Hydrochlorothiazide

Identification

Summary

Hydrochlorothiazide is a thiazide diuretic used to treat edema associated with a number of conditions, and hypertension.

Brand Names
Accuretic, Actelsar Hct, Aldactazide, Altace HCT, Atacand, Atacand Hct, Avalide, Benicar Hct, Diovan Hct, Exforge Hct, Hyzaar, Ifirmacombi, Karvezide, Lopressor Hct, Lotensin Hct, Maxzide, Micardis-hct, Olmetec Plus, Tekturna Hct, Teveten HCT, Tribenzor, Urozide, Vaseretic, Viskazide, Zestoretic, Ziac
Generic Name
Hydrochlorothiazide
DrugBank Accession Number
DB00999
Background

Hydrochlorothiazide is the most commonly prescribed thiazide diuretic.2 It is indicated to treat edema and hypertension.2,10,11 Hydrochlorothiazide use is common but declining in favour of angiotensin converting enzyme inhibitors.2 Many combination products are available containing hydrochlorothiazide and angiotensin converting enzyme inhibitors14,15 or angiotensin II receptor blockers.12,13

Hydrochlorothiazide was granted FDA approval on 12 February 1959.9

Type
Small Molecule
Groups
Approved, Vet approved
Structure
Weight
Average: 297.739
Monoisotopic: 296.964474846
Chemical Formula
C7H8ClN3O4S2
Synonyms
  • HCTZ
  • Hidroclorotiazida
  • Hydrochlorothiazide
  • Hydrochlorothiazidum
External IDs
  • NSC-53477
  • SU-5879

Pharmacology

Indication

Hydrochlorothiazide is indicated alone or in combination for the management of edema associated with congestive heart failure, hepatic cirrhosis, nephrotic syndrome, acute glomerulonephritis, chronic renal failure, and corticosteroid and estrogen therapy.10,11 Hydrochlorothiazide is also indicated alone or in combination for the management of hypertension.2,10,11,16

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Prophylaxis ofCalcium nephrolithiasis••• •••••
Used as adjunct in combination to manageCirrhosis of liverCombination Product in combination with: Spironolactone (DB00421)••••••••••••
Used in combination to manageCongestive heart failureCombination Product in combination with: Spironolactone (DB00421), Digitoxin (DB01396)••••••••••••
Management ofDiabetes insipidus••• •••••
Used in combination to manageEdemaCombination Product in combination with: Spironolactone (DB00421)•••••••••••••••••••••• •••••••• •• ••••• •••••••••
Contraindications & Blackbox Warnings
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Pharmacodynamics

Hydrochlorothiazide prevents the reabsorption of sodium and water from the distal convoluted tubule, allowing for the increased elimination of water in the urine.2,3,4,10,11 Hydrochlorothiazide has a wide therapeutic window as dosing is individualized and can range from 25-100mg.10,11 Hydrochlorothiazide should be used with caution in patients with reduced kidney or liver function.10,11

Mechanism of action

Hydrochlorothiazide is transported from the circulation into epithelial cells of the distal convoluted tubule by the organic anion transporters OAT1, OAT3, and OAT4.6,3 From these cells, hydrochlorothiazide is transported to the lumen of the tubule by multidrug resistance associated protein 4 (MRP4).6

Normally, sodium is reabsorbed into epithelial cells of the distal convoluted tubule and pumped into the basolateral interstitium by a sodium-potassium ATPase, creating a concentration gradient between the epithelial cell and the distal convoluted tubule that promotes the reabsorption of water.4

Hydrochlorothiazide acts on the proximal region of the distal convoluted tubule, inhibiting reabsorption by the sodium-chloride symporter, also known as Solute Carrier Family 12 Member 3 (SLC12A3).2,3,4 Inhibition of SLC12A3 reduces the magnitude of the concentration gradient between the epithelial cell and distal convoluted tubule, reducing the reabsorption of water.4

TargetActionsOrganism
ASolute carrier family 12 member 3
inhibitor
Humans
ACalcium-activated potassium channel subunit alpha-1
inhibitor
Humans
Absorption

An oral dose of hydrochlorothiazide is 65-75% bioavailable, with a Tmax of 1-5 hours, and a Cmax of 70-490ng/mL following doses of 12.5-100mg.10,11 When taken with a meal, bioavailability is 10% lower, Cmax is 20% lower, and Tmax increases from 1.6 to 2.9 hours.11

Volume of distribution

The volume of distribution varies widely from one study to another with values of 0.83-4.19L/kg.8

Protein binding

Hydrochlorothiazide is 40-68% protein bound in plasma.10,11 Hydrochlorothiazide has been shown to bind to human serum albumin.5

Metabolism

Hydrochlorothiazide is not metabolized.10,11

Route of elimination

Hydrochlorothiazide is eliminated in the urine as unchanged hydrochlorothiazide.10,11

Half-life

The plasma half life of hydrochlorothiazide is 5.6-14.8h.10

Clearance

The renal clearance of hydrochlorothiazide in patients with normal renal function is 285mL/min.7 Patients with a creatinine clearance of 31-80mL/min have an average hydroxychlorothiazide renal clearance of 75mL/min, and patients with a creatinine clearance of ≤30mL/min have an average hydroxychlorothiazide renal clearance of 17mL/min.7

