Hydrochlorothiazide (HCTZ) is a drug that is commonly used to treat edema, hypertension, kidney, and liver problems, as well as certain other conditions. This medicine is a diuretic, which means that it acts to expel excess fluid from the body, and though there are many types of diuretics that are stronger than hydrochlorothiazide, it is the drug of choice in many situations. HCTZ dosage is primarily based on the patient’s age, size, and the condition for which he or she is being treated.
The initial pediatric dose for hypertension is administered once daily and is based on the child’s weight, with a maximum overall dosage of no more than 50 mg per day for children under the age of 18. When given for edema, the dosage is again based on weight, with a maximum dosage of 37.5 mg per day for children under two, and 50 mg per day for ages two through 17, which can be divided and given twice per day if indicated.
Adult HCTZ dosage typically has a maximum recommended level of 50 mg per day, but for conditions such as diabetes insipidus and edema the dose can go as high as 100 mg per day. In many cases medication may be split to be given twice daily, but for some conditions, including osteoporosis, the HCTZ dosage should only be given once per day. Often the choice of whether to use the medication once or twice daily is left up to the physician. Patients suffering from edema often do well only taking the medication three to five days per week, so if the patient responds well to the medicine it may not be given every day.
Certain medical conditions can have a significant impact on HCTZ dosage, and may limit the total dosage given due to the effects of the drug on the kidney and liver. A diuretic is usually contraindicated in a person suffering from liver disease, and if it must be given the HCTZ dosage amount should be as small as possible so as to cause minimal disruption to the body’s electrolyte balance. The same is true for patients with kidney problems, since the use of the diuretic will affect the body's fluid balance and may lead to more serious kidney issues.
There are some significant risks associated with the use of HCTZ. One major complication can be that this drug may cause the onset of diabetes by increasing blood sugar levels in patients that had not experienced previous problems. It can also irritate or precipitate kidney problems, including kidney failure in susceptible people, and the increase in uric acid levels this medication typically causes may also trigger serious gout episodes in some patients. HCTZ can cause low magnesium, potassium, and sodium levels in some cases, which can result in the onset of heart arrhythmias and associated problems. Patients at risk for any of these conditions should either avoid using this drug or the health risks should be considered as a factor when determining the appropriate HCTZ dosage.