ESIDREX ® is a hydrochlorothiazide based drug
THERAPEUTIC GROUP: Diuretics / Thiazide diuretics
IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects
Indications ESIDREX ® Hydrochlorothiazide
ESIDREX ® is used in the treatment of edema of cardiac origin (mild or moderate congestive heart failure), ascites resulting from liver cirrhosis, and renal diabetes insipidus.
ESIDREX ® both in monotherapy and in combination 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 achieving maximum effectiveness at the fourth hour, can be taken easily by mouth. The diuretic effect of ESIDREX ® is due to the presence of hydrochlorothiazide, the active ingredient benzothiazidic able to mainly increase the excretion of sodium and chlorine, but in second analysis also of potassium and magnesium, inhibiting the sodium / chlorine transporter expressed on the surface apical of the cells of the distal convoluted tubule of the nephron.
The diuretic action of ESIDREX ® is generally followed by a direct antihypertensive action on the 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 my arterial fibrillary cells.
After its action, which lasted for about 6/12 hours, the hydrochlorothiazide is eliminated via the kidneys.
Studies carried out and clinical efficacy
1 HYDROCHLOROTHIAZIDE IN ASSOCIATION: the new therapeutic response to hypertension
The efficacy of hydrochlorothiazide in the treatment of hypertension is now known, but all new studies are oriented towards finding the right combination of this active ingredient and other antihypertensive drugs, able to guarantee 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 pressure from 180mmHg to 150mmHg was observed in 73% of cases, only after 7 weeks of treatment.
2. ADDITIONAL OBESITY: RISK FACTOR ALSO FOR SIDE EFFECTS FROM HYDROCHLOROTHYZIDE
This very interesting study shows that abdominal obesity can not only increase the cardiovascular risk and the incidence of pathologies such as hypertension, but also significantly affect the onset of side effects related to hydrochlorothiazide (antihypertensive drug). More precisely, among the patients suffering from abdominal obesity there was the greatest number of episodes of hypertriglyceridemia and hyperglycemia accompanied - in 6% of the cases - also by manifest diabetes and hyperuricemia.
3. HYDROCHLOROTHIAZIDE AND OSTEPOROSIS
As known, the activation of the sodium / calcium exchanger on the surface of smooth muscle fibrocells is one of the mechanisms of antihypertensive action of hydrochlorothiazide. This exchange inevitably translates into an increase in serum calcium levels and a greater availability of this element, which is particularly valuable for menopausal women.
Given the "collateral" effect of this antihypertensive drug, we tried to understand how the hypercalcemic effect of hydrochlorothiazide could affect the fate of osteoporosis in 185 menopausal women.
The results obtained showed, after 2 years of therapy, a sensitive - albeit slight - increase in cortical bone mineralization, mainly in the limbs.
Method of use and dosage
ESIDREX ® hydrochlorothiazide 25mg tablets: in the treatment of hypertension, an initial dose of 1-2 tablets per day is recommended, taken in the morning with breakfast, followed by maintenance therapy with a ½ tablet daily.
In the treatment of the edematous condition, on the other hand, up to 3 tablets a day can be administered, provided they are divided into 2 daily doses, followed by a maintenance regimen with 1 tablet on alternate days.
In pathological conditions such as diabetes renal insipidus and hypercalciuria, 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 analyzing the severity of the pathology and the extent of the treatment plan.
Warnings ESIDREX ® Hydrochlorothiazide
Like all diuretics, it is advisable to assess the plasma levels of the electrolytes before proceeding with the administration of ESIDREX ®, and if necessary correct them.
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 hyperglycaemic effect of hydrochlorothiazide. In hyperuremic patients, the haemoconcentration effect following the administration of ESIDREX ® could lead to an increase in gout attacks.
Given the increased secretion of potassium, determined by the saluretic effect of hydrochlorothiazide, to avoid episodes of hypokalemia, with consequent associated symptoms, it could be useful to add a diet rich in potassium to pharmacological therapy.
It is also necessary to consider that diuretics, and in particular thiazide ones, expose the patient to potential hypokalemia, with symptoms characterized by a significant decrease in perceptive and reactive capacities, which could make driving or the use of machinery dangerous.
PREGNANCY AND BREASTFEEDING
The use of diuretics such as hydrochlorothiazide, could determine an alteration of the normal blood flow to organs important for the growth of the fetus, compromising their 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 increase the side effects of lithium salts, reducing their excretion, and 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 simultaneous administration of non-steroidal anti-inflammatory drugs.
Concomitant use of corticosteroids, on the other hand, could increase potassium loss 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 derived from an excessive accumulation), in case of electrolyte imbalance and naturally 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 determine the onset of dermatological reactions such as skin rashes, hives and in more serious cases also cardio-respiratory symptoms.
More common, on the other hand, are minor adverse events, such as gastrointestinal disorders, fatigue, fatigue and loss of appetite, however associated with possible hydro-electrolyte balance disorders.
Finally, blood phenomena such as thrombocytopenia, leukopenia, agranulocytosis, anemia and haemoconcentration are more serious but definitely less frequent.
Note
ESIDREX ® is salable only under medical prescription.
The use of ESIDREX ® should always take place after consulting your doctor.
The indiscriminate use of ESIDREX ® between athletes and non-athletes, in the search for the loss of a few pounds, 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 weight loss effect, understood as a loss of fat mass.
Therefore ESIDREX ® is classified as a DOPANTI substance.
