Triamterene/hydrochlorothiazide: Facts And Side Effects
What else should I know about triamterene and hydrochlorothiazide? What is triamterene and hydrochlorothiazide, and how does it work (mechanism of action)? Triamterene / hydrochlorothiazide is an oral diuretic (water pill) that is used for treating high blood pressure ( hypertension ) and edema (water accumulation). It is a combination of two different diuretics. The FDA approved triamterene/hydrochlorothiazide in December 1965. The kidneys control the amount of sodium and water within the body. Normally, blood circulates through the kidneys where much of the water, sodium and other small molecules are filtered out of the blood and into the tubules of the kidney. Once in the tubules, much of the water and sodium are reabsorbed back into the blood. The water and sodium that is not reabsorbed passes on through the tubules and becomes urine that is eliminated from the body. Diuretics affect the reabsorption of sodium and water from the tubules and thus, the amount of sodium and water retained or eliminated by the body. In addition to controlling sodium, the kidney also controls the amount of potassium that is retained or eliminated from the body. Diuretics eliminate salt (sodium) and water from the body.Hydrochlorothiazide is a diuretic that can be used alone for treating high blood pressure and edema. It works by blocking sodium and water reabsorption in the kidneys, thereby reducing sodium and water in the body. (Whereas it is clear how hydrochlorothiazide eliminates water from the body, its mechanism of action in lowering high blood pressure is not well understood.) To compensate for the increased amount of sodium and water in the tubules that will be lost as urine, the kidney tries to reabsorb more sodium and water. It does this by removing potassium from the blood an Continue reading >>
Hydrochlorothiazide: Indications, Side Effects, Warnings - Drugs.com
It is used to treat high blood pressure . It may be given to you for other reasons. Talk with the doctor. What do I need to tell my doctor BEFORE I take Hydrochlorothiazide? If you have an allergy to hydrochlorothiazide or any other part of hydrochlorothiazide. If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives ; itching; shortness of breath; wheezing ; cough; swelling of face, lips, tongue, or throat; or any other signs. If you are breast-feeding or plan to breast-feed. This is not a list of all drugs or health problems that interact with hydrochlorothiazide. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins ) and health problems. You must check to make sure that it is safe for you to take hydrochlorothiazide with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor. What are some things I need to know or do while I take Hydrochlorothiazide? Tell all of your health care providers that you take hydrochlorothiazide. This includes your doctors, nurses, pharmacists, and dentists. Avoid driving and doing other tasks or actions that call for you to be alert until you see how hydrochlorothiazide affects you. To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs. If you have high blood sugar (diabetes), you will need to watch your blood sugar closely. Have your blood pressure checked often. Talk with your doctor. Have blood work checked as you have been told by the doctor. Talk with the doctor. This medicine may affect certain lab tests. Tell all of y Continue reading >>
Drugs That Can Worsen Diabetes Control
One of the main goals of any diabetes control regimen is keeping blood glucose levels in the near-normal range. The cornerstones of most plans to achieve that goal include following a healthy diet, getting regular exercise, and taking insulin or other medicines as necessary. However, it’s not uncommon for people with diabetes to have other medical conditions that also require taking medicines, and sometimes these drugs can interfere with efforts to control blood glucose. A few medicines, including some commonly prescribed to treat high blood pressure and heart disease, have even been implicated as the cause of some cases of diabetes. This article lists some of the medicines that can worsen blood glucose control, the reasons they have that effect, the usual magnitude of the blood glucose changes, as well as the pros and cons of using these drugs in people who have diabetes. Where the problems occur To understand how various medicines can worsen blood glucose control, it helps to understand how insulin, the hormone responsible for lowering blood glucose, works in the body. Insulin is released from the beta cells of the pancreas in response to rising levels of glucose in the bloodstream, rising levels of a hormone called GLP-1 (which is released from the intestines in response to glucose), and signals from the nerve connections to the pancreas. The secretion of insulin occurs in two phases: a rapid first phase and a delayed second phase. Both of these phases are dependent on levels of potassium and calcium in the pancreas. Insulin acts on three major organs: the liver, the muscles, and fat tissue. In the liver, insulin enhances the uptake of glucose and prevents the liver from forming new glucose, which it normally does to maintain fasting glucose levels. In muscle and f Continue reading >>
Are Blood Pressure Meds Increasing Blood Sugar?
