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Hydrochlorothiazide is a long-established prescription diuretic commonly used in the management of raised blood pressure and conditions with excess fluid. The active compound in these tablets is hydrochlorothiazide, a member of the thiazide group.
It can be prescribed on its own or combined with other antihypertensive agents. Route, dose and duration are decided by the prescriber after reviewing the patient’s medical history and response to treatment. For details on dosing see how to respond to it.
What Hydrochlorothiazide Treats
Regular symptoms include:
- Fluid accumulation due to heart failure or other causes
- The condition of high blood pressure, i.e. hypertension
- Fluid retention from liver cirrhosis or some kidney disorders
- Swelling that can arise as a side effect of medicines such as corticosteroids or oestrogens
Decisions about suitability should always follow a clinician consultation. Use the navigation to return to the first place: Return to the previous step top.
Strengths and shapes that are on offer
In the UK the most common tablet strengths supplied are:
- 25 mg
- a quantity of 12.5 mg
Depending on clinical need, prescribers may adjust the dose or select combination products with other antihypertensives. For a different path drugs and comparisons see a rival option drug options and related pharmaceuticals.
Tips on the proper use of hydrochlorothiazide under medical guidance
- Wash the pills down with water. They may be taken with food or on an empty stomach as directed by your prescriber.
- Because the drug increases urine output, many patients take it in the morning or before 6 pm to avoid night-time trips to the toilet.
- Do not start potassium supplements or large diet changes without discussing this with your clinician; they may prescribe supplements when needed.
- If you are unsure about timing, positive the process of interactions enhance user satisfaction., or forgot to take the doses consult your pharmacist or doctor. See support on the dose was skipped situations for what to do if you forget a tablet.
Drug classification and action the mechanism involved of Action
Hydrochlorothiazide belongs to thiazide diuretics. It works in the kidney, reducing reabsorption of sodium and chloride in the distal convoluted tubule. This causes increased urine production, a reduction in circulating fluid volume and, over time, a lowering of blood pressure and a reduction in swelling.
For information on constant monitoring and maximum potential unintended consequences, see warning notices and precautionary steps and ill effects that may occur.
Missed an entire dose
If you regularly take hydrochlorothiazide and miss a dose, take it when you remember unless the next dose is due soon. Do not double your dose to catch up on a missed tablet.
If you are taking it intermittently or have specific dosing instructions from your prescriber, follow those directions. When in doubt contact your healthcare provider or pharmacist.
Storage module
- Store at around 20 to 25 degrees C. Short excursions between 15 and 30 degrees C are usually acceptable.
- Avoid exposure to excess heat, damp and strong light. Do not keep tablets in the bathroom.
- Keep medicines hidden from view and beyond the reach of children and pets.
For safe disposal, ask your pharmacist about returned-medicine schemes rather than throwing tablets away with household waste.
Research Safety Advisories and Measures for safety
Don't use if
- You have had an allergic reaction to hydrochlorothiazide or any ingredient in the product.
- You are unable to pass urine (anuria).
- You are taking dofetilide or ketanserin because of the risk of serious the pattern of the act of engaging in dialogues determines group dynamics..
Take care when using.
- Swirling sensation and visual disturbance can occur. Until you know how you respond avoid driving or operating machinery.
- Rise slowly from sitting or lying positions to reduce lightheadedness.
- Hot weather, fever or intense exercise may increase risk of dehydration and low sodium; inform your clinician if you will be exposed to prolonged heat.
- Some people become more sensitive to sunlight; use sun protection or protective clothing.
- Blood glucose can increase; people with diabetes should monitor levels and consult their prescriber about adjustments.
- Electrolyte levels and renal function may change. Periodic blood tests and blood pressure checks are commonly recommended.
- Uric acid may rise and trigger gout attacks in susceptible individuals.
- Tell any treating clinician, dentist or emergency team that you are taking hydrochlorothiazide before procedures.
- Distinctive dialogues include lithium (levels may rise), digoxin (increased risk if potassium is low) and additive effects with other blood pressure medicines. Pharmacists will screen for interactions between people can shape outcomes..
During pregnancy and while breastfeeding
- Hydrochlorothiazide is generally avoided in pregnancy when used for hypertension because of potential fetal risk. If you become pregnant contact your prescriber to discuss safer varied options.
