Adjunctive therapy for edema associated with CHF, hepatic cirrhosis, renal function impairment, and corticosteroid and estrogen therapy; treatment of hypertension.
Therapy for nephrogenic diabetes insipidus.
Diuresis (tablets only)
Children (6 mo to 12 y of age): PO 1 to 2 mg/kg/day in single or 2 divided doses. Max dose for children 2 to 12 y of age is 100 mg/day; for 6 mo to 2 y of age is 37.5 mg/day.
Edema (tablets only)
Adults: PO 25 to 100 mg/day as a single or divided dose.
Adults: PO 25 to 50 mg/day as a single dose or 2 divided doses.
Children (6 mo to 12 y of age): PO 1 to 2 mg/kg/day in a single dose or 2 divided doses. Max dose for children 2 to 12 y of age is 100 mg/day; for 6 mo to 2 y of age is 37.5 mg/day.
Infants (younger than 6 mo): PO Doses up to 3 mg/kg/day in 2 divided doses may be required.
Adults: PO 12.5 mg daily (max, 50 mg/day) given alone or in combination with other antihypertensives.
Store tablets in tightly closed container at 15° to 30°C (59° to 86°F).
Enhances excretion of sodium, chloride, and water by interfering with transport of sodium ions across renal tubular epithelium.
CV: Orthostatic hypotension.
CNS: Dizziness, headache, insomnia, light-headedness, paresthesias, restlessness, vertigo, weakness.
DERM: Alopecia, erythema multiforme, exfoliative dermatitis, necrotizing angiitis (vasculitis and cutaneous vasculitis), photosensitivity, purpura, rash, Stevens-Johnson syndrome, TEN, urticaria.
EENT: Blurred vision, xanthopsia (yellow vision).
GI: Abdominal pain or cramping, anorexia, bloating, constipation, diarrhea, gastric irritation, nausea, pancreatitis, sialadenitis, vomiting.
GU: Impotence, interstitial nephritis, reduced libido.
HEMA: Agranulocytosis, aplastic or hypoplastic anemia, hemolytic anemia, leukopenia, thrombocytopenia.
METAB: Electrolyte imbalance, glycosuria, hyperglycemia, hyperuricemia.
RESP: Pneumonitis, pulmonary edema, respiratory distress.
OTHER: Anaphylactic reactions, fever, muscle cramp or spasm.
Bile acid sequestrants
May reduce thiazide absorption; give thiazide at least 2 h before resin.
May cause hyperglycemia.
Diuretic-induced hypokalemia and hypomagnesemia may precipitate digitalis-induced arrhythmias.
May decrease hypoglycemic effect of sulfonylureas. May need to increase dosage of sulfonylureas or insulin.
May decrease renal excretion of lithium.
Synergistic effects may result in profound diuresis and serious electrolyte abnormalities.
Therapeutic Classification: antihypertensives, diuretics
Absorption: Rapidly absorbed after oral administration.
Distribution: Distributed into extracellular space; crosses the placenta and enters breast milk.
Metabolism/Excretion: Excreted mainly unchanged by the kidneys.
Half-life: 6–15 hr.
Onset of antihypertensive effect is 3–4 days and does not become maximal for 7–14 days of dosing.
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