Adverse Effects
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Toxicity

The oral LD50 of hydrochlorothiazide is >10g/kg in mice and rats.10,11

Patients experiencing an overdose may present with hypokalemia, hypochloremia, and hyponatremia.10,11,2 Treat patients with symptomatic and supportive treatment including fluids and electrolytes.10,11,2 Vasopressors may be administered to treat hypotension and oxygen may be given for respiratory impairment.2,10,11

Pathways
PathwayCategory
Hydrochlorothiazide Action PathwayDrug action
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbacavirHydrochlorothiazide may increase the excretion rate of Abacavir which could result in a lower serum level and potentially a reduction in efficacy.
AbaloparatideThe risk or severity of adverse effects can be increased when Hydrochlorothiazide is combined with Abaloparatide.
AbciximabThe therapeutic efficacy of Abciximab can be decreased when used in combination with Hydrochlorothiazide.
AcarboseThe therapeutic efficacy of Acarbose can be decreased when used in combination with Hydrochlorothiazide.
AcebutololThe therapeutic efficacy of Acebutolol can be increased when used in combination with Hydrochlorothiazide.
Food Interactions
  • Avoid alcohol. Alcohol may potentiate orthostatic hypotension.
  • Avoid multivalent ions. Take this medication 2 hours before or after the administration of antacids, calcium supplements, or iron supplements to avoid decreased absorption of hydrochlorothiazide.
  • Avoid natural licorice. Licorice potentiates the hypokalemic effect of hydrochlorothiazide.
  • Increase consumption of potassium-rich foods. This medication may cause potassium depletion. Foods containing potassium include bananas and orange juice.
  • Limit salt intake. Avoid excessive salt, unless recommended by a physician.
  • Take with or without food.

Products

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Product Images
International/Other Brands
Dichlotride (M & H) / Esidrex (Novartis) / HydroDIURIL (Merck)
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Diuchlor H Tab 50mgTablet50 mgOralMedic Laboratory LtÉe1964-12-311996-09-09Canada flag
EsidrixTablet50 mg/1OralNovartis1959-02-122008-08-04US flag
EsidrixTablet25 mg/1OralNovartis1959-02-122008-08-04US flag
HydrochlorothiazideTablet50 mg/1OralVintage Pharmaceuticals, LLC2007-08-022007-08-02US flag
HydrochlorothiazideTablet25 mgOralPro Doc Limitee2019-08-14Not applicableCanada flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Apo-hydrochlorothiazideTablet50 mgOralApotex Corporation1974-12-31Not applicableCanada flag
Apo-hydrochlorothiazideTablet25 mgOralApotex Corporation1975-12-31Not applicableCanada flag
Apo-hydrochlorothiazideTablet100 mgOralApotex Corporation1988-12-31Not applicableCanada flag
Apo-hydrochlorothiazideTablet12.5 mgOralApotex Corporation2009-07-02Not applicableCanada flag
Ava-hydrochlorothiazideTablet25 mgOralAvanstra Inc2011-10-112014-08-21Canada flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
Aa-amilzideHydrochlorothiazide (50 mg) + Amiloride hydrochloride (5 mg)TabletOralAa Pharma Inc1989-12-31Not applicableCanada flag
Accel-candesartan/hctzHydrochlorothiazide (12.5 mg) + Candesartan cilexetil (32 mg)TabletOralAccel Pharma Inc2017-12-272020-03-05Canada flag
Accel-candesartan/hctzHydrochlorothiazide (25 mg) + Candesartan cilexetil (32 mg)TabletOralAccel Pharma Inc2017-12-272020-03-05Canada flag
Accel-candesartan/hctzHydrochlorothiazide (12.5 mg) + Candesartan cilexetil (16 mg)TabletOralAccel Pharma Inc2017-12-272020-03-05Canada flag
AccureticHydrochlorothiazide (12.5 mg/1) + Quinapril Hydrochloride (10 mg/1)Tablet, film coatedOralParke-Davis Div of Pfizer Inc1999-12-282022-04-30US flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
CapozideHydrochlorothiazide (15 mg/1) + Captopril (25 mg/1)TabletOralPhysicians Total Care, Inc.1996-05-142011-05-31US flag
CapozideHydrochlorothiazide (25 mg/1) + Captopril (50 mg/1)TabletOralPhysicians Total Care, Inc.1997-01-032002-06-30US flag

