Hydrochlorothiazide
Brand Names: Inzirqo, Microzide
Methodology & AI Transparency ⓘ
Hydrochlorothiazide Key Takeaways
Translated by Sarah Jenkins (AI RN Plain-English Translator) at a 7th-grade reading level
- 1 What it does: Indications and usage: Hydrochlorothiazide capsules, USP are indicated in the management of hypertension either as the sole therapeutic agent, or in combination with other antihypertensives.
- 2 Real-world patient consensus: Real-world cohort score of 87% across 17 de-identified Hydrochlorothiazide entries.
- 3 Typical cash cost range: Public pharmacy ledger: $5.25 low cash benchmark vs. $34.50 chain retail average ($0.0303/unit CMS NADAC).
- 4 Top reported side effects / signs: Primary clinical safety signals tracked in FAERS for Hydrochlorothiazide include orthostatic hypotension (4.2%), dizziness (7%), headache (5.8%).
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Hydrochlorothiazide Mechanism, CYP450 Pathways & DailyMed Monograph
Indications and usage: Hydrochlorothiazide capsules, USP are indicated in the management of hypertension either as the sole therapeutic agent, or in combination with other antihypertensives. Unlike potassium sparing combination diuretic products, hydrochlorothiazide capsules, USP may be used in those patients in whom the development of hyperkalemia cannot be risked, including patients taking ACE inhibitors. Usage in Pregnancy: The routine use of diuretics in an otherwise healthy woman is inappropriate and exposes mother and fetus to unnecessary hazard.
CLINICAL PHARMACOLOGY Hydrochlorothiazide blocks the reabsorption of sodium and chloride ions, and it thereby increases the quantity of sodium traversing the distal tubule and the volume of water excreted. A portion of the additional sodium presented to the distal tubule is exchanged there for potassium and hydrogen ions. With continued use of hydrochlorothiazide and depletion of sodium, compensatory mechanisms tend to increase this exchange and may produce excessive loss of potassium, hydrogen and chloride ions.
Systemic exposure to Hydrochlorothiazide reflects Oral fraction absorbed ranges from 79% to 91% (Hydrochlorothiazide 25) absorption kinetics and dual hepatorenal clearance pathway combining glucuronidation and urinary filtration of hydrochlorothiazide, sustaining receptor engagement across a Mean elimination half-life of 7 to 19 hours across adult Hydrochlorothiazide dosing half-life window (oral tmax achieved within 2 to 4 hours following hydrochlorothiazide ingestion response profile).
Dosing protocols (25 mg/1 Tablet or 12.5 mg/1 Capsule, Gelatin Coated or 12.5 mg/1 Capsule or 12.5 mg/1 Tablet or 50 mg/1 Tablet) balance efficacy (87.00% patient satisfaction across 17 logs) against dizziness (7% of reports), headache (5.8% of reports), fatigue (5.6% of reports), with strict avoidance in contraindications hydrochlorothiazide is contraindicated in patients with anuria.; hypersensitivity to this product or other sulfonamide derived drugs is also contraindicated..
Additive hyperkalemic or renal hemodynamic effects may emerge between Hydrochlorothiazide and RAAS therapy.
Verify medication reconciliation lists so Hydrochlorothiazide is not inadvertently duplicated with another thiazide diuretic.
Standard Adult Titration & Dosages
Absolute & Relative Contraindications
- CONTRAINDICATIONS Hydrochlorothiazide is contraindicated in patients with anuria.
- Hypersensitivity to this product or other sulfonamide derived drugs is also contraindicated.