Are blood pressure meds increasing blood sugar? Dear Dr. Roach I am 70 years old, male, about eight pounds underweight, walk 3 miles almost every day, have high blood pressure and am at high risk of developing diabetes, because my mother and brother had diabetes. I take losartan/HCTZ (I used to take quinapril/HCTZ), which, according to the literature, causes elevated blood glucose. I have elevated glucose and A1c levels on my blood tests, and I think its caused by the medications. It seems to me that these medications will push me to full-blown diabetes. Am I missing something? J.M. Answer First of all, you are doing a great job in reducing your risk of diabetes by walking daily and not being overweight. However, some people still will get diabetes, even if they do everything right. Losartan/HCTZ is a combination of two medications: losartan, an angiotensin-receptor blocker; and hydrochlorothiazide (HCTZ), a diuretic that works by forcing the kidney to excrete excess salt and water. Losartan is a good choice for people with diabetes or prediabetes because it protects both the kidney and the heart, though perhaps not as well as the quinapril you used to take. As far as I know, quinapril may reduce the risk of diabetes, and losartan doesnt seem to increase or decrease the risk. The HCTZ, however, does increase the risk of new-onset diabetes by about 30 percent. Given that your blood sugar and hemoglobin A1c which looks at blood sugar over several months are abnormal, it may make sense to change the HCTZ part of your regimen to a different class, such as a calcium channel blocker. On the other hand, if your blood sugar and A1c are near normal, and your blood pressure is well-controlled, I dont think I would be too anxious to change it, because HCTZ is probably the most ef Continue reading >>
Drug-induced Glucose Alterations Part 2: Drug-induced Hyperglycemia
A variety of pharmacological agents A variety of pharmacological agents affect glucose homeostasis resulting in either hypo- or hyperglycemia. Hormones such as insulin, glucagon, catecholamines, growth hormone, and cortisol, among others, contribute to normoglycemia. Drug-induced serum glucose alterations manifested as hyperglycemia or hypoglycemia can have perpetual effects on the body, particularly in patients with diabetes. This article is the second of a two-part series reviewing drug-induced serum glucose alterations. The first article in the series appeared in the previous issue of this journal (Diabetes Spectrum 24:171-177, 2011). In this article, we review select therapies commonly contributing to the development of hyperglycemia. Hyperglycemia is clinically defined as a serum glucose level > 180 mg/dl that persists for more than 2 hours. Unlike hypoglycemia, acute hyperglycemia is often benign and may persist without any clinically significant signs or symptoms; however the development of diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) are hyperglycemic emergencies. Often signs and symptoms of hyperglycemia manifest when serum glucose levels are in the range of 270–360 mg/dl for an extended period and include the classical symptoms of polyphagia, polydipsia, and polyuria (Table 1). Untreated hyperglycemia, when accompanied with excretion of ketones in urine (DKA), is a medical emergency more common in people with type 1 diabetes. It results in the following symptoms: fatigue, weakness, fruity odor of the breath, confusion, lack of concentration, shortness of breath, nausea and vomiting, dry skin, and flushing of the skin. People with type 2 diabetes are more likely to develop HHS, formerly known as hyperosmolar hyperglycemic nonketotic c Continue reading >>
Lower Blood Pressure, Higher Glucose?