Categories

ATC Codes
C09BX03 — Ramipril, amlodipine and hydrochlorothiazideC03AX01 — Hydrochlorothiazide, combinationsC03AB03 — Hydrochlorothiazide and potassiumC09DX03 — Olmesartan medoxomil, amlodipine and hydrochlorothiazideC03EA01 — Hydrochlorothiazide and potassium-sparing agentsC09DX06 — Candesartan, amlodipine and hydrochlorothiazideC09XA52 — Aliskiren and hydrochlorothiazideG01AE10 — Combinations of sulfonamidesC09DX01 — Valsartan, amlodipine and hydrochlorothiazideC03AA03 — HydrochlorothiazideC09XA54 — Aliskiren, amlodipine and hydrochlorothiazideC09DX08 — Telmisartan, amlodipine and hydrochlorothiazideC09DX07 — Irbesartan, amlodipine and hydrochlorothiazide
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as 1,2,4-benzothiadiazine-1,1-dioxides. These are aromatic heterocyclic compounds containing a 1,2,4-benzothiadiazine ring system with two S=O bonds at the 1-position.
Kingdom
Organic compounds
Super Class
Organoheterocyclic compounds
Class
Thiadiazines
Sub Class
Benzothiadiazines
Direct Parent
1,2,4-benzothiadiazine-1,1-dioxides
Alternative Parents
Secondary alkylarylamines / Organosulfonamides / Benzenoids / Aryl chlorides / Aminosulfonyl compounds / Azacyclic compounds / Organopnictogen compounds / Organochlorides / Organic oxides / Hydrocarbon derivatives
Substituents
1,2,4-benzothiadiazine-1,1-dioxide / Amine / Aminosulfonyl compound / Aromatic heteropolycyclic compound / Aryl chloride / Aryl halide / Azacycle / Benzenoid / Hydrocarbon derivative / Organic nitrogen compound
Molecular Framework
Aromatic heteropolycyclic compounds
External Descriptors
sulfonamide, organochlorine compound, benzothiadiazine (CHEBI:5778)
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
0J48LPH2TH
CAS number
58-93-5
InChI Key
JZUFKLXOESDKRF-UHFFFAOYSA-N
InChI
InChI=1S/C7H8ClN3O4S2/c8-4-1-5-7(2-6(4)16(9,12)13)17(14,15)11-3-10-5/h1-2,10-11H,3H2,(H2,9,12,13)
IUPAC Name
6-chloro-1,1-dioxo-3,4-dihydro-2H-1lambda6,2,4-benzothiadiazine-7-sulfonamide
SMILES
NS(=O)(=O)C1=C(Cl)C=C2NCNS(=O)(=O)C2=C1

References

Synthesis Reference

Frederic J. Nugent, John K. C. Yen, "Process for preparing the combination products of triamterene and hydrochlorothiazide." U.S. Patent US4804540, issued July, 1987.

US4804540
General References
  1. Pickkers P, Hughes AD, Russel FG, Thien T, Smits P: Thiazide-induced vasodilation in humans is mediated by potassium channel activation. Hypertension. 1998 Dec;32(6):1071-6. doi: 10.1161/01.hyp.32.6.1071. [Article]
  2. Herman LL, Bashir K: Hydrochlorothiazide . [Article]
  3. Akbari P, Khorasani-Zadeh A: Thiazide Diuretics . [Article]
  4. Gamba G: The thiazide-sensitive Na+-Cl- cotransporter: molecular biology, functional properties, and regulation by WNKs. Am J Physiol Renal Physiol. 2009 Oct;297(4):F838-48. doi: 10.1152/ajprenal.00159.2009. Epub 2009 May 27. [Article]
  5. Balaei F, Ghobadi S: Hydrochlorothiazide binding to human serum albumin induces some compactness in the molecular structure of the protein: A multi-spectroscopic and computational study. J Pharm Biomed Anal. 2019 Jan 5;162:1-8. doi: 10.1016/j.jpba.2018.09.009. Epub 2018 Sep 5. [Article]
  6. Hasegawa M, Kusuhara H, Adachi M, Schuetz JD, Takeuchi K, Sugiyama Y: Multidrug resistance-associated protein 4 is involved in the urinary excretion of hydrochlorothiazide and furosemide. J Am Soc Nephrol. 2007 Jan;18(1):37-45. doi: 10.1681/ASN.2005090966. Epub 2006 Nov 29. [Article]
  7. Niemeyer C, Hasenfuss G, Wais U, Knauf H, Schafer-Korting M, Mutschler E: Pharmacokinetics of hydrochlorothiazide in relation to renal function. Eur J Clin Pharmacol. 1983;24(5):661-5. doi: 10.1007/bf00542218. [Article]
  8. Chen TM, Chiou WL: Large differences in the biological half-life and volume of distribution of hydrochlorothiazide in normal subjects from eleven studies. Correlation with their last blood sampling times. Int J Clin Pharmacol Ther Toxicol. 1992 Jan;30(1):34-7. [Article]
  9. FDA Approved Drug Products: Esidrix Hydrochlorothiazide Oral Tablets (Discontinued) [Link]
  10. FDA Approved Drug Products: Hydrochlorothiazide Oral Tablets [Link]
  11. FDA Approved Drug Products: Hydrochlorothiazide Oral Capsules [Link]
  12. FDA Approved Drug Products: Losartan and Hydrochlorothiazide Oral Tablets [Link]
  13. FDA Approved Drug Products: Irbesartan and Hydrochlorothiazide Oral Tablets [Link]
  14. FDA Approved Drug Products: Lisinopril and Hydrochlorothiazide Oral Tablet [Link]
  15. FDA Approved Drug Products: Quinapril and Hydrochlorothiazide Oral Tablets [Link]
  16. FDA Approved Drug Products: HYZAAR (losartan potassium and hydrochlorothiazide) tablets for oral use (March 2023) [Link]
Human Metabolome Database
HMDB0001928
KEGG Drug
D00340
KEGG Compound
C07041
PubChem Compound
3639
PubChem Substance
46504440
ChemSpider
3513
BindingDB
13076
RxNav
5487
ChEBI
5778
ChEMBL
CHEMBL435
ZINC
ZINC000000896569
Therapeutic Targets Database
DAP000750
PharmGKB
PA449899
PDBe Ligand
HCZ
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Hydrochlorothiazide
MSDS
Download (72.7 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedDiagnosticHypertension, Essential Hypertension1
4CompletedDiagnosticHypertension / Type 2 Diabetes Mellitus1
4CompletedPreventionAngina Pectoris / Diabetes Mellitus / Myocardial Infarction / Stroke1
4CompletedPreventionAtrial Fibrillation1
4CompletedPreventionDiabetic Nephropathy1

