HTN Adult 1 tab daily, preferably at the same time of the day. Combination w/ other antihypertensive agents 12.5-25 mg hydrochlorothiazide. Elderly >65 yr & renal insufficiency Initially 2.5 mg daily. May be increased to 5 mg, if needed. Chronic heart failure Initiate dose w/ gradual uptitration until optimal individual maintenance dose is reached. Initial uptitration (at 1-2 wkly intervals): 1.25 mg to be increased to 2.5 mg once daily, then to 5 mg once daily & further to 10 mg once daily. Max: 10 mg once daily.
Not to interrupt or abruptly discontinue therapy. Discontinue treatment if heart failure worsens. History of anaphylactic reactions. Severe, protracted hypotension & difficulty in restarting or maintaining heart beat may occur during surgery. May mask signs & symptoms of hypoglycemia & signs of hyperthyroidism eg, tachycardia. May exacerbate manifestations of hyperthyroidism or precipitate thyroid storm upon abrupt treatment w/drawal. May precipitate or aggravate symptoms of arterial insufficiency in patients w/ peripheral vascular disease. Patients w/ inadequate cardiac function, since further depression of myocardial contractility & cardiac failure may be precipitated; well-compensated heart failure; angina pectoris or recent MI; undergoing major surgery involving general anesth; bronchospastic disease; subject to spontaneous hypoglycemia & diabetic patients receiving insulin or oral hypoglycemic agents. Carefully monitor & advise patients to temporarily limit physical activity. Prior treatment w/ α-adrenergic blocking agent before β-blocker therapy in patients w/ known or suspected pheochromocytoma. Concomitant use w/ nondihydropyridine Ca-channel blocking agents eg, verapamil, diltiazem. Not recommended in severe renal insufficiency (serum creatinine ≥250 μmol/L). Not to be used during pregnancy. Lactation. Hypoglycemia & bradycardia in fetus & neonate. Increased risk of cardiac & pulmonary complications in neonate in postnatal period. Not recommended in childn & adolescents <18 yr.
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