Hydrochlorothiazide

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jul 13, 2022

Warnings

What are the risks of taking Hydrochlorothiazide?

Hydrochlorothiazide can cause serious health problems, especially in certain high-risk patients. Some of the risks of hydrochlorothiazide use include:

VISION CHANGES: Taking hydrochlorothiazide can lead to eye conditions called acute transient myopia and acute angle-closure glaucoma. Vision changes due to these eye conditions can occur within weeks or months of first using hydrochlorothiazide. Surgery may be required in some patients to prevent permanent vision loss. People who have an allergy to penicillin or sulfa drugs are at increased risk of this happening. Stop taking hydrochlorothiazide and contact your doctor immediately if you experience eye pain or vision changes.
DEHYDRATION AND ELECTROLYTE IMBALANCE: Hydrochlorothiazide causes you to make more urine. This can lead to dehydration and low levels of serum electrolytes like sodium, potassium, chloride, and magnesium in the body. The risk is higher in hot weather and for people with poor kidney function. Tell your doctor if you experience dry mouth, excessive thirst, dizziness, tiredness, weakness, muscle pain, muscle cramps, nausea, vomiting, or increased heart rate while on hydrochlorothiazide.
INCREASE IN BLOOD SUGAR LEVELS: Hydrochlorothiazide can lead to an increase in blood glucose levels. People with diabetes may need to check their blood sugar more frequently while on hydrochlorothiazide and contact their doctor if blood sugar levels are persistently higher or lower than usual.
PARATHYROID DISEASE: Hydrochlorothiazide makes the body retain calcium, which can affect the parathyroid glands.
GOUT: Taking hydrochlorothiazide can raise uric acid levels and cause worsening of gout in people with a history of gout or kidney problems. If you are at a high risk of complications or adverse effects from hydrochlorothiazide use, your doctor or pharmacist can help you find other antihypertensive agents.

Precautions Before Starting Hydrochlorothiazide

Tell your doctor if you have ever had an allergic reaction to hydrochlorothiazide, penicillin, sulfa drugs, or other medications. Your pharmacy can give you a list of ingredients in hydrochlorothiazide tablets and capsules.

Give your healthcare provider a complete medical history. Hydrochlorothiazide may not be right for people with certain medical conditions such as kidney failure, kidney disease, asthma, diabetes, gout, systemic lupus erythematosus (SLE), high cholesterol, or liver disease.

Give your doctor a complete list of all your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid serious interactions between hydrochlorothiazide and other drugs.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

What precautions should I take while on lisinopril Hydrochlorothiazide?

Keep all your medical and lab appointments while on hydrochlorothiazide. Your doctor may want to order certain medical tests while you are on this medication.

Tell your doctors you are taking hydrochlorothiazide, especially before any surgery, including dental procedures.

If you are taking a cholesterol-lowering medication called colestipol or cholestyramine, be sure to take it 1 hour before or 4 hours after your hydrochlorothiazide capsule or oral tablet.

Your doctor may ask you to eat a low-sodium (low-salt) diet to help lower blood pressure. They may also ask you to increase the amount of potassium-rich foods such as bananas, orange juice, raisins, and prunes in your diet. This is because hydrochlorothiazide can cause serum potassium depletion. Follow these dietary instructions carefully.

Call your doctor if you become pregnant while on hydrochlorothiazide.

Hydrochlorothiazide can cause dizziness as a side effect. Do not drive or operate heavy machinery until you know how this medicine affects you. Arise slowly from a sitting or lying position to prevent dizziness.

Hydrochlorothiazide can make your skin more sensitive to sunlight and increase your risk of some types of skin cancer. Avoid unnecessary sun exposure and wear protective clothing, sunscreen, and sunglasses while on this medicine. Keep all appointments with your dermatologist for skin checks. Call your doctor if you notice any new skin growths or changes.

What drugs can interact with Hydrochlorothiazide?

Taking hydrochlorothiazide with other medicines can affect how each of the medications works. Interactions between certain drugs can also increase the risk of serious side effects. Your physician may choose a different drug combination, change the dose or frequency of one or both medicines, and/or closely monitor you for side effects if there are known interactions between hydrochlorothiazide and your other drugs.

There can be possible drug interactions between hydrochlorothiazide and the following medications:

Corticosteroids
Corticotropin (H.P., ACTH, Acthar Gel)
Barbiturates like phenobarbital and secobarbital (Seconal)
Lithium (Lithobid, Eskalith)
Insulin and oral diabetes medications
Other medications for high blood pressure
Pain medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Naprosyn, Aleve) and ibuprofen (Motrin, Advil)

This list does not describe all possible hydrochlorothiazide drug interactions. Before your doctor prescribes hydrochlorothiazide, give them a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products.

Also, tell your doctor if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription drugs.

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