Pronunciation:

(in DAP a mide)

U.S. Brand Names:

Generic Available:

Canadian Brand Names:

Use:

Pregnancy Risk Factor:

Lactation:

Contraindications:

Warnings/Precautions:

Chemical similarities are present among sulfonamides, sulfonylureas, carbonic anhydrase inhibitors, thiazides, and loop diuretics (except ethacrynic acid). Use in patients with thiazide or sulfonamide allergy is specifically contraindicated in product labeling, however, a risk of cross-reaction exists in patients with allergy to any of these compounds; avoid use when previous reaction has been severe.

Adverse Reactions:

1% to 10%:

Cardiovascular: Orthostatic hypotension, palpitation (<5%), flushing

Central nervous system: Dizziness (<5%), lightheadedness (<5%), vertigo (<5%), headache (5%), restlessness (<5%), drowsiness (<5%), fatigue, lethargy, malaise, lassitude, anxiety, agitation, depression, nervousness (5%)

Dermatologic: Rash (<5%), pruritus (<5%), hives (<5%)

Endocrine & metabolic: Hyperglycemia (<5%), hyperuricemia (<5%)

Gastrointestinal: Anorexia, gastric irritation, nausea, vomiting, abdominal pain, cramping, bloating, diarrhea, constipation, dry mouth, weight loss

Genitourinary: Nocturia, frequent urination, polyuria, impotence (<5%), reduced libido (<5%), glycosuria (<5%)

Neuromuscular & skeletal: Muscle cramps, spasm, weakness (5%)

Ocular: Blurred vision (<5%)

Renal: Necrotizing angiitis, vasculitis, cutaneous vasculitis (<5%)

Respiratory: Rhinorrhea (<5%)

<1% (Limited to important or life-threatening symptoms, and/or postmarketing reports): Hepatitis, hypercalcemia, jaundice, liver function test abnormality, pancreatitis, purpura

Overdosage/Toxicology:

Drug Interactions:

ACE inhibitors: Increased hypotension if aggressively diuresed with a thiazide diuretic.

Beta-blockers increase hyperglycemic effects in type 2 diabetes mellitus (noninsulin dependent, NIDDM)

Cyclosporine and thiazides can increase the risk of gout or renal toxicity; avoid concurrent use.

Digoxin toxicity can be exacerbated if a thiazide induces hypokalemia or hypomagnesemia.

Lithium toxicity can occur by reducing renal excretion of lithium; monitor lithium concentration and adjust as needed.

Neuromuscular blocking agents can prolong blockade; monitor serum potassium and neuromuscular status.

NSAIDs can decrease the efficacy of thiazides reducing the diuretic and antihypertensive effects.

Ethanol/Nutrition/Herb Interactions:

Mechanism of Action:

Pharmacodynamics/Kinetics:

Onset of action: 1-2 hours

Duration: 36 hours

Absorption: Complete

Protein binding, plasma: 71% to 79%

Metabolism: Extensively hepatic

Half-life elimination: 14-18 hours

Time to peak: 2-2.5 hours

Excretion: Urine (~60%) within 48 hours; feces (~16% to 23%)

Dosage:

Edema: 2.5-5 mg/day. Note: There is little therapeutic benefit to increasing the dose >5 mg/day; there is, however, an increased risk of electrolyte disturbances

Hypertension: 1.25 mg in the morning, may increase to 5 mg/day by increments of 1.25-2.5 mg; consider adding another antihypertensive and decreasing the dose if response is not adequate

Monitoring Parameters:

Dietary Considerations:

Patient Education:

Nursing Implications:

Cardiovascular Considerations:

Dental Health: Effects on Dental Treatment:

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

Mental Health: Effects on Mental Status:

Mental Health: Effects on Psychiatric Treatment:

Dosage Forms:

Tablet: 1.25 mg, 2.5 mg

Lozol®: 1.25 mg

International Brand Names: