ESIDREX ® is a hydrochlorothiazide-based drug
THERAPEUTIC GROUP: Diuretics / Thiazide diuretics
Indications ESIDREX ® Hydrochlorothiazide
ESIDREX ® is used in the treatment of edema of cardiac origin (mild or moderate congestive heart failure), ascites following liver cirrhosis, and renal diabetes insipidus.
ESIDREX ® either as monotherapy or combined with other antihypertensive drugs - can also be used in the treatment of hypertension.
Mechanism of action ESIDREX ® Hydrochlorothiazide
ESIDREX ® starting to carry out its diuretic action after about 2 hours and reaching maximum effectiveness at the fourth hour, can be easily taken orally.The diuretic effect of ESIDREX ® is due to the presence of hydrochlorothiazide, a benzothiazide active ingredient that can mainly increase the excretion of sodium and chlorine, but in second analysis also of potassium and magnesium, inhibiting the sodium / chlorine cotransporter expressed on the surface apical cells of the distal convoluted tubule of the nephron.
The diuretic action of ESIDREX ® is generally followed by a "direct antihypertensive action on vascular smooth muscle, mediated by the" increase in the exchange activity of the sodium / calcium channel. The "increased flow of this element from the muscle cell to the blood , accompanied by a reabsorption of cellular sodium, guarantees a better control of the spastic contraction of myofibrillar arteriolar cells.
At the end of its action, which lasts for about 6/12 hours, the hydrochlorothiazide is eliminated by the kidney.
Studies carried out and clinical efficacy
1. HYDROCHLOROTHIAZIDE IN ASSOCIATION: the new therapeutic response to hypertension
J Clin Hypertens (Greenwich). 2010 Jul 1; 12: 487-94.
Efficacy and safety of irbesartan / HCTZ in severe hypertension according to cardiometabolic factors.
Franklin SS, Neutel JM.
The efficacy of hydrochlorothiazide in the treatment of hypertension is now known, but all the new studies are aimed at finding the right combination between this active ingredient and other antihypertensive drugs, capable of guaranteeing a significant improvement in results. For example, in this study conducted on 468 patients with severe hypertension, at high cardiovascular risk treated with irbesartan / hydrochlorothiazide, a reduction in systolic blood pressure from 180mmHg to 150mmHg was observed in 73% of cases, only after 7 weeks of treatment.
2. "ABDOMINAL OBESITY: RISK FACTOR ALSO FOR SIDE EFFECTS FROM HYDROCHLOROTHIAZIDE
Hypertension. 2010 Jan; 55: 61-8. Epub 2009 Nov 16.
Impact of abdominal obesity on incidence of adverse metabolic effects associated with antihypertensive medications.
Cooper-DeHoff RM, Wen S, Beitelshees AL, Zineh I, Gums JG, Turner ST, Gong Y, Hall K, Parekh V, Chapman AB, Boerwinkle E, Johnson JA.
This very interesting study shows how abdominal obesity can not only increase the cardiovascular risk and the incidence of diseases such as hypertension, but also significantly affect the onset of side effects related to hydrochlorothiazide (antihypertensive drug). More precisely, among the in patients with abdominal obesity, the greatest number of episodes of hypertriglyceridemia and hyperglycemia was recorded, accompanied - in 6% of cases - also by manifest diabetes and hyperuricemia.
3. HYDROCHLOROTHIAZIDE AND OSTEPOROSIS
Osteoporos Int. 2007 Apr; 18: 479-86. Epub 2006 Nov 21.
The effect of treatment with a thiazide diuretic for 4 years on bone density in normal postmenopausal women.
Bolland MJ, Ames RW, Horne AM, Orr-Walker BJ, Gamble GD, Reid IR.
As known, among the antihypertensive action mechanisms of hydrochlorothiazide there is also the activation of the sodium / calcium exchanger on the surface of the smooth muscle fiber cells. This exchange inevitably translates into an increase in calcium levels and a greater availability of this element, which is particularly valuable for postmenopausal women.
Given the "side effect" of this antihypertensive drug, we tried to understand how much the hypercalcemic effect of hydrochlorothiazide could affect the fate of osteoporosis in 185 postmenopausal women.