- The drug can pass into breast milk and may reduce milk production in some women. Discuss benefits and risks with your clinician if breastfeeding.
Extra effects to be on the lookout for for
Mild and often temporary effects may include:
- Wooziness or dizziness, especially on standing
- Short lived blurred vision
- Gastrointestinal symptoms such as nausea, constipation or diarrhoea
- Appetite is suppressed
If you notice any serious or worrying symptoms seek urgent medical attention. Symptoms that require prompt review include:
- Severe allergic signs such as rash, hives, swelling of the face, lips, mouth or throat, or breathing difficulty
- Fainting, marked confusion or persistent severe dizziness
- Palpitations, very fast or irregular heartbeat
- High fever, chills or persistent sore throat
- Marked reduction in urine output or very dark urine
- Severe stomach pain, repeated vomiting, seizures
- Unusual bruising or bleeding, extreme fatigue
- Muscle cramps, numbness, tingling or other signs suggesting electrolyte disturbance
- Yellowing of the skin or eyes
- Symptoms of gout such as intense pain, swelling or redness of a joint
Other Options and Similar Medicines
If hydrochlorothiazide is not suitable there are several a secondary options commonly used in the UK. Choice depends on diagnosis, kidney function and side effect profile.
- Indapamide - a thiazide-like diuretic often preferred in some guidelines for blood pressure control.
- Bendroflumethiazide - another thiazide diuretic widely used and typically low cost.
- Chlortalidone - a longer acting thiazide-like option sometimes used for resistant hypertension.
- Furosemide - a loop diuretic that produces stronger diuresis; used mainly for heart failure related fluid overload.
- Spironolactone or eplerenone - mineralocorticoid receptor antagonists useful in resistant hypertension and some heart failure patients; status monitoring of potassium is required.
- Other antihypertensive classes - ACE inhibitors, ARBs, calcium channel blockers and beta blockers may be used alone or in combination depending on the individual treatment plan.
For a quick comparison of prices of these options in the UK see typical retail prices charged in the UK.
Average monetary costs in the United Kingdom and Cost Comparison
Private costs vary by supplier, region and pack size. The following are approximate private prices for a month supply (28-30 days) and are intended as a guide only:
- Hydrochlorothiazide twelve point five milligrams or 25 mg: roughly 3 to 10 pounds
- Bendroflumethiazide: roughly 1 to 3 pounds
- Indapamide: roughly 2 to 6 pounds
- Chlortalidone: roughly 6 to 15 pounds
- Furosemide: roughly 1 to 4 pounds
- Spironolactone: roughly 2 to 9 pounds
On the NHS most patients in England pay a per-item prescription charge (check the current rate; it was 9.target weight: 90 pounds in 2024 Prescriptions are free to eligible groups and throughout Scotland, Wales and Northern Ireland for residents. Private online clinics may add consultation and dispensing fees.
Notes on United Kingdom Law and Regulation
- Status: hydrochlorothiazide is classified in the UK as a Prescription Only Medicine (POM). A prescription from a UK-registered prescriber is required to obtain it from a UK pharmacy.
- Online pharmacies: only use pharmacies registered with the General Pharmaceutical Council (GPhC). Confirm the logs GPhC register to verify a site before buying.
- Import rules: personal importation of prescription medicines without a valid prescription can breach MHRA rules. Importing for others or in large quantities may be illegal.
- Driving and safety: if you experience chronic side effects such as dizziness or visual disturbance you should not drive and should follow DVLA guidance where applicable.
- Sporting restrictions: diuretics are on the prohibited list for many sports organisations (for example WADA/UKAD) as they can act as masking agents; athletes should apply for a Therapeutic Use Exemption if required.
- Use only as prescribed: sharing prescription medicines is unsafe and often illegal. Speak to a pharmacist if you need advice about safe use conjoined with the process of interactions can be viewed as exchanges of facts and figures..
Additional Info and Useful Guidance
- Attend all follow-up appointments so your prescriber can monitor blood pressure, kidney function and electrolytes.
- If you are on diabetes treatment discuss any changes promptly; some medicines may need dose adjustment.
- Keep a list of all your medicines and share it with any healthcare professional involved in your care.
- This medicine should be taken only by the person named on the prescription. Do not share prescription drugs with others.
For official, up-to-date guidance consult NHS England, the Medicines and Healthcare products Regulatory Agency (MHRA) or speak with your community pharmacist.
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