Pharmacoeconomics

Manufacturers
  • Apotex inc
  • Aurobindo pharma ltd
  • Cadista pharmaceuticals inc
  • Ipca laboratories ltd
  • Ivax pharmaceuticals inc sub teva pharmaceuticals usa
  • Mylan pharmaceuticals inc
  • Unichem laboratories ltd
  • Vintage pharmaceuticals inc
  • West ward pharmaceutical corp
  • Watson laboratories inc
  • Morton grove pharmaceuticals inc
  • Roxane laboratories inc
  • Novartis pharmaceuticals corp
  • Abc holding corp
  • Actavis elizabeth llc
  • Alra laboratories inc
  • Ascot hosp pharmaceuticals inc div travenol laboratories inc
  • Barr laboratories inc
  • Caraco pharmaceutical laboratories ltd
  • Dava pharmaceuticals inc
  • Elkins sinn div ah robins co inc
  • Excellium pharmaceutical inc
  • Heather drug co inc
  • Heritage pharmaceuticals inc
  • Impax laboratories inc
  • Inwood laboratories inc sub forest laboratories inc
  • Lannett holdings inc
  • Mm mast and co
  • Mutual pharmaceutical co inc
  • Private formulations inc
  • Sandoz inc
  • Solvay pharmaceuticals
  • Superpharm corp
  • Teva pharmaceuticals usa inc
  • Tg united labs llc
  • Usl pharma inc
  • Vangard laboratories inc div midway medical co
  • Warner chilcott div warner lambert co
  • Whiteworth towne paulsen inc
  • Halsey drug co inc
  • Merck and co inc
  • Abbott laboratories pharmaceutical products div
Packagers
  • Abbott Laboratories Ltd.
  • Actavis Group
  • Advanced Pharmaceutical Services Inc.
  • Aidarex Pharmacuticals LLC
  • Amerisource Health Services Corp.
  • Apotex Inc.
  • Apotheca Inc.
  • A-S Medication Solutions LLC
  • AstraZeneca Inc.
  • Atlantic Biologicals Corporation
  • Aurobindo Pharma Ltd.
  • Barr Pharmaceuticals
  • Boehringer Ingelheim Ltd.
  • Bristol-Myers Squibb Co.
  • Bryant Ranch Prepack
  • BTA Pharmaceuticals
  • C.O. Truxton Inc.
  • Cadista Pharmaceuticals Inc.
  • Calvin Scott and Co. Inc.
  • Caraco Pharmaceutical Labs
  • Cardinal Health
  • Carlisle Laboratories Inc.
  • Central Texas Community Health Centers
  • Ciba Geigy Ltd.
  • Comprehensive Consultant Services Inc.
  • Corepharma LLC
  • Coupler Enterprises Inc.
  • Darby Dental Supply Co. Inc.
  • DAVA Pharmaceuticals
  • Dee Stevens and Son Feeder
  • DHHS Program Support Center Supply Service Center
  • Direct Dispensing Inc.
  • Dispensing Solutions
  • Diversified Healthcare Services Inc.
  • Doctor Reddys Laboratories Ltd.
  • Duramed
  • E.R. Squibb and Sons LLC
  • Endo Pharmaceuticals Inc.
  • Eon Labs
  • Excellium Pharmaceutical Inc.
  • Genpharm LP
  • Glenmark Generics Ltd.
  • Golden State Medical Supply Inc.
  • Goldline Laboratories Inc.
  • Greenstone LLC
  • Group Health Cooperative
  • H and H Laboratories
  • H.J. Harkins Co. Inc.
  • Heartland Repack Services LLC
  • Heritage Pharmaceuticals
  • International Laboratories Inc.
  • Ipca Laboratories Ltd.
  • Ivax Pharmaceuticals
  • Kaiser Foundation Hospital
  • Kraft Pharmaceutical Co. Inc.
  • Lake Erie Medical and Surgical Supply
  • Lannett Co. Inc.
  • Liberty Pharmaceuticals
  • Major Pharmaceuticals
  • Mckesson Corp.
  • Medisca Inc.
  • Medvantx Inc.
  • Merck & Co.
  • Murfreesboro Pharmaceutical Nursing Supply
  • Mylan
  • Novartis AG
  • Nucare Pharmaceuticals Inc.
  • Ohm Laboratories Inc.
  • Palmetto Pharmaceuticals Inc.
  • Par Pharmaceuticals
  • Patheon Inc.
  • PCA LLC
  • PD-Rx Pharmaceuticals Inc.
  • Pharmaceutical Utilization Management Program VA Inc.
  • Pharmedix
  • Pharmpak Inc.
  • Physicians Total Care Inc.
  • Pliva Inc.
  • Preferred Pharmaceuticals Inc.
  • Prepackage Specialists
  • Prepak Systems Inc.
  • Qualitest
  • Quality Research Pharmaceutical Inc.
  • Ranbaxy Laboratories
  • Rebel Distributors Corp.
  • Remedy Repack
