Acuren 25

Indications

Acuren is indicated for managing edema related to congestive heart failure, hepatic cirrhosis, premenstrual tension, and various renal dysfunctions (e.g., nephrotic syndrome, acute glomerulonephritis, chronic renal failure). It is also used for hypertension, either alone or in combination with other antihypertensive medications. Consult a registered physician before using this medication.

Pharmacology

Hydrochlorothiazide, a thiazide diuretic, facilitates fluid loss by inhibiting sodium and chloride reabsorption in the distal convoluted tubules of the kidneys. It may lead to potassium depletion and increased serum uric acid levels. While thiazides are commonly prescribed for hypertension, their hypotensive effects are not solely attributed to diuresis. These medications also induce vasodilation through the activation of calcium-activated potassium channels and inhibition of certain carbonic anhydrases in vascular tissues.

Dosage & Administration

For edema, start with 25 to 50 mg daily; adjust for maintenance if possible, with a maximum of 100 mg daily. For hypertension, the initial dose is 25 mg daily, which can be increased to 50 mg if needed. In the elderly, an initial dose of 12.5 mg daily may suffice. For children, begin with 1 to 2 mg per kg of body weight in two divided doses; infants under 6 months may require up to 3 mg per kg daily. Consult a registered physician before using this medication.

Interactions

Co-administration with alcohol, barbiturates, or narcotics may enhance orthostatic hypotension. Adjustments may be necessary for oral and parenteral antidiabetic drugs, and other antihypertensives may have an additive effect. Discontinuing diuretics 2-3 days before starting ACE inhibitors can help mitigate first-dose hypotension.

Contraindications

Not to be used in patients with anuria, hypersensitivity to Hydrochlorothiazide or sulphonamide drugs, severe renal or hepatic failure, Addison’s disease, hypercalcemia, or those on concurrent lithium therapy.

Side Effects

Common side effects include gastrointestinal issues (anorexia, nausea, vomiting, cramps), central nervous system effects (dizziness, headache), and potential hematological issues (leucopenia, thrombocytopenia). Cardiovascular effects may include hypotension. Monitor for electrolyte imbalances and other symptoms. Adjust dosage or discontinue if severe side effects occur.

Pregnancy & Lactation

Thiazides cross the placental barrier; use during pregnancy must weigh benefits against risks to the fetus, including jaundice and thrombocytopenia. If deemed essential during breastfeeding, the patient may need to cease nursing.

Precautions & Warnings

Monitor for signs of fluid and electrolyte imbalances, including symptoms like weakness and muscle cramps. Hypokalemia can exacerbate the effects of digitalis. Use potassium-conserving agents if needed, and exercise caution in patients with impaired renal or hepatic function.

Overdose Effects

Signs of overdose may include electrolyte depletion and dehydration due to excessive diuresis. Management involves symptomatic treatment, possibly including gastric lavage.

Therapeutic Class

Thiazide diuretics and related medications.

Storage Conditions

Store below 30°C, away from light and moisture, out of reach of children.