HYDROPANE
Clinical safety rating: caution
Comprehensive clinical and safety monograph for HYDROPANE (HYDROPANE).
Thiazide diuretic; inhibits sodium chloride cotransporter in distal convoluted tubule, increasing excretion