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This document outlines essential safety information regarding the use of hydrochlorothiazide. Please read carefully and discuss any concerns with your healthcare provider.

• Vision Concerns: Users may experience vision changes soon after initiating hydrochlorothiazide. Report any alterations in vision or eye discomfort to your doctor and discontinue use immediately. In severe cases, surgery might be required to prevent permanent vision loss, especially if you have allergies to sulfa or penicillin.

• Fluid and Electrolyte Imbalance: Excessive urination due to hydrochlorothiazide can deplete bodily fluids and electrolytes (sodium, potassium, magnesium, chloride). This can be particularly risky for individuals with liver issues, potentially leading to coma. Look out for symptoms such as dry mouth, fatigue, dizziness, muscle cramps, rapid heart rate, nausea, or vomiting, and contact your doctor if these occur.

• Waste Accumulation: Those with kidney issues should inform their healthcare provider, as hydrochlorothiazide can lead to waste build-up. Symptoms to watch for include difficulty urinating, leg swelling, weakness, and confusion.

• Increased Blood Sugar Levels: Hydrochlorothiazide may elevate blood glucose levels. Patients with diabetes should monitor their blood sugar closely and consult their doctor if levels change significantly, as medication adjustments may be necessary.

• Gout Risk: The medication can increase uric acid levels, potentially triggering or worsening gout. If you have a history of gout or kidney problems, your risk is heightened. Consult your healthcare provider promptly if you observe joint swelling, redness, or pain.

• Allergic Reactions: Individuals with known allergies to sulfa-containing drugs may experience similar reactions with hydrochlorothiazide. Ensure that your healthcare provider and pharmacist are aware of any severe allergies. Discontinue use and seek medical attention if you develop a rash or other allergic symptoms.

Contraindications:

• Do not use hydrochlorothiazide if your kidneys cannot produce urine or if you have a known allergy to sulfa-containing medications. Consult your healthcare provider for alternatives if these conditions apply to you.

Common side effects:

• upset stomach
• dizziness
• headache
• temporary blurred vision

Less common but important to monitor:

• low blood pressure
• skin becoming more sensitive to sunlight
• difficulty maintaining an erection
• nausea
• vomiting
• diarrhea
• loss of appetite
• muscle spasms

Serious side effects:

• severe allergic reactions characterized by rash, itching or swelling of the face, tongue, or throat
• severe dizziness
• trouble breathing
• dehydration
• electrolyte imbalance
• unusual dry mouth
• muscle cramps
• irregular heartbeat
• changes in urine output
• eye pain
• abdominal pain
• fever
• rapid heartbeat

Interactions with high risk of serious adverse effects and should be avoided:

• Dofetilide

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Lithium
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) such as Ibuprofen, Naproxen
• Various Cardiac and Blood Pressure Medications including Digoxin and its derivatives

Interactions with low risk that usually do not require a change in therapy:

• Carbamazepine
• Ginkgo
• Licorice