Hydrochlorothiazide

Generic name: hydrochlorothiazide · Brand names: Microzide, Oretic, Esidrix, Hydrodiuril, Zide

Quick facts

Drug class
Value
Thiazide Diuretic [EPC]
Source
openFDA label API count of openfda.pharm_class_epc for generic_name HYDROCHLOROTHIAZIDE (last_updated 2026-10-30)
Source url
https://api.fda.gov/drug/label.json?search=openfda.generic_name.exact:"HYDROCHLOROTHIAZIDE"&count=openfda.pharm_class_epc.exact
Rx or otc
Value
Rx only
Source
DailyMed label: 'Rx only'
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Forms and strengths
Text
Each tablet for oral administration contains 12.5 mg, 25 mg and 50 mg of hydrochlorothiazide USP respectively.
Section
DESCRIPTION
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Generic available
Value
Yes. Chosen label is an ANDA (ANDA040702) generic tablet label.
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Common use one line
Treats high blood pressure and edema (fluid buildup).
Scope note
Covers SINGLE-INGREDIENT hydrochlorothiazide TABLETS (12.5 mg, 25 mg, 50 mg) only. Hydrochlorothiazide capsules (separate DailyMed labels, e.g. Actavis, Westminster, Sciegen), oral solution and the many combination products (with ACE inhibitors, ARBs, beta blockers, spironolactone, triamterene and others) are NOT covered.

What it is used for

Hydrochlorothiazide helps treat edema (extra fluid) linked to heart failure, liver cirrhosis, and corticosteroid and estrogen therapy, and edema from kidney problems. It is also used for high blood pressure, alone or with other blood pressure medicines.
Section
INDICATIONS AND USAGE
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Hydrochlorothiazide tablets USP are indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. Hydrochlorothiazide tablets USP have also been found useful in edema due to various forms of renal dysfunction such as nephrotic syndrome, acute glomerulonephritis, and chronic renal failure. Hydrochlorothiazide tablets USP are indicated in the management of hypertension either as the sole therapeutic agent or to enhance the effectiveness of other antihypertensive drugs in the more severe forms of hypertension.

How it works

How thiazides lower blood pressure is unknown. Hydrochlorothiazide acts on the kidney to increase the loss of sodium and chloride in urine, and some potassium and bicarbonate may be lost too. After a dose, urine output starts within 2 hours, peaks in about 4 hours and lasts about 6 to12 hours.
Section
CLINICAL PHARMACOLOGY
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
The mechanism of the antihypertensive effect of thiazides is unknown. Hydrochlorothiazide does not usually affect normal blood pressure. Hydrochlorothiazide affects the distal renal tubular mechanism of electrolyte reabsorption. Hydrochlorothiazide increases excretion of sodium and chloride in approximately equivalent amounts. Natriuresis may be accompanied by some loss of potassium and bicarbonate. After oral use diuresis begins within 2 hours, peaks in about 4 hours and lasts about 6 to12 hours.

Dosage: adults

The prescriber sets the smallest dose that works. For edema, the usual adult dose is 25mg to 100 mg daily, as a single or divided dose, and many patients respond to dosing on alternate days or on 3 to 5 days each week. For high blood pressure, the usual starting dose is 25 mg once daily, and it may be raised to 50 mg daily. Doses above 50 mg are often associated with marked drops in potassium.
Section
DOSAGE AND ADMINISTRATION (Adults)
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Therapy should be individualized according to patient response. Use the smallest dosage necessary to achieve the required response. For Edema: The usual adult dosage is 25mg to 100 mg daily as a single or divided dose. Many patients with edema respond to intermittent therapy, i.e., administration on alternate days or on 3 to 5 days each week. For Control of Hypertension: The usual initial dose in adults is 25 mg daily given as a single dose. The dose may be increased to 50 mg daily, given as a single or two divided doses. Doses above 50 mg are often associated with marked reductions in serum potassium (see also PRECAUTIONS). Patients usually do not require doses in excess of 50 mg of hydrochlorothiazide daily when used concomitantly with other antihypertensive agents.