  • Resource Optimization and Innovation LLC
  • Roxane Labs
  • Sandoz
  • Solvay Pharmaceuticals
  • Southwood Pharmaceuticals
  • Stat Rx Usa
  • Stat Scripts LLC
  • Talbert Medical Management Corp.
  • Taro Pharmaceuticals USA
  • Teva Pharmaceutical Industries Ltd.
  • UDL Laboratories
  • Unichem Laboratories Ltd.
  • United Research Laboratories Inc.
  • Va Cmop Dallas
  • Vangard Labs Inc.
  • Vintage Pharmaceuticals Inc.
  • Watson Pharmaceuticals
  • West-Ward Pharmaceuticals
Dosage Forms
FormRouteStrength
TabletOral100 mg
TabletOral5 mg
TabletOral12.5 mg
TabletOral16 mg
TabletOral12.500 mg
Tablet, film coatedOral
TabletOral25.000 mg
Tablet, coatedOral
Tablet, film coatedOral
Tablet, film coatedOral25.0 mg
Tablet, film coatedOral12.50 mg
Tablet, film coatedOral12.5 mg
Tablet, film coatedOral25 mg
Tablet, film coatedOral25.00 mg
Tablet, film coatedOral10.00 mg
Tablet, film coatedOral5.00 mg
TabletOral20.00 mg
TabletOral1250000 mg
CapsuleOral
CapsuleOral12.5 mg/1
Capsule, gelatin coatedOral12.5 mg/1
TabletOral
TabletOral12.5 mg/1
TabletOral25 mg/1
TabletOral25 mg/25mg
TabletOral50 mg/1
TabletOral50 mg/50mg
TabletOral100 mg
TabletOral
Tablet, extended releaseOral
TabletOral12.5 mg
TabletOral12.50 mg
CapsuleOral5.000 mg
TabletOral12.500 mg
Tablet, film coated, extended releaseOral
TabletOral25.00 mg/tablet
TabletOral12.50 mg
Tablet, coatedOral5 mg
Tablet, film coatedOral12.5 mg
Tablet, film coatedOral25 mg
Capsule, coatedOral
Capsule, liquid filledOral
TabletOral25 mg
TabletOral50 mg
Tablet
Prices
Unit descriptionCostUnit
Niferex-150 Forte 100 80-70 mg capsule Box109.86USD box
Niferex 100 mg/5ml Elixir 236ml Bottle80.55USD bottle
Niferex 100 40-20 mg capsule Box77.99USD box
Capozide 50-25 mg tablet3.63USD tablet
Ziac 10-6.25 mg tablet3.6USD tablet
Ziac 2.5-6.25 mg tablet3.6USD tablet
Ziac 5-6.25 mg tablet3.6USD tablet
Capozide 50-15 tablet3.49USD tablet
Capozide 50-25 tablet3.49USD tablet
Capozide 50-15 mg tablet2.59USD tablet
Lotensin 20 mg tablet2.25USD tablet
Lotensin 10 mg tablet2.09USD tablet
Lotensin 40 mg tablet2.09USD tablet
Lotensin 5 mg tablet2.09USD tablet
Accuretic 20-12.5 mg tablet2.04USD tablet
Capozide 25-15 tablet2.03USD tablet
Capozide 25-25 tablet2.03USD tablet
Accuretic 10-12.5 mg tablet2.0USD tablet
Accuretic 20-25 mg tablet2.0USD tablet
Lotensin HCT 20-12.5 mg tablet1.97USD tablet
Lotensin HCT 10-12.5 mg tablet1.95USD tablet
Lotensin HCT 20-25 mg tablet1.94USD tablet
Lotensin hct 10-12.5 tablet1.9USD tablet
Lotensin hct 20-12.5 tablet1.9USD tablet
Lotensin hct 20-25 tablet1.9USD tablet
Lotensin hct 5-6.25 tablet1.9USD tablet
Niferex-150 150-50-50 mg capsule1.62USD capsule
Capozide 25-15 mg tablet1.51USD tablet
Lotensin HCT 5-6.25 mg tablet1.31USD tablet
Hydrochlorothiazide powder1.1USD g
Hydrochlorothiazide 12.5 mg tablet0.82USD tablet
Moduretic 5-50 mg tablet0.68USD tablet
Hydrochlorothiazide 12.5 mg capsule0.5USD capsule
Hydrochlorothiazide 50 mg tablet0.16USD tablet
Apo-Hydro 100 mg Tablet0.13USD tablet
Hydrochlorothiazide 25 mg tablet0.11USD tablet
Apo-Hydro 50 mg Tablet0.06USD tablet
Novo-Hydrazide 50 mg Tablet0.06USD tablet
Apo-Hydro 25 mg Tablet0.04USD tablet
Novo-Hydrazide 25 mg Tablet0.04USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US6294197Yes2001-09-252017-12-18US flag
US6358986No2002-03-192020-01-10US flag
US5559111Yes1996-09-242019-01-21US flag
US5616599Yes1997-04-012016-10-25US flag
US8618172No2013-12-312028-07-13US flag
US6878703Yes2005-04-122022-05-19US flag
US8101599No2012-01-242023-05-16US flag
US8475839Yes2013-07-022023-11-16US flag
US8618174No2013-12-312021-11-15US flag
US8183295No2012-05-222023-05-16US flag
US5994348Yes1999-11-302015-12-07US flag
US9023893No2015-05-052022-03-03US flag