Logged Side-Effect Incidence (17 Reports)
Hydrochlorothiazide Real-World Side Effects: openFDA FAERS vs. Patient Micro-Logs
Peer-Reviewed Human Clinical Trials & Meta-Analyses (Hydrochlorothiazide)
| Study & Plain-English Finding | Sample (N) | Rigor | Primary Source |
|---|---|---|---|
| New Insights on Safety profile of telmisartan as single-drug treatment or combined with: What a 8,023-Participant Study Found The consolidated data show that telmisartan +/- HCTZ are well tolerated in patients of all ages and have placebo-like tolerabilities. Blood pressure. Supplement • 2008-06-15 • Randomized Controlled Trial | N = 8,023 | 96/100 | PMID 18705533 ↗ |
| New Insights on Efficacy and Tolerability of Telmisartan/Amlodipine + Hydrochlorothiazide Versus: What a 310-Participant Study Found We randomized 310 patients to the treatment groups. Clinical therapeutics • 2018-01-15 • Phase III Randomized Trial | N = 310 | 93/100 | PMID 29248384 ↗ |
| Can This Approach Help? Inside the Latest Research on A noninferiority comparison of valsartan/hydrochlorothiazide combination versus The proportion of patients reporting side effects and the incidence of most events were similar in both treatment groups, although more patients treated with amlodipine reported peripheral edema (5.8% versus 1.7%; P=0.03) and... Hypertension (Dallas, Tex. : 1979) • 2005-09-15 • Randomized Controlled Trial | Multi-cohort | 88/100 | PMID 16116046 ↗ |
| Can This Approach Help? Inside the Latest Research on Comparative effect of canrenone or hydrochlorothiazide addition to These findings indicate that, despite similar BP-lowering effect, the addition of canrenone to valsartan/amlodipine combination was more effective in reducing UAE than HCTZ addition. Expert opinion on pharmacotherapy • 2014-03-15 • Randomized Controlled Trial | N = 120 | 88/100 | PMID 24410484 ↗ |
| Can This Approach Help? Inside the Latest Research on Add-on effect of hydrochlorothiazide 12.5 mg in Japanese subjects with essential L50/H12.5/A5 was well tolerated. Hypertension research : official journal of the Japanese Society of Hypertension • 2015-05-15 • Randomized Controlled Trial | Multi-cohort | 88/100 | PMID 25716649 ↗ |
Hydrochlorothiazide Public Price Transparency Ledger
| Dispensing Channel / Benchmark | Verification Source | Reference Cost | Details |
|---|---|---|---|
| Pharmacy Acquisition Cost (CMS NADAC) | CMS Medicaid NADAC Weekly National Survey | $0.0303/unit (~$0.91/30u) | Wholesale baseline |
| Mark Cuban Cost Plus Drugs (Mail-Order Generic) | Public Wholesale Price List (NADAC + 15% + pharmacy fee) | $5.25 / mo | Formulary listing ↗ |
| Average U.S. Walk-In Retail Cash Price | Chain Pharmacy Uninsured Cash Index | $34.50 / mo | Before coupon/insurance |
| Patient-Logged Out-of-Pocket Average | 17 Anonymous DotMD Community Micro-Logs | $7.50 / mo | View logs ↓ |
| Sesame Direct Cash-Pay Prescriber Network (Licensed Telehealth Cash Program) | State-licensed clinician review • ~1d mail fulfillment | $29.00 consult | Program details |
Hydrochlorothiazide Federal Verification & Benchmark Summary
| Metric | Verified Benchmark | Source |
|---|---|---|
| Hydrochlorothiazide RxNorm Concept ID | 199903 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $0.0303 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $34.50 / mo | U.S. Uninsured Retail Cash Index |
| Public Mail-Order Wholesale Benchmark | $5.25 / mo (Cost Plus Drugs) | Mark Cuban Cost Plus Public API |
| Real-World Patient Consensus | 87.00% Worth It (17 anonymous logs) | DotMD Zero-PHI Patient Ledger |
Hydrochlorothiazide Patient Community, Cohort Filters & Dosage Logs
Evidence synthesis for Hydrochlorothiazide: FDA labeling (2025-05-15, NDC 50090-6987), CYP/interaction screening, and public pharmacy acquisition costs.
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