Dosage: children

For children the usual dose is 0.5 mg to 1 mg per pound (1 to 2 mg/kg) per day in one or two doses, not above 37.5 mg per day in infants up to 2 years or 100 mg per day in children 2 to 12 years. Infants under 6 months may need up to 1.5 mg per pound (3 mg/kg) per day in two doses. There are no well-controlled trials in children.
Section
DOSAGE AND ADMINISTRATION (Infants and Children); PRECAUTIONS (Pediatric Use)
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
For Diuresis and for Control of Hypertension: The usual pediatric dosage is 0.5 mg to 1 mg per pound (1 to 2 mg/kg) per day in single or two divided doses, not to exceed 37.5 mg per day in infants up to 2 years of age or 100 mg per day in children 2 to 12 years of age. In infants less than 6 months of age, doses up to 1.5 mg per pound (3 mg/kg) per day in two divided doses may be required. There are no well -controlled clinical trials in pediatric patients.

Dosage adjustments

Drug interaction caps
Antidiabetic drug doses may need adjusting. When used with other blood pressure medicines, patients usually do not need more than 50 mg of hydrochlorothiazide daily.
Section
PRECAUTIONS (Drug Interactions); DOSAGE AND ADMINISTRATION
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Antidiabetic Drugs (Oral Agents And Insulin): Dosage adjustment of the antidiabetic drug may be required. Patients usually do not require doses in excess of 50 mg of hydrochlorothiazide daily when used concomitantly with other antihypertensive agents.
Kidney
Section
WARNINGS; PRECAUTIONS (General)
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Use with caution in severe renal disease. In patients with renal disease, thiazides may precipitate azotemia. Cumulative effects of the drug may develop in patients with impaired renal function. If progressive renal impairment becomes evident, consider withholding or discontinuing diuretic therapy.
Liver
Section
WARNINGS
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Thiazides should be used with caution in patients with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma.
Elderly
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba

Missed dose

Take a missed dose when you remember. If it is almost time for the next dose, skip it. Do not take a double dose. (The DailyMed label has no missed-dose section.)
Section
What should I do if I forget a dose?
Source
MedlinePlus Hydrochlorothiazide (Last Revised - 02/15/2021)
Source url
https://medlineplus.gov/druginfo/meds/a682571.html
Source text (exact source wording)
Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Overdose

Overdose mostly causes electrolyte loss and dehydration from too much urine output, and low potassium may worsen heart rhythm problems in people on digitalis. Treatment is supportive. Poison control: 1-800-222-1222 (MedlinePlus).
Section
OVERDOSAGE
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Poison control
Source
MedlinePlus Hydrochlorothiazide (Last Revised - 02/15/2021)
Source url
https://medlineplus.gov/druginfo/meds/a682571.html
Source text (exact source wording)
In case of overdose, call the poison control helpline at 1-800-222-1222.
Source text (exact source wording)
The most common signs and symptoms observed are those caused by electrolyte depletion (hypokalemia, hypochloremia, hyponatremia) and dehydration resulting from excessive diuresis. If digitalis has also been administered, hypokalemia may accentuate cardiac arrhythmias. In the event of overdosage, symptomatic and supportive measures should be employed. Emesis should be induced or gastric lavage performed. Correct dehydration, electrolyte imbalance, hepatic coma and hypotension by established procedures. If required, give oxygen or artificial respiration for respiratory impairment. The degree to which hydrochlorothiazide is removed by hemodialysis has not been established.

Storage

Store at 20° to 25°C (68° to 77°F) in a well-closed container, and keep out of the reach of children. This is the labeler's text. MedlinePlus separately says to store away from excess heat and moisture (not in the bathroom).
Section
HOW SUPPLIED (Leading Pharma label)
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Dispense in a well-closed container as defined in the USP, with a child-resistant closure (as required). Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature]. KEEP THIS AND ALL MEDICATIONS OUT OF THE REACH OF CHILDREN.

