HYDRO-RIDE
Clinical safety rating: caution
Comprehensive clinical and safety monograph for HYDRO-RIDE (HYDRO-RIDE).
Thiazide diuretic that inhibits sodium-chloride symporter in the distal convoluted tubule, increasing excretion of sodium and water.
| Metabolism | Not extensively metabolized; small amount undergoes hepatic metabolism. |
| Excretion | Primarily renal (50% unchanged; remainder as glucuronide conjugate); biliary/fecal <10%. |
| Half-life | Terminal half-life 4-6 hours (prolonged in renal impairment). |
| Protein binding | 95% (mainly albumin). |
| Volume of Distribution | 0.15 L/kg (indicates high plasma binding; minimal extravascular distribution). |
| Bioavailability | Oral: 60-70% (due to first-pass metabolism); IV: 100%. |
| Onset of Action | Oral: 30-60 minutes; IV: 5-10 minutes; IM: 20-30 minutes. |
| Duration of Action | 6-12 hours (dose-dependent; increased with GFR<30 mL/min). |
| Molecular Weight | 388.46 |
Initiate at 12.5-25 mg orally once daily. Titrate to 50-100 mg once daily. Maximum 200 mg per day.
| Dosage form | TABLET |
| Renal impairment | GFR 30-60: Reduce dose by 50%. GFR 15-30: Reduce dose by 75%. GFR <15: Contraindicated. |
| Liver impairment | Child-Pugh A: No adjustment. Child-Pugh B: Reduce dose by 50%. Child-Pugh C: Contraindicated. |
| Pediatric use | 1 mg/kg orally once daily, not to exceed 25 mg/day. Titrate up to 2 mg/kg/day (max 50 mg) if needed. |
| Geriatric use | Initiate at 12.5 mg orally once daily. Titrate cautiously. Monitor renal function and electrolytes. |
| 1st trimester | Avoid due to potential teratogenic effects; limited data in humans, animal studies show fetal abnormalities. |
| 2nd trimester | Use only if clearly needed and benefit outweighs risk; may cause fetal harm. |
| 3rd trimester | Avoid; risk of neonatal complications such as electrolyte disturbances and hypotension. |
Clinical note
Comprehensive clinical and safety monograph for HYDRO-RIDE (HYDRO-RIDE).
| Placental transfer | Crosses placenta; detected in fetal serum and amniotic fluid. |
| Breastfeeding | Excreted in breast milk in low concentrations; monitor infant for diarrhea, electrolyte imbalance, and weight loss. Use with caution. |
| Lactation Rating |
■ FDA Black Box Warning
None.
| Serious Effects |
AnuriaHypersensitivity to sulfonamides or thiazidesSevere renal impairment (CrCl <30 mL/min)
| Precautions | Electrolyte disturbances (hypokalemia, hyponatremia, hypomagnesemia), Hyperuricemia, Acute angle-closure glaucoma, Systemic lupus erythematosus exacerbation, Sulfonamide allergy cross-reactivity |
| Food/Dietary | Avoid excessive salt intake; may decrease drug effect. Limit alcohol consumption. May increase potassium loss; eat potassium-rich foods (e.g., bananas, oranges) unless on potassium-sparing diuretics. Grapefruit juice has not been reported to interact significantly. |
| Clinical Pearls |
Loading safety data…
| L3 (Moderately Safe) |
| Teratogenic Risk | FDA Pregnancy Category C. First trimester: potential for congenital anomalies (not well studied). Second and third trimesters: risk of fetal jaundice, thrombocytopenia, electrolyte disturbances. Avoid in preeclampsia due to reduced placental perfusion. |
| Fetal Monitoring | Monitor maternal serum electrolytes, uric acid, blood pressure, fetal growth ultrasound, and amniotic fluid index. |
| Fertility Effects | No documented adverse effects on fertility in humans. |
| Hydro-Ride (hydrochlorothiazide) is a thiazide diuretic used for hypertension and edema. Monitor serum potassium and glucose; can cause hypokalemia and hyperglycemia. Onset of diuresis is 2 hours, peak at 4 hours, duration 6-12 hours. Avoid use in severe renal impairment (CrCl <30 mL/min). May cause photosensitivity. Use with caution in patients with history of gout or SLE. |
| Patient Advice | Take exactly as prescribed, usually once daily in the morning to avoid nighttime urination. · Avoid prolonged sun exposure and use sunscreen; may increase sensitivity to sunlight. · Do not stop taking without consulting your doctor, even if you feel well. · Report signs of electrolyte imbalance: muscle cramps, weakness, irregular heartbeat, or excessive thirst. · Monitor blood pressure regularly at home and keep a log. |