochlorothiazide

The medication is also known to trigger side effects as a result of interaction with other drugs. Commonly reported drug interactions include medications that are used for treating psychiatric disorders, blood pressure, high cholesterol levels, anxiety, seizure and diabetes. Similarly, the medication is also known to interact with muscle relaxants and certain non-steroidal anti-inflammatory drugs.

Easily distinguishable symptoms of drug interactions

Individuals with anxiety and seizure disorder on medications such as barbiturates may end up with lowered blood pressure levels as a result of the drug interaction. Common symptoms include a dizzy feeling when rising from a seated or reclining position. Patients on medications for lowering cholesterol levels may experience lesser effectiveness of hydrochlorothiazide. For instance, the reduction of swelling or reduction in blood pressure may not be as per expectations. When hydrochlorothiazide is taken alongwith diabetes drugs, there is a strong possibility of blood sugar levels shooting up. It may be necessary to increase the dosage of diabetes medications for it to be effective. Similarly, patients on blood pressure medications may experience very low blood pressure levels as a result of the drug interactions between hydrochlorothiazide and blood pressure drugs.

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