Boxed warning

The label has no boxed warning.
Present
NONE (no boxed warning section found in the label text)
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display

Contraindications

Do not use it if you make no urine (anuria) or are allergic to it or to other sulfonamide-derived drugs.
Section
CONTRAINDICATIONS
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Anuria. Hypersensitivity to this product or to other sulfonamide-derived drugs.

Warnings and precautions

Use with caution in severe kidney disease; thiazides may cause azotemia and the drug can build up.
Heading
Severe renal disease
Section
WARNINGS
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Use with caution in severe renal disease. In patients with renal disease, thiazides may precipitate azotemia. Cumulative effects of the drug may develop in patients with impaired renal function.
Use with caution with liver disease; small fluid and electrolyte changes may cause hepatic coma.
Heading
Impaired hepatic function
Section
WARNINGS
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Thiazides should be used with caution in patients with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma.
Thiazides add to other blood pressure medicines. Allergic-type reactions can occur even without a history of allergy or asthma. Lupus may flare. Lithium generally should not be given with diuretics.
Heading
Other antihypertensives, sensitivity reactions, lupus, lithium
Section
WARNINGS
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Thiazides may add to or potentiate the action of other antihypertensive drugs. Sensitivity reactions may occur in patients with or without a history of allergy or bronchial asthma. The possibility of exacerbation or activation of systemic lupus erythematosus has been reported. Lithium generally should not be given with diuretics.
It can cause sudden near-sightedness and angle-closure glaucoma, with decreased vision or eye pain within hours to weeks of starting. Untreated, it can lead to permanent vision loss. The main treatment is to stop the drug quickly. A history of sulfonamide or penicillin allergy may be a risk factor.
Heading
Acute myopia and secondary angle-closure glaucoma
Section
WARNINGS
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Hydrochlorothiazide, a sulfonamide, can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma. Symptoms include acute onset of decreased visual acuity or ocular pain and typically occur within hours to weeks of drug initiation., Untreated acute angle-closure glaucoma can lead to permanent vision loss. The primary treatment is to discontinue hydrochlorothiazide as rapidly as possible. Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy.
Patients should be watched for fluid or electrolyte imbalance. Signs include dry mouth, thirst, weakness, drowsiness, confusion, seizures, muscle cramps, low blood pressure, fast heartbeat, nausea and vomiting. Low potassium can cause heart rhythm problems and worsen digitalis effects.
Heading
Fluid and electrolyte imbalance; hypokalemia
Section
PRECAUTIONS - General
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
All patients receiving diuretic therapy should be observed for evidence of fluid or electrolyte imbalance: namely, hyponatremia, hypochloremic alkalosis, and hypokalemia. Warning signs or symptoms of fluid and electrolyte imbalance, irrespective of cause, include dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, confusion, seizures, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia and gastrointestinal disturbances such as nausea and vomiting. Hypokalemia may develop, especially with brisk diuresis, when severe cirrhosis is present or after prolonged therapy. Hypokalemia may cause cardiac arrhythmia and may also sensitize or exaggerate the response of the heart to the toxic effects of digitalis (e.g., increased ventricular irritability).
Thiazides can raise uric acid and trigger gout, raise blood sugar, lower magnesium, reduce calcium loss in urine, and raise cholesterol and triglycerides. Diabetes medicine doses may need adjusting. Thiazides should be stopped before parathyroid function tests.
Heading
Gout, diabetes, calcium, magnesium and lipids
Section
PRECAUTIONS - General
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Hyperuricemia may occur or acute gout may be precipitated in certain patients receiving thiazides. In diabetic patients dosage adjustments of insulin or oral hypoglycemic agents may be required. Hyperglycemia may occur with thiazide diuretics. Thiazides have been shown to increase the urinary excretion of magnesium; this may result in hypomagnesemia. Thiazides may decrease urinary calcium excretion. Thiazides should be discontinued before carrying out tests for parathyroid function. Increases in cholesterol and triglyceride levels may be associated with thiazide diuretic therapy.
Hydrochlorothiazide is linked to a higher risk of non-melanoma skin cancer, mainly squamous cell carcinoma. The added risk was about 1 case per 16,000 patients per year overall and about 1 case for every 6,700 patients per year in white patients with cumulative doses of ≥50,000 mg. Protect skin from the sun and get regular skin cancer screening.
Heading
Non-melanoma skin cancer
Section
PRECAUTIONS - Information for Patients; ADVERSE REACTIONS - Postmarketing Experience
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Non-melanoma Skin Cancer: Instruct patients taking hydrochlorothiazide to protect skin from the sun and undergo regular skin cancer screening. Hydrochlorothiazide is associated with an increased risk of non-melanoma skin cancer. In a study conducted in the Sentinel System, increased risk was predominantly for squamous cell carcinoma (SCC) and in white patients taking large cumulative doses. The increased risk for SCC in the overall population was approximately 1 additional case per 16,000 patients per year, and for white patients taking a cumulative dose of ≥50,000 mg the risk increase was approximately 1 additional SCC case for every 6,700 patients per year.
Blood electrolytes should be checked periodically.
Heading
Laboratory monitoring
Section
PRECAUTIONS - Laboratory Tests
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Periodic determination of serum electrolytes to detect possible electrolyte imbalance should be done at appropriate intervals.