I've read that hydrochlorothiazide can raise blood sugar levels. Is this true? My doctor prescribed it for my high blood pressure, but why would he do that if he knew it could raise my glucose levels? — Connie, Ohio The jury is still out regarding the long-term effect of hydrochlorothiazide on blood glucose because the results from studies have been mixed. While some studies have shown that there is indeed a higher risk of elevated glucose, others have not confirmed this finding. Here's what we know: Individuals who are taking thiazide diuretics, of which hydrochlorothiazide is one, can develop a mild case of elevated glucose, usually if their potassium levels are also low. When the potassium level normalizes, the glucose level goes back to normal. Thiazide diuretics have proven beneficial to people with high blood pressure and are among the best, safest, and least expensive of blood pressure drugs. The use of beta-blockers (which are also prescribed to treat high blood pressure) along with thiazide diuretics can, however, increase blood glucose levels. It is possible that hydrochlorothiazide increases the production of glucose from the liver, and because beta-blockers limit the absorption of glucose into cells, the use of these medicines in tandem can raise glucose levels significantly enough to cause diabetes. My recommendation is this: Make sure your potassium level is normal or high-normal when taking hydrochlorothiazide. If your doctor tells you that your levels are low, eating bananas — which are rich in potassium — can help. And, unless absolutely necessary, avoid mixing beta-blockers with hydrochlorothiazide. Your best bet is to visit your doctor. Ask him to explain the benefits and risks of taking hydrocholorthiazide versus some other antihypertensive dru Continue reading >>
Thiazide Diuretics Alone Or With Beta-blockers Impair Glucose Metabolism In Hypertensive Patients With Abdominal Obesity
Thiazide Diuretics Alone or with Beta-blockers Impair Glucose Metabolism in Hypertensive Patients with Abdominal Obesity 1 University of Missouri-Columbia School of Medicine, Department of Medicine 3 Department of Diabetes and Cardiovascular Center 1 University of Missouri-Columbia School of Medicine, Department of Medicine 3 Department of Diabetes and Cardiovascular Center 1 University of Missouri-Columbia School of Medicine, Department of Medicine 2 Department of Physiology and Pharmacology 3 Department of Diabetes and Cardiovascular Center 1 University of Missouri-Columbia School of Medicine, Department of Medicine 2 Department of Physiology and Pharmacology 3 Department of Diabetes and Cardiovascular Center Corresponding Author: James R. Sowers, M.D, ASCI, FAHA, FACP, Professor of Medicine, Physiology and Pharmacology, D109 HSC Diabetes Center, One Hospital Drive, Columbia, MO 65212, Telephone (573) 884-0769, FAX (573) 884-5530, [email protected] The publisher's final edited version of this article is available free at Hypertension See the article " IMPACT OF ABDOMINAL OBESITY ON INCIDENCE OF ADVERSE METABOLIC EFFECTS ASSOCIATED WITH ANTIHYPERTENSIVE MEDICATIONS " in Hypertension, volume 6 onpage61. See other articles in PMC that cite the published article. Randomized clinical trials in patients with hypertension and other cardiovascular disease (CVD) risk factors have shown that anti-hypertensive therapy with thiazide diuretics and beta-blockers is associated with increased incidence of new onset diabetes and other metabolic abnormalities ( 1 , 2 ). There is growing evidence that those patients with central obesity and other components of the cardiometabolic syndrome are especially prone to new onset diabetes ( 1 5 ). In persons with abdominal obesity, h Continue reading >>
Hydrochlorothiazide Hypertension Treatment Induced Metabolic Effects In Type 2 Diabetes: A Meta-analysis Of Parallel-design Rcts.