The results obtained showed a significant - albeit slight - increase in cortical bone mineralization after 2 years of therapy, mainly in the limbs.
Method of use and dosage
ESIDREX ® 25mg tablets of hydrochlorothiazide: in the treatment of hypertension an initial attack dose of 1-2 tablets per day is suggested, taken in the morning with breakfast, followed by maintenance therapy with ½ daily tablet.
In the treatment of the oedematous condition, on the other hand, up to 3 tablets per day can be administered, provided they are divided into 2 daily doses, followed by a maintenance regimen with 1 tablet every other day.
In pathological conditions such as renal diabetes insipidus and hypercalciuria, even different dosages can be used depending on the therapeutic needs.
In any case, the correct dosage should be formulated by the doctor after a careful anamnestic evaluation and after having analyzed the severity of the disease and the extent of the therapeutic plan.
ESIDREX ® Hydrochlorothiazide warnings
Like all diuretics, before resorting to the administration of ESIDREX ® it would be advisable to carry out an evaluation of the plasma levels of the electrolytes, and if necessary to provide for their correction.
In diabetic patients it is necessary to administer the drug with particular care, as it may be necessary to adjust the dose of the hypoglycemic drug, given the hyperglycemic effect of hydrochlorothiazide. In hyperuremic patients, the haemoconcentration effect following the administration of ESIDREX ® could lead to an increase in gouty attacks.
Given the increased secretion of potassium, determined by the saluretic effect of hydrochlorothiazide, in order to avoid episodes of hypokalaemia, with consequent associated symptoms, it could be useful to combine pharmacological therapy with a diet rich in potassium.
It is also necessary to consider that diuretics, and in particular thiazide ones, expose the patient to potential hypokalaemia, with symptoms characterized by a significant decrease in perceptive and reactive abilities, which could make driving or use of machinery dangerous.
PREGNANCY AND BREASTFEEDING
The use of diuretics such as hydrochlorothiazide could cause an alteration of the normal blood flow to organs important for the growth of the fetus, compromising its development; therefore, the use of this drug is not recommended during the first trimester of pregnancy, and subsequently only under strict medical supervision.
Instead, it would be necessary to suspend breastfeeding during the therapeutic protocol
Interactions
ESIDREX ® could determine an increase in the side effects of lithium salts, reducing their excretion, and of curare derivatives.
The hypotensive action of this drug could be enhanced by the concomitant administration of other antihypertensives, alcohol or barbiturates, and inhibited by the concomitant administration of non-steroidal anti-inflammatory drugs.
The simultaneous intake of corticosteroids, on the other hand, could increase the loss of potassium and expose the patient to more or less severe symptoms depending on the extent of the loss.
Contraindications ESIDREX ® Hydrochlorothiazide
The administration of ESIDREX ® should be avoided in case of renal insufficiency and anuria (given the possible side effects deriving from excessive accumulation), in case of electrolyte imbalance and of course in case of hypersensitivity to one of the components of the drug.
Undesirable Effects - Side Effects
In case of hypersensitivity to one of the compounds present in ESIDREX ®, the drug could cause the onset of dermatological reactions such as skin rash, urticaria and in the most serious cases even cardio-respiratory symptoms.
More common, however, are adverse events of modest entity, such as gastrointestinal disorders, fatigue, asthenia and inappetence, however associated with possible disturbances of the hydro-electrolytic balance.
Finally, blood phenomena such as thrombocytopenia, leukopenia, agranulocytosis, anemia and haemoconcentration are more serious but decidedly less frequent.
Note
ESIDREX ® can only be sold under medical prescription.
The use of ESIDREX ® should always be done after consulting your doctor.
The indiscriminate use of ESIDREX ® among athletes and non-athletes, to search for the loss of a few kilos, exposes the body to serious side effects. Furthermore, it is always advisable to reiterate that weight loss is dictated by the elimination of liquids and salts and not by a real slimming effect, intended as a loss of fat mass.
Therefore ESIDREX ® is classified among the DOPING substances.
The information on ESIDREX ® Hydrochlorothiazide published on this page may be out of date or incomplete. For a correct use of this information, see the Disclaimer and useful information page.