Pregnancy and breastfeeding

Pregnancy
There are no adequate studies in pregnant women, so use during pregnancy only if clearly needed. Thiazides cross the placenta and carry a risk of jaundice and low platelets in the fetus or newborn. Routine diuretic use in normal pregnancy is inappropriate.
Section
PRECAUTIONS - Pregnancy; INDICATIONS AND USAGE - Use in pregnancy
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Thiazides cross the placental barrier and appear in cord blood. There is a risk of fetal or neonatal jaundice, thrombocytopenia, and possibly other adverse reactions that have occurred in adults. Routine use of diuretics during normal pregnancy is inappropriate and exposes mother and fetus to unnecessary hazard.
Breastfeeding
Thiazides pass into breast milk. A decision should be made to stop nursing or stop the drug, based on how important the drug is to the mother.
Section
PRECAUTIONS - Nursing Mothers
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Thiazides are excreted in breast milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue hydrochlorothiazide, taking into account the importance of the drug to the mother.
Medlineplus
Tell your doctor if you are pregnant, plan to be, or are breastfeeding, and call right away if you become pregnant.
Section
What special precautions should I follow?
Source
MedlinePlus Hydrochlorothiazide (Last Revised - 02/15/2021)
Source url
https://medlineplus.gov/druginfo/meds/a682571.html
Source text (exact source wording)
tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking hydrochlorothiazide, call your doctor immediately.

