Edema 25-100 mg daily, reduced to 25-50 mg daily or intermittently. Severe cases Initially up to 200 mg daily. Nephrogenic diabetes insipidus Initially up to 100 mg daily. HTN 25-50 mg daily.
Hyponatremia may occur in patients w/ severe heart failure who are very oedematous, particularly w/ large doses of thiazide in conjunction w/ restricted salt in diet. Observe for signs of fluid & electrolyte imbalance especially in the presence of vomiting or during parenteral fluid therapy. May precipitate attacks of gout. May cause hyperglycemia & aggravate or unmask DM. Increased risk of non-melanoma skin cancer, basal cell carcinoma & squamous cell carcinoma. Regularly check skin for any new lesions. Limit exposure to sunlight & UV rays. Patients w/ existing fluid & electrolyte disturbances or those at risk from changes in fluid & electrolyte balance. Renal impairment. Elderly.
May enhance toxicity of digitalis glycosides. Increased risk of arrhythmias w/ drugs that prolong QT interval eg, astemizole, terfenadine, halofantrine, pimozide & sotalol. May enhance neuromuscular blocking action of competitive muscle relaxants. Enhanced K-depleting effect w/ corticosteroids, corticotropin, β2 agonists eg, salbutamol, carbenoxolone, amphotericin B, or reboxetine. May enhance effect of other antihypertensives particularly the 1st-dose hypotension that occurs w/ α-blockers or ACE inhibitors. Orthostatic hypotension associated w/ diuretic therapy may be enhanced by concomitant ingestion of alcohol, barbiturates or opioids. Antihypertensive effects of diuretics may be antagonized by drugs that cause fluid retention, eg, corticosteroids, NSAIDs, or carbenoxolone. May diminish response to pressor amines eg, noradrenaline. May lead to toxic blood conc of lithium. Increased toxicity w/ allopurinol & tetracyclines.
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