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)266-268U.S. Patent 3,163,645.
water solubility722 mg/L (at 25 °C)YALKOWSKY,SH & DANNENFELSER,RM (1992)
logP-0.07HANSCH,C ET AL. (1995)
logS-2.62ADME Research, USCD
Caco2 permeability-6.06ADME Research, USCD
pKa7.9SANGSTER (1994)
Predicted Properties
PropertyValueSource
Water Solubility2.24 mg/mLALOGPS
logP-0.16ALOGPS
logP-0.58Chemaxon
logS-2.1ALOGPS
pKa (Strongest Acidic)9.09Chemaxon
pKa (Strongest Basic)-2.7Chemaxon
Physiological Charge0Chemaxon
Hydrogen Acceptor Count5Chemaxon
Hydrogen Donor Count3Chemaxon
Polar Surface Area118.36 Å2Chemaxon
Rotatable Bond Count1Chemaxon
Refractivity63.11 m3·mol-1Chemaxon
Polarizability25.35 Å3Chemaxon
Number of Rings2Chemaxon
Bioavailability1Chemaxon
Rule of FiveYesChemaxon
Ghose FilterNoChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleNoChemaxon
Predicted ADMET Features
PropertyValueProbability
Human Intestinal Absorption+0.9202
Blood Brain Barrier-0.9659
Caco-2 permeable-0.8956
P-glycoprotein substrateNon-substrate0.6533
P-glycoprotein inhibitor INon-inhibitor0.8624
P-glycoprotein inhibitor IINon-inhibitor0.8688
Renal organic cation transporterNon-inhibitor0.8416
CYP450 2C9 substrateNon-substrate0.7664
CYP450 2D6 substrateNon-substrate0.8333
CYP450 3A4 substrateNon-substrate0.6217
CYP450 1A2 substrateNon-inhibitor0.9401
CYP450 2C9 inhibitorNon-inhibitor0.9071
CYP450 2D6 inhibitorNon-inhibitor0.9252
CYP450 2C19 inhibitorNon-inhibitor0.9025
CYP450 3A4 inhibitorNon-inhibitor0.9569
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9036
Ames testNon AMES toxic0.9133
CarcinogenicityNon-carcinogens0.7986
BiodegradationNot ready biodegradable0.9964
Rat acute toxicity2.0666 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9576
hERG inhibition (predictor II)Non-inhibitor0.9135
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Download (11.5 KB)
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSsplash10-014i-1490000000-623736f34c52e89bbc88
Mass Spectrum (Electron Ionization)MSsplash10-00r2-6490000000-3f5d9320308b823c6489
MS/MS Spectrum - Quattro_QQQ 10V, PositiveLC-MS/MSsplash10-052b-0090000000-aaa48e4702874457ae26
MS/MS Spectrum - Quattro_QQQ 25V, PositiveLC-MS/MSsplash10-0r6r-0920000000-b129acf72e7dde12441e
MS/MS Spectrum - Quattro_QQQ 40V, PositiveLC-MS/MSsplash10-0a4i-1900000000-67f803f38aed0bd12ade
LC-MS/MS Spectrum - LC-ESI-qTof , PositiveLC-MS/MSsplash10-001i-0490000000-86abfe4bae6e32f1189a
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-014i-0090000000-7906a6e4cfb51dce1396
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-0002-0090000000-c44dbed5084dc5df03d8
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-0002-0090000000-976dcb246a2272b22565
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-0uxr-1090000000-16e563e592e4a566424d
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-0fb9-9580000000-3c9227e3df8ed6dc9ae9
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-004i-9720000000-12525bfcb83ea1611970
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-004i-9200000000-df37b796b59f084b0229
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-0002-0090000000-220666bc28231ad387e8
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-0002-0090000000-f434c5d8ee94540ec0d2
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-0uxr-1090000000-8a3c270e0fb285b26f15
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-0fb9-9480000000-5f6c5ed1d291d71a0aae