Side effects

Common
The label does not say which reactions are most common, so none are listed as common from the label.
Section
ADVERSE REACTIONS
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Medlineplus tell doctor if severe
MedlinePlus lists frequent urination, diarrhea, loss of appetite, headache and hair loss as side effects to report if severe or persistent.
Section
What side effects can this medication cause?
Source
MedlinePlus Hydrochlorothiazide (Last Revised - 02/15/2021)
Source url
https://medlineplus.gov/druginfo/meds/a682571.html
Source text (exact source wording)
Tell your doctor if any of these symptoms are severe or do not go away: frequent urination; diarrhea; loss of appetite; headache; hair loss
Less common
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Label full list
The label lists reactions by body system, from most severe to least severe, without saying how often they occur.
Section
ADVERSE REACTIONS
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Body as a Whole: Weakness. Cardiovascular: Hypotension including orthostatic hypotension (may be aggravated by alcohol, barbiturates, narcotics or antihypertensive drugs). Digestive: Pancreatitis, jaundice (intrahepatic cholestatic jaundice), diarrhea, vomiting, sialadenitis, cramping, constipation, gastric irritation, nausea, anorexia. Hematologic: Aplastic anemia, agranulocytosis, leucopenia, hemolytic anemia, thrombocytopenia. Hypersensitivity: Anaphylactic reactions, necrotizing angiitis (vasculitis and cutaneous vasculitis), respiratory distress including pneumonitis and pulmonary edema, photosensitivity, fever, urticaria, rash, purpura. Metabolic: Electrolyte imbalance (see PRECAUTIONS ), hyperglycemia, glycosuria, hyperuricemia. Musculoskeletal: Muscle spasm. Nervous System/Psychiatric: Vertigo, paresthesias, dizziness, headache, restlessness. Renal: Renal failure, renal dysfunction, interstitial nephritis (see WARNINGS). Skin: Erythema multiforme including Stevens-Johnson syndrome, exfoliative dermatitis including toxic epidermal necrolysis, alopecia. Special Senses: Transient blurred vision, xanthopsia. Urogenital: Impotence. Whenever adverse reactions are moderate or severe, thiazide dosage should be reduced or therapy withdrawn.
Serious
Label
Serious reactions in the label include pancreatitis, blood disorders, severe allergic reactions, lung and kidney problems, serious skin reactions, sudden eye problems and non-melanoma skin cancer.
Section
ADVERSE REACTIONS; WARNINGS
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Pancreatitis; aplastic anemia, agranulocytosis, hemolytic anemia, thrombocytopenia; anaphylactic reactions, necrotizing angiitis; respiratory distress including pneumonitis and pulmonary edema; renal failure, interstitial nephritis; erythema multiforme including Stevens-Johnson syndrome, exfoliative dermatitis including toxic epidermal necrolysis; acute transient myopia and acute angle-closure glaucoma; non-melanoma skin cancer.
Medlineplus
MedlinePlus says to call your doctor right away or get emergency help for these symptoms.
Section
What side effects can this medication cause?
Source
MedlinePlus Hydrochlorothiazide (Last Revised - 02/15/2021)
Source url
https://medlineplus.gov/druginfo/meds/a682571.html
Source text (exact source wording)
If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: dry mouth; thirst; nausea; vomiting; weakness, tiredness; drowsiness; restlessness; confusion; muscle weakness, pain, or cramps; fast heartbeat and other signs of dehydration and electrolyte imbalance; blisters or peeling skin; hives; rash; itching; difficulty breathing or swallowing; fever, sore throat, chills, and other signs of infection; unusual bleeding or bruising; ongoing pain that begins in the stomach area, but may spread to the back; joint pain or swelling; changes in vision, eye pain, or swelling or redness in or around the eye
Reporting
You may report side effects to FDA at 1-800-FDA-1088.

