What is Hydrochlorothiazide? Addiction, Abuse, Effects & Symptoms

Hydrochlorothiazide, also known by the brand names Microzide, Esidrix, Zide, Oretic, HydroDiuril, and Ezide, is a medication commonly prescribed to treat high blood pressure. It is a diuretic and helps rid your body of excess salt and water by increasing your urine production. It can also be prescribed for the treatment of edema (swelling) commonly experienced with liver disease, kidney disease, or heart failure. Some doctors have prescribed Microzide to treat a fluid imbalance known as diabetes insipidus and to prevent kidney stones in people with high calcium levels. This medication is commonly used in conjunction with other medications and lifestyle changes to manage high cholesterol, high blood pressure, and heart disease.

Approved by the U.S. Food and Drug Administration (FDA) in 1959, hydrochlorothiazide is now the second-most commonly prescribed medication in the United States to treat high blood pressure. Despite this popularity, studies have found that hydrochlorothiazide may be inferior to other blood pressure medications on the market. One manufacturer that produced tablets containing hydrochlorothiazide and lorsartan potassium also voluntarily recalled the tablets after impurities were found in some ingredients.

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Side Effects of Hydrochlorothiazide

Even with prescribed use, there are many side effects possible when taking hydrochlorothiazide. Users might experience the following:

  • Upset stomach or nausea
  • Headaches
  • Dizziness
  • Lightheadedness
  • Dehydration
  • Salt/mineral imbalances
  • Dry mouth
  • Muscle cramps or weakness
  • Confusion
  • Decreased urination or frequent urination
  • Irregular heartbeat
  • Diarrhea
  • Constipation
  • Loss of appetite
  • Increased thirst
  • Hair loss
  • Photosensitivity
  • Blurred vision

Users may often manage such side effects with assistance from their doctors, who may change the dosage on their prescriptions or take other measures. For some users, the side effects may be more significant, including severe dehydration, jaundice, unusual bleeding, seizures, life-threatening changes to the heart rate or rhythm, tingling or numbness, kidney damage, severe stomach pain, or clay-colored stool. Such side effects are considered emergencies and people should seek treatment immediately.

Can You Get High From Hydrochlorothiazide?

A drug such as hydrochlorothiazide does not produce a high in the way we typically think of being high. The drug does not alter one’s mental state or mood, nor does it typically impact one’s behavior. It also does not give users a feeling of euphoria that reinforces their substance use. Therefore, a diuretic is not typically a drug of choice for someone with a substance use disorder.

There are some individuals, primarily women and athletes, who abuse hydrochlorothiazide as a way to cope with water retention since the drugs prompt people to urinate frequently. Some women tend to abuse diuretics for this reason, sometimes using them without a prescription to lose weight before a vacation or special event or use them as part of an eating disorder. In addition, some people abuse the medication as a way to attempt to dilute their urine and pass a drug screening test if they have been using other drugs.

Athletes Doping with Diuretics

Diuretic abuse is a particular concern among athletes. Athletes such as wrestlers may use diuretics as a way to lose weight rapidly and dehydrate their bodies so that they can compete at a lower weight class. Diuretic abuse among athletes also occurs when gymnasts and ballet dancers misuse the drugs as a way to maintain a lower body weight and reduce bloating.

In addition to lowering body weight, some athletes use diuretics as a way to flush traces of performance-enhancing steroids or stimulants out of their bodies before undergoing mandatory urine drug tests. But drug tests detect the presence of diuretics such as hydrochlorothiazide, especially within the twenty-four to forty-eight hours after using the drug.

It is worth noting that diuretics, including hydrochlorothiazide, are banned substances in many major sporting organizations, as well as sporting events relating to Olympic events and the National Collegiate Athletic Association (NCAA). The U.S. Anti-Doping Agency has banned hydrochlorothiazide during and outside of competition.

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Risks and Dangers of Long-Term Hydrochlorothiazide Abuse

Physicians who prescribe diuretics monitor people for significant or harmful side effects. If people do not tolerate the drug well, doctors may adjust the dosage accordingly. Physicians will also likely monitor the patients’ hearts, livers, and kidneys to make sure the medication is not negatively impacting any of the body’s systems. They may also quickly correct any problems that people experience, such as dehydration or electrolyte imbalances.

When people abuse hydrochlorothiazide, they frequently do not have the assistance of physicians who are monitoring their health. In addition, if people are abusing diuretics, they may not even tell their physicians they are using them. While diuretic abuse is rare, the side effects of the medication, combined with a lack of monitoring and a lack of knowledge of any potential drug interactions, may lead to significant and even life-threatening consequences.

Using diuretics, especially using them without prescriptions or without monitoring from physicians, may lead to severe dehydration, further affecting the heart, kidneys, brain, and respiratory system. To function appropriately, the body requires a careful balance of fluids and electrolytes. In healthy individuals, the kidneys are easily able to maintain this balance as long as people drink an adequate amount of liquids and do not ingest too much or too little salt.

If you do not have a kidney problem or issues maintaining appropriate electrolyte balance, taking a diuretic could quickly cause an imbalance and make you lose too much fluid too quickly. When this electrolyte imbalance occurs, brain damage, seizures, cardiac arrest, and death may occur.

Hydrochlorothiazide and Drug Interactions

Hydrochlorothiazide and other diuretics may interact with a variety of prescription medications and illicit drugs. Significant and sometimes life-threatening interactions may occur may occur if people use hydrocholorthiazide with the following drugs:

  • Acarbose
  • Acetaminophen
  • Alcohol
  • Amphetamines (legal and illicit)
  • Antianxiety medications
  • Antiarrhythmic drugs
  • Antidepressants
  • Antihypertensive agents
  • Barbiturates
  • Caffeine
  • Cocaine
  • Cymbalta
  • Digoxin
  • Furosemide (Lasix)
  • Ibuprofen
  • Lithium
  • MDMA
  • Metformin
  • Metoprolol
  • Muscle relaxers
  • Nexium
  • Norco
  • Opioid antagonists
  • Percocet
  • Prednisone
  • Proton pump inhibitors
  • Sedatives
  • Vitamin D3
  • Xanax

Additionally, people who are allergic to penicillin or sulfonamides (sulfa drugs) are often unable to take hydrochlorothiazide. While the exact reason is not yet known, many who are allergic or sensitive to penicillin or sulfa medications are also allergic or sensitive to some diuretics, including hydrochlorothiazide.

Combining other substances with hydrochlorothiazide may be potentially dangerous. For example, try to avoid consuming alcohol if you are using hydrochlorothiazide. Alcohol can dehydrate the body. Combining the two substances may lead to a sudden drop in blood pressure, resulting in dizziness, fainting, and even potential head injuries.

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Treatment for Doping or Diuretic Abuse

Athletes using performance enhancing drugs (doping) or using diuretics without the guidance of a licensed physicians should seek help to prevent severe dehydration, cardiac issues, or organ damage. Athletes can find support through anti-doping organizations or through their athletic programs. It will be important to get clean if you wish to continue competing in your sport, so reaching out for help as soon as possible is essential for getting back on the playing field.

If your diuretic abuse is a result of attempting to hide other types of substance use disorder or an eating disorder, finding a qualified treatment facility can help you address your mental health and substance use disorder disorders. By taking a whole-person approach to substance use disorder treatment, we can help you stop your diuretic use by addressing the factors that lead to your substance use disorder in the first place. Call us today for help ending your doping or substance use disorder disorder.

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Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance use disorder, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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