Hydrochlorothiazide hypertension treatment induced metabolic effects in type 2 diabetes: a meta-analysis of parallel-design RCTs. Department of Pharmacy, Feng-Yuan Hospital, Ministry of Health Welfare, Taichung, Taiwan, R.O.C. [email protected] Thiazide diuretics are still widely used as an initial therapy in essential hypertension, sometimes in both hypertensive and diabetic patients. However, the metabolic effects in type 2 diabetes treated with a thiazide diuretic have not been fully elucidated. Randomized controlled trials (RCTs) were identified from the electronic databases: the Cochrane Library, MEDLINE, and PubMed web of knowledge. The trials compared the metabolic effects of hydrochlorothiazide (HCTZ) versus no- HCTZ hypertension treatment in type 2 diabetes. A total of 368 papers showed a match, in the keyword search. Upon screening the title, reading the abstract and the entire article, 13 parallel-design RCTs, described in 7 reports, involving 720 patients, showed fasting glucose (FG) (SMD = 0.27, 95% CI 0.11-0.43) and HbA1c (SMD = 1.09, 95% CI 0.47-1.72)significantly increased in the patients treated with HCTZ groups and high-density lipoprotein-cholesterol (HDL-C) (SMD = -0.44, 95% CI -0.81- -0.08) decreased in the patients treated with low-dose HCTZ groups. Our study showed FG, HbA1c and HDL-C significantly affected in the patients treated with low-dose HCTZ groups. Our study showed FG and HbA1c increased in the patients treated with the low-dose HCTZ groups, and HDL-C decreased in the patients. While thiazide diuretics are still a recommended medication of hypertension therapy for type 2 diabetes, treatment with low-dose HCTZ should be attempted to evaluate the effectiveness and adverse metabolic effects. Continue reading >>
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Hydrochlorothiazide Tablet | Side Effects, Dosage, Uses & More
Hydrochlorothiazide is a prescription drug. It comes as a tablet, capsule, or solution that you take by mouth. Hydrochlorothiazide is available as the brand-name drug Microzide. Its also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. Hydrochlorothiazide is used to treat high blood pressure. Its also used to treat swelling thats caused by heart failure, liver damage (cirrhosis), and taking certain medications (corticosteroids or estrogens). It may also help treat swelling thats caused by kidney problems. This drug may be used alone. If you have a severe form of high blood pressure, it may be used with other drugs. Hydrochlorothiazide belongs to a class of drugs called thiazide diuretics. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions. It isnt known exactly how hydrochlorothiazide works. Its thought that it works to remove excess salt and water from your body. This keeps your heart from working as hard to pump blood. This lowers high blood pressure levels and reduces swelling. trouble getting or keeping an erection (erectile dysfunction) If these effects are mild, they may go away within a few days or a couple of weeks. If theyre more severe or dont go away, talk to your doctor or pharmacist. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think youre having a medical emergency. Serious side effects and their symptoms can include the following: severe skin reactions such as Stevens-Johnson syndrome and exfoliative dermatitis, with symptoms such as: increased swelling in your legs, ankles, or feet Continue reading >>
Hydrochlorothiazide & Blood Glucose
Roseanne Omalacy became a published author and freelance writer in 2006. She is the author of several novels and has been published with Literary Partners Group, Alyson Publishing and "Scarlet Magazine." She is a Pittsburgh health and relationships columnist, holds a bachelor's degree in nursing from Pennsylvania State University and has over 15 years of nursing experience. A man is filling a syringe with insulin.Photo Credit: Images_By_Kenny/iStock/Getty Images Hydrochlorothiazide is a diuretic that treats water retention by reducing the amount of salt absorbed by the body. This is especially important in patients with high blood pressure, kidney disorders and diabetes. Diabetes is a metabolic disease characterized by high levels of sugar in the bloodstream. Diabetes increases your risk of heart disease, blindness and stroke. Combining certain medications with diabetes can cause adverse reactions, so you must know how hydrochlorothiazide affects your blood sugar. Insulin is a hormone produced by the pancreas that changes food into energy. When your cells become resistant to insulin or your pancreas quits making insulin, diabetes can develop. There are two kinds of diabetes, but diabetes type 2 is the most common form of the disease. As of 2011, more than 25 million Americans have diabetes, according to the American Diabetes Association. Symptoms of diabetes include increased thirst, vision changes, hunger and increased urination. Diabetes increases your risk of stroke, heart disease, blindness and kidney disease. Physicians treat diabetes with dietary changes, oral medications and insulin injections. Diuretics are a family of drugs used to treat fluid retention associated with kidney disease, heart disease, diabetes and other disorders. Diuretics are sometimes called Continue reading >>
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- Exercise and Blood Glucose Levels
Does Hydrochlorothiazide Cause Diabetes?