Interactions

Drugs
May worsen dizziness or fainting on standing.
Name
Barbiturates or narcotics
Section
PRECAUTIONS - Drug Interactions
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Alcohol, Barbiturates or Narcotics: Potentiation of orthostatic hypotension may occur.
Diabetes medicine doses may need adjusting.
Name
Antidiabetic drugs (oral agents and insulin)
Section
PRECAUTIONS - Drug Interactions
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Dosage adjustment of the antidiabetic drug may be required.
Blood-pressure-lowering effects add together.
Name
Other antihypertensive drugs
Section
PRECAUTIONS - Drug Interactions
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Additive effect or potentiation.
These resins bind hydrochlorothiazide and reduce its absorption by up to 85% (cholestyramine) and 43% (colestipol).
Name
Cholestyramine and colestipol resins
Section
PRECAUTIONS - Drug Interactions
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or cholestipol resins bind the hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85% and 43%, respectively.
Low potassium and other electrolyte loss can be worse.
Name
Corticosteroids, ACTH
Section
PRECAUTIONS - Drug Interactions
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Intensified electrolyte depletion, particularly hypokalemia.
Response may be slightly lower, but they can still be used.
Name
Pressor amines (e.g. norepinephrine)
Section
PRECAUTIONS - Drug Interactions
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Possible decreased response to pressor amines but not sufficient to preclude their use.
The muscle relaxant may work more strongly.
Name
Nondepolarizing skeletal muscle relaxants (e.g. tubocurarine)
Section
PRECAUTIONS - Drug Interactions
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Possible increased responsiveness to the muscle relaxant.
Generally should not be given with diuretics because of a high risk of lithium toxicity.
Name
Lithium
Section
PRECAUTIONS - Drug Interactions
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Generally should not be given with diuretics. Diuretic agents reduce the renal clearance of lithium and add a high risk of lithium toxicity.
NSAIDs may weaken the water-pill and blood-pressure effects in some patients.
Name
Non-steroidal anti-inflammatory drugs (NSAIDs)
Section
PRECAUTIONS - Drug Interactions
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
In some patients, the administration of a non-steroidal anti-inflammatory agent can reduce the diuretic, natriuretic and antihypertensive effects of loop, potassium-sparing and thiazide diuretics.
Thiazides should be stopped before parathyroid function tests.
Name
Parathyroid function tests
Section
PRECAUTIONS - Drug Interactions
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Thiazides should be discontinued before carrying out tests for parathyroid function.
Food and alcohol
Alcohol may worsen dizziness or fainting when standing up.
Name
Alcohol
Section
PRECAUTIONS - Drug Interactions; MedlinePlus
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba and MedlinePlus Hydrochlorothiazide (Last Revised - 02/15/2021)
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Alcohol, Barbiturates or Narcotics: Potentiation of orthostatic hypotension may occur. (label) Alcohol can add to these side effects. (MedlinePlus)
Follow any low-salt or potassium-rich diet your doctor gives you.
Name
Low-salt / potassium-rich foods
Section
What special dietary instructions should I follow?
Source
MedlinePlus Hydrochlorothiazide (Last Revised - 02/15/2021)
Source url
https://medlineplus.gov/druginfo/meds/a682571.html
Source text (exact source wording)
If your doctor prescribes a low-salt or low-sodium diet, or to eat or drink increased amounts of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice) in your diet, follow these instructions carefully.
Name
Grapefruit
Other
NSAIDs such as ibuprofen and naproxen may interact with hydrochlorothiazide.
Name
Nonprescription NSAIDs
Section
What special precautions should I follow?
Source
MedlinePlus Hydrochlorothiazide (Last Revised - 02/15/2021)
Source url
https://medlineplus.gov/druginfo/meds/a682571.html
Source text (exact source wording)
the following nonprescription products may interact with hydrochlorothiazide: nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve).
MedlinePlus says to take cholestyramine or colestipol 1 hour before or 4 hours after hydrochlorothiazide.
Name
Cholestyramine/colestipol timing
Section
What special precautions should I follow?
Source
MedlinePlus Hydrochlorothiazide (Last Revised - 02/15/2021)
Source url
https://medlineplus.gov/druginfo/meds/a682571.html
Source text (exact source wording)
if you are taking cholestyramine or colestipol, take them 1 hour before or 4 hours after taking hydrochlorothiazide.

Patient tips

Label
Protect your skin from the sun and get regular skin cancer screening. (This label has no Patient Information or Medication Guide section.)
Section
PRECAUTIONS - Information for Patients
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Source url
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=8c868894-667e-4a51-906a-838d63e420ba&type=display
Source text (exact source wording)
Non-melanoma Skin Cancer: Instruct patients taking hydrochlorothiazide to protect skin from the sun and undergo regular skin cancer screening.
Medlineplus
It controls but does not cure high blood pressure. Keep taking it even if you feel well and do not stop without talking to your doctor. Stand up slowly, avoid too much alcohol, and keep your appointments, blood pressure checks and blood tests.
Section
How should this medicine be used? / What special precautions should I follow?
Source
MedlinePlus Hydrochlorothiazide (Last Revised - 02/15/2021)
Source url
https://medlineplus.gov/druginfo/meds/a682571.html
Source text (exact source wording)
Hydrochlorothiazide controls high blood pressure but does not cure it. Continue to take hydrochlorothiazide even if you feel well. Do not stop taking hydrochlorothiazide without talking to your doctor. you should know that hydrochlorothiazide may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. Alcohol can add to these side effects. Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly, and blood tests should be done occasionally.

Alternatives

Class
Thiazide Diuretic [EPC]
Class source
openFDA label API (openfda.pharm_class_epc)
Class source url
https://api.fda.gov/drug/label.json?search=openfda.pharm_class_epc.exact:"Thiazide Diuretic [EPC]"&count=openfda.generic_name.exact&limit=12
Indication source
Not checked.