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-004i-9520000000-679def33e8239c1382f3
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-004i-9400000000-c9b80274d62fda64c531
LC-MS/MS Spectrum - LC-ESI-ITFT , negativeLC-MS/MSsplash10-014i-0090000000-0a962453b9e31eec3822
LC-MS/MS Spectrum - LC-ESI-QTOF , negativeLC-MS/MSsplash10-0002-0090000000-ac2b5d07eaacba87a181
LC-MS/MS Spectrum - LC-ESI-QTOF , negativeLC-MS/MSsplash10-0gb9-1090000000-8649018477d708cb6bd7
LC-MS/MS Spectrum - LC-ESI-QTOF , negativeLC-MS/MSsplash10-004i-9400000000-266cd4efe3deeebe29f3
MS/MS Spectrum - Linear Ion Trap , negativeLC-MS/MSsplash10-014i-0090000000-bc85dd2515151e4fec03
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-001i-0090000000-f8a0765b6023cbf47593
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-001i-0090000000-ca679180c1ca0c54141e
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-001i-0090000000-5aee0df6931c521ae675
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-001i-0390000000-2d94b79cdd59fb180851
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-0f79-0920000000-a3852b5fd8f817191c39
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-000i-0900000000-017f1f0aa88d206d3790
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-05br-1900000000-9adb8f34fa45627894bb
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-001i-0090000000-49e6e4b4d7de4164fea3
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-001i-0090000000-eba848023908f7d51e1a
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-001i-0490000000-09360a196ae79b28c238
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-0f79-0920000000-f620823c599998180372
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-000i-1900000000-bb4b565d2cab86e56d75
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-052r-2900000000-67c9a5ba10fd79140b7d
LC-MS/MS Spectrum - LC-ESI-ITFT , positiveLC-MS/MSsplash10-001i-0090000000-de56ae9572cecd0e3bce
MS/MS Spectrum - Linear Ion Trap , positiveLC-MS/MSsplash10-00lr-0090000000-6ec2b0c4b0ea116fd154
MS/MS Spectrum - , positiveLC-MS/MSsplash10-001i-0490000000-86abfe4bae6e32f1189a
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSsplash10-0002-0090000000-50215d712d2c1968b1e7
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSsplash10-0002-0090000000-f0f7d95826138984ce9f
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSsplash10-000t-0090000000-c398b8141034672e9591
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSsplash10-0002-1090000000-b3574e852d7f0fa2c73a
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSsplash10-004i-9220000000-0805e03b91877ff937a0
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSsplash10-0006-0920000000-c8404b55a0693fd3030f
1H NMR Spectrum1D NMRNot Applicable
1H NMR Spectrum1D NMRNot Applicable
13C NMR Spectrum1D NMRNot Applicable
Predicted 1H NMR Spectrum1D NMRNot Applicable
Predicted 13C NMR Spectrum1D NMRNot Applicable
[1H,13C] 2D NMR Spectrum2D NMRNot Applicable
Chromatographic Properties
Collision Cross Sections (CCS)
AdductCCS Value (Å2)Source typeSource
[M-H]-160.3849404
predicted
DarkChem Lite v0.1.0
[M-H]-158.7839714
predicted
DarkChem Lite v0.1.0
[M-H]-154.1231
predicted
DeepCCS 1.0 (2019)
[M+H]+161.0779404
predicted
DarkChem Lite v0.1.0
[M+H]+168.3554659
predicted
DarkChem Lite v0.1.0
[M+H]+156.4811
predicted
DeepCCS 1.0 (2019)
[M+Na]+160.3553404
predicted
DarkChem Lite v0.1.0
[M+Na]+167.8674124
predicted
DarkChem Lite v0.1.0
[M+Na]+162.57423
predicted
DeepCCS 1.0 (2019)