No, hydrochlorothiazide does not cause diabetes. If you are already heading towards diabetes it may be the proverbial straw that broke the camels back. However it and many other medications that potentially raise blood sugar levels have little to no impact on the majority of people taking those medications. Present data suggests that if you are pre-diabetic or diabetic type 1 or type 2, to be careful and work with your doctors due to the possibility of higher levels of blood sugars while on those medications. Type 1 diabetes, is an autoimmune disorder, caused by heredity that destroys the Beta cells that are found in the islets of Langerhans within the pancreas. With Type 1 diabetes antibodies that are produced in white blood cells are hard wired to attack beta cells as though they were a pathogen and destroy the beta cells needed to produce insulin. Type 2 diabetes is not an autoimmune disorder. Type 2occurs when the cells become resistant to insulin produced by the pancreas, causing an increase of sugar in the blood stream or the pancreas simply can't make enough insulin. With Type 2 there are various causes: heredity, obesity, inactivity, poor nutrition and many other factors or a combination of those factors may cause the onset of type 2 diabetes. Regardlesshydrochlorothiazide maybe one of many factors that lead to diabetes but it alone will not cause type 2 diabetes. Continue reading >>
What Medicines Can Make Your Blood Sugar Spike?
If you have diabetes or high blood sugar, you probably know some of the things that cause your glucose (another name for blood sugar) to go up. Like a meal with too many carbohydrates, or not enough exercise. But other medicines you might take to keep yourself healthy can cause a spike, too. Know Your Meds Medicines you get with a prescription and some that you buy over the counter (OTC) can be a problem for people who need to control their blood sugar. Prescription medicines that can raise your glucose include: Steroids (also called corticosteroids). They treat diseases caused by inflammation, like rheumatoid arthritis, lupus, and allergies. Common steroids include hydrocortisone and prednisone. But steroid creams (for a rash) or inhalers (for asthma) aren’t a problem. Drugs that treat high blood pressure, such as beta-blockers and thiazide diuretics High doses of asthma medicines, or drugs that you inject for asthma treatment OTC medicines that can raise your blood sugar include: Cough syrup. Ask your doctor if you should take regular or sugar-free. How Do You Decide What to Take? Even though these medicines can raise your blood sugar, it doesn’t mean that you shouldn’t take them if you need them. The most important thing is to work with your doctor on the right way to use them. If you have diabetes or you’re watching your blood sugar, ask your doctor before you take new medicines or change any medicines, even if it’s just something for a cough or cold. (Remember, just being sick can raise your blood sugar.) Make sure your doctor knows all the medicines you take -- for diabetes or any other reason. If one of them may affect your blood sugar, she may prescribe a lower dose or tell you to take the medicine for a shorter time. You may need to check your blood s Continue reading >>
Hydrochlorothiazide - Wikipedia
Primarily kidney (>95% as unchanged drug) Potential side effects include poor kidney function, electrolyte imbalances especially low blood potassium and less commonly low blood sodium , gout , high blood sugar , and feeling faint initially upon standing up .  While allergies to HCTZ are reported to occur more often in those with allergies to sulfa drugs , this association is not well supported.  It may be used during pregnancy but is not a first line medication in this group.  It is in the thiazide medication class and acts by decreasing the kidneys ' ability to retain water.  This initially reduces blood volume, decreasing blood return to the heart and thus cardiac output .  Long term, however, it is believed to lower peripheral vascular resistance .  Two companies, Merck and Ciba , state they discovered the medication which became commercially available in 1959.  It is on the World Health Organization's List of Essential Medicines , the most effective and safe medicines needed in a health system .  In 2008 it was the second most commonly used blood pressure medication in the United States.  