Frequently asked questions

Question
What is hydrochlorothiazide used for?
Answer
It is used as adjunctive therapy in edema linked to congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy, for edema from kidney problems, and in managing hypertension, alone or to enhance other blood pressure medicines.
Source section
INDICATIONS AND USAGE
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Question
What is the usual dose for high blood pressure?
Answer
The label says the usual initial dose in adults is 25 mg daily as a single dose, which may be increased to 50 mg daily as a single or two divided doses. Doses above 50 mg are often associated with marked reductions in potassium. Your prescriber sets your dose.
Source section
DOSAGE AND ADMINISTRATION
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Question
What should I do if I miss a dose?
Answer
Take it when you remember. If it is almost time for the next dose, skip the missed one. Do not take a double dose.
Source section
What should I do if I forget a dose?
Source
MedlinePlus Hydrochlorothiazide
Question
Can I drink alcohol with hydrochlorothiazide?
Answer
Alcohol can add to dizziness and fainting. The label says alcohol, barbiturates or narcotics may potentiate orthostatic hypotension.
Source section
PRECAUTIONS - Drug Interactions; MedlinePlus
Source
DailyMed label and MedlinePlus
Question
Does hydrochlorothiazide raise skin cancer risk?
Answer
Yes. The label says hydrochlorothiazide is associated with an increased risk of non-melanoma skin cancer and tells patients to protect their skin from the sun and get regular skin cancer screening.
Source section
PRECAUTIONS; ADVERSE REACTIONS - Postmarketing Experience
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Question
Is it safe in pregnancy or breastfeeding?
Answer
There are no adequate studies in pregnant women, so it should be used only if clearly needed. Thiazides appear in breast milk, and a decision should be made to stop nursing or the drug.
Source section
PRECAUTIONS - Pregnancy; Nursing Mothers
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Question
What should I not combine with hydrochlorothiazide?
Answer
Lithium generally should not be given with diuretics. NSAIDs may reduce its effect, cholestyramine and colestipol reduce its absorption, and antidiabetic drugs may need dose changes.
Source section
PRECAUTIONS - Drug Interactions
Source
DailyMed label, Leading Pharma, LLC hydrochlorothiazide tablets, set ID 8c868894-667e-4a51-906a-838d63e420ba
Question
Should I stop it when I feel well?
Answer
No. MedlinePlus says it controls but does not cure high blood pressure, to keep taking it even if you feel well, and not to stop without talking to your doctor.
Source section
How should this medicine be used?
Source
MedlinePlus Hydrochlorothiazide

Sources

  • DailyMed hydrochlorothiazide tablets, Leading Pharma, LLC (chosen label)
    Set id: 8c868894-667e-4a51-906a-838d63e420ba · Label effective or revised date: Revised: 6/2026 (manufacturer revision code Rev.07 01/26) · Dailymed version date: Jun 15, 2026 (DailyMed list publish date) · Fetched at: 2026-11-03 · Sections used: DESCRIPTION, CLINICAL PHARMACOLOGY, INDICATIONS AND USAGE, CONTRAINDICATIONS, WARNINGS, PRECAUTIONS, ADVERSE REACTIONS, OVERDOSAGE, DOSAGE AND ADMINISTRATION, HOW SUPPLIED
  • MedlinePlus Hydrochlorothiazide
    Label effective or revised date: Last Revised - 02/15/2021 · Fetched at: 2026-11-03 · Sections used: all patient sections
  • openFDA drug label API (class)
    Label effective or revised date: API last_updated 2026-10-30 · Fetched at: 2026-11-03 · Sections used: pharm_class_epc
  • Drugs@FDA
    Label effective or revised date: NOT FOUND (not searched) · Fetched at: 2026-11-03 · Sections used: none

Information is taken from the cited sources and is for general reference only. It is not medical advice. Report side effects to FDA MedWatch at 1-800-FDA-1088. For a poison emergency call 1-800-222-1222. See prices for this drug