Hydrochlorothiazide (HCTZ) side effects

This is anecdotal information, based solely on my own experience...

Your symptoms suggest you probably need a potassium supplement, and I am surprised that your doctor
has not checked your level after placing you on HCTZ.

I have been on Maxzide (combination of Hydrochlorothiazide and Triamterene) for years. Even though
the Triamterene is potassium-sparing (HCTZ is potassium-depleting), I need extra potassium. In fact,
even with the supplement (I use KCl instead of salt), my K level was low when I went into the
hospital for some surgery last year.

Chas.

On 5 Jan 2004, [email hidden] (Charles Jones) wrote:

I have used HCTZ for years. The only problem I've had is that

Quoted message said:

My doctor prescribed Hydrochlorothiazide (HCTZ) for high blood pressure about five months ago.
(More recently, he also added Toprol.) Since receiving the HCTZ, my pulse seems to have gone up
drastically, from 70 to between 90 and 100. Is this a known potential side-effects of HCTZ?

I have tried searching the Web for an answer, and it's surprisingly difficult to find a clear
answer. Some web sites say HCTZ can cause "irregular" heartbeat, without specifying if that means
faster or slower. Some other sites discuss HCTZ along with related medicines, so it's hard to know
if the side effects they list relate to HCTZ or to the other medicines. (If anyone can direct me to
a Web site that gives comprehensive information exclusively for HCTZ, that would be helpful.)

One other question -- I've also been getting muscle spasms in my neck. In the past I've had spasms
in my back, which seemed to be tension related, but these neck spasms are new. Can either HCTZ or
Toprol cause this?

Thanks in advance for all replies.

CJ

[email hidden] (Charles Jones) wrote in message news:<[email hidden]>...

Quoted message said:

My doctor prescribed Hydrochlorothiazide (HCTZ) for high blood pressure about five months ago.
(More recently, he also added Toprol.) Since receiving the HCTZ, my pulse seems to have gone up
drastically, from 70 to between 90 and 100. Is this a known potential side-effects of HCTZ?

Hi,

The following should be addressed:

1. Your blood pressure before initiation of HCTZ
2. The dose of HCTZ and any changes
3. Your blood pressure before initiation of Toprol (metoprolol)
4. The dose of metoprolol and any changes in dose
5. Your current blood pressure
6. How long time it took before your pulse went up and if it is still high
7. Your blood glucose
8. Any other medications you might be on
9. Your serum potassium level and serum magnesium level (the former should be monitored regularly)
(-any leg cramps or muscle weaknesses?)

First of all, the goal of therapy is usually to reduce the blood pressure (BP) to below 140/90 mmHg.
Before initiation of therapy it is normal to try to acheive this goal by changes in diet (reduce
salt intake). A dose of 25 mg HCTZ daily (in the morning) is usually sufficient to reduce the BP by
20/10 mmHg and higher doses usually increase the risk of side effects. Thiazides may result in
hypokalaemia (low potassium) which might lead to hypomagnesia. The latter may result in heart
disturbances. It might be worth to check up these levels. Initially, thiazides reduce you blood
volume (you probably had to visit the bathroom pretty regularly the first 2-4 weeks?) - however this
stabilises after about 4 weeks. This is the main cause of the BP lowering effect of thiazides.
Thiazides may also activate the renin-angiotensin system which is a response system to compensate
for the BP. Increased heart rate is also a way to compensate for reduced BP.

Has your heart rate gone down to your regular rythm after initiation of metoprolol? Is your BP
within the target range now?

Wops, I just read about your muscle spasms in your neck. You should definitely check your potassium
level (and magnesium level) - it might be a clear indication for putting you on potassium
supplements. You could also get potassium from bananas and potatoes (but high intake is not
recommended due to high carbohydrate).

Hope this might help.

Rgds, Oistein London

Quoted message said:

I have tried searching the Web for an answer, and it's surprisingly difficult to find a clear
answer. Some web sites say HCTZ can cause "irregular" heartbeat, without specifying if that means
faster or slower. Some other sites discuss HCTZ along with related medicines, so it's hard to know
if the side effects they list relate to HCTZ or to the other medicines. (If anyone can direct me
to a Web site that gives comprehensive information exclusively for HCTZ, that would be helpful.)

One other question -- I've also been getting muscle spasms in my neck. In the past I've had spasms
in my back, which seemed to be tension related, but these neck spasms are new. Can either HCTZ or
Toprol cause this?

Thanks in advance for all replies.

CJ