It is available as a generic drug  and is relatively affordable.  Hydrochlorothiazide is frequently used for the treatment of hypertension , congestive heart failure , symptomatic edema , diabetes insipidus , renal tubular acidosis .  It is also used for the prevention of kidney stones in those who have high levels of calcium in their urine.  Most of the research supporting the use of thiazide diuretics in hypertension was done using chlorthalidone , a different medication in the same class. Some more recent studies have suggested that chlorthalidone might be the more effective thiazide diuretic.  It is also sometimes used for treatment of Continue reading >>
Diuretics Side Effects Are Dangerous And Common
Diuretics Side Effects Are Dangerous and Common A new study has discovered that thiazide diuretics side effects are far more common than previously thought and doctors arent monitoring patients properly. Diuretics side effects are more common than previously thought. Patients in the U.S. whose doctors follow national guidelines for treating high blood pressure are typically prescribed a diuretic such as hydrochlorothiazide as the primary therapy. According to the guidelines, these drugs, known as thiazide diuretics , should be the preferred initial medication for the treatment of hypertension in older adults. However, a new study published in the Journal of the American Geriatric Society has found that diuretics side effects are more common than previously thought. The authors urge doctors to use greater caution when prescribing these so-called safe high-blood-pressure drugs. Diuretics such as hydrochlorothiazide (HCTZ) are some of the least expensive and most commonly prescribed drugs for high blood pressure. They work by increasing the excretion of sodium and fluid by the kidneys, reducing the total amount of fluid in the body, and lowering the concentration of sodium and calcium in the walls of the arteries, which causes them to relax. Prevent a heart attack, reduce your stroke risk, and lower your blood pressure. Avoid medications, when possibleeven avoid doctor and hospital visits! Maintain a healthy heart by claiming, right now, your FREE copy of our definitive guide to avoiding heart disease and taking care of your ticker. High Rates of Thiazide Diuretic Side Effects Discovered The new study looked at 35,865 veterans with hypertension . The participants were predominantly men whose average age was 74. Of those prescribed a thiazide diuretic for hyperten Continue reading >>
Risk Of Diabetes And Diuretics
Chicago, IL - Results from a six-month extension study have shown that impairment in glycemic control after one year of diuretic-based combination treatment is reversible by switching to treatment not involving a diuretic, in this case, an ACE inhibitor and calcium-channel blocker [ 1 ]. "When we looked at who developed new-onset diabetes, the plan was to then switch these patients over to the ACE-inhibitor/calcium-channel-blocker combination to see whether we could regress or bring back to baseline these metabolic changes," lead investigator Dr George Bakris (University of Chicago, IL) told heart wire . "This effect of new-onset diabetes, at least if you intervene within a short time of starting the therapy, does not appear to be permanent." The hypothesis-generating study, an extension of the Study of Trandolapril/Verapamil SR And Insulin Resistance (STAR), was presented earlier this week at the American Society of Hypertension 2007 Scientific Sessions. In the original STAR study, published in 2006, investigators showed that in patients with impaired glucose tolerance, normal kidney function, and hypertension, the fixed-dose combination of trandolapril and verapamil reduces the risk of new-onset diabetes compared with a losartan/hydrochlorothiazide-based therapy. Speaking with heart wire , Bakris said clinicians previously believed marrying diuretic therapy to an ACE inhibitor or angiotensin receptor blocker (ARB) might provide protection from new-onset diabetes, although this turned out not to be true. The risk of new-onset diabetes is also dose dependent, he said, such that at 25-mg hydrochlorothiazide (HCTZ) there is substantial risk of impairing the glucose response. Testing the hypothesis that impaired glycemic control might be reversible early in the diuretic/l Continue reading >>