Targets

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Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Inhibitor
General Function
Transporter activity
Specific Function
Key mediator of sodium and chloride reabsorption in this nephron segment, accounting for a significant fraction of renal sodium reabsorption.
Gene Name
SLC12A3
Uniprot ID
P55017
Uniprot Name
Solute carrier family 12 member 3
Molecular Weight
113138.04 Da
References
  1. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [Article]
  2. Ran XW, Wang C, Dai F, Jiang JJ, Tong NW, Li XJ, Liang JZ: [A case of Gitelman's syndrome presenting with severe hypocalcaemia and hypokalemic periodic paralysis]. Sichuan Da Xue Xue Bao Yi Xue Ban. 2005 Jul;36(4):583-7. [Article]
  3. Turner ST, Schwartz GL, Chapman AB, Boerwinkle E: WNK1 kinase polymorphism and blood pressure response to a thiazide diuretic. Hypertension. 2005 Oct;46(4):758-65. Epub 2005 Sep 19. [Article]
  4. Abuladze N, Yanagawa N, Lee I, Jo OD, Newman D, Hwang J, Uyemura K, Pushkin A, Modlin RL, Kurtz I: Peripheral blood mononuclear cells express mutated NCCT mRNA in Gitelman's syndrome: evidence for abnormal thiazide-sensitive NaCl cotransport. J Am Soc Nephrol. 1998 May;9(5):819-26. [Article]
  5. Barry EL, Gesek FA, Kaplan MR, Hebert SC, Friedman PA: Expression of the sodium-chloride cotransporter in osteoblast-like cells: effect of thiazide diuretics. Am J Physiol. 1997 Jan;272(1 Pt 1):C109-16. [Article]
  6. Kurschat C, Heering P, Grabensee B: [Gitelman's syndrome: an important differential diagnosis of hypokalemia]. Dtsch Med Wochenschr. 2003 May 30;128(22):1225-8. [Article]
  7. Monroy A, Plata C, Hebert SC, Gamba G: Characterization of the thiazide-sensitive Na(+)-Cl(-) cotransporter: a new model for ions and diuretics interaction. Am J Physiol Renal Physiol. 2000 Jul;279(1):F161-9. [Article]
  8. Significant Drug–Drug Interactions with Antineoplastics [Link]
Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Inhibitor
General Function
Voltage-gated potassium channel activity
Specific Function
Potassium channel activated by both membrane depolarization or increase in cytosolic Ca(2+) that mediates export of K(+). It is also activated by the concentration of cytosolic Mg(2+). Its activati...
Gene Name
KCNMA1
Uniprot ID
Q12791
Uniprot Name
Calcium-activated potassium channel subunit alpha-1
Molecular Weight
137558.115 Da
References
  1. Pickkers P, Hughes AD, Russel FG, Thien T, Smits P: Thiazide-induced vasodilation in humans is mediated by potassium channel activation. Hypertension. 1998 Dec;32(6):1071-6. doi: 10.1161/01.hyp.32.6.1071. [Article]

Carriers

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Binder
General Function
Toxic substance binding
Specific Function
Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloid...
Gene Name
ALB
Uniprot ID
P02768
Uniprot Name
Serum albumin
Molecular Weight
69365.94 Da
References
  1. Balaei F, Ghobadi S: Hydrochlorothiazide binding to human serum albumin induces some compactness in the molecular structure of the protein: A multi-spectroscopic and computational study. J Pharm Biomed Anal. 2019 Jan 5;162:1-8. doi: 10.1016/j.jpba.2018.09.009. Epub 2018 Sep 5. [Article]

Transporters

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inhibitor
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Involved in the renal elimination of endogenous and exogenous organic anions. Functions as organic anion exchanger when the uptake of one molecule of organic anion is coupled with an efflux of one ...
Gene Name
SLC22A6
Uniprot ID
Q4U2R8
Uniprot Name
Solute carrier family 22 member 6
Molecular Weight
61815.78 Da
References
  1. Race JE, Grassl SM, Williams WJ, Holtzman EJ: Molecular cloning and characterization of two novel human renal organic anion transporters (hOAT1 and hOAT3). Biochem Biophys Res Commun. 1999 Feb 16;255(2):508-14. [Article]
  2. Uwai Y, Saito H, Hashimoto Y, Inui KI: Interaction and transport of thiazide diuretics, loop diuretics, and acetazolamide via rat renal organic anion transporter rOAT1. J Pharmacol Exp Ther. 2000 Oct;295(1):261-5. [Article]
  3. Akbari P, Khorasani-Zadeh A: Thiazide Diuretics . [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Plays an important role in the excretion/detoxification of endogenous and exogenous organic anions, especially from the brain and kidney. Involved in the transport basolateral of steviol, fexofenad...
Gene Name
SLC22A8
Uniprot ID
Q8TCC7
Uniprot Name
Solute carrier family 22 member 8
Molecular Weight
59855.585 Da
References
  1. Hasegawa M, Kusuhara H, Adachi M, Schuetz JD, Takeuchi K, Sugiyama Y: Multidrug resistance-associated protein 4 is involved in the urinary excretion of hydrochlorothiazide and furosemide. J Am Soc Nephrol. 2007 Jan;18(1):37-45. doi: 10.1681/ASN.2005090966. Epub 2006 Nov 29. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Mediates saturable uptake of estrone sulfate, dehydroepiandrosterone sulfate and related compounds.
Gene Name
SLC22A11
Uniprot ID
Q9NSA0
Uniprot Name
Solute carrier family 22 member 11
Molecular Weight
59970.945 Da
References
  1. Akbari P, Khorasani-Zadeh A: Thiazide Diuretics . [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Atpase activity, coupled to transmembrane movement of substances
Specific Function
May be an organic anion pump relevant to cellular detoxification.
Gene Name
ABCC4
Uniprot ID
O15439
Uniprot Name
Multidrug resistance-associated protein 4
Molecular Weight
149525.33 Da
References
  1. Hasegawa M, Kusuhara H, Adachi M, Schuetz JD, Takeuchi K, Sugiyama Y: Multidrug resistance-associated protein 4 is involved in the urinary excretion of hydrochlorothiazide and furosemide. J Am Soc Nephrol. 2007 Jan;18(1):37-45. doi: 10.1681/ASN.2005090966. Epub 2006 Nov 29. [Article]

Drug created at June 13, 2005 13:24 / Updated at March 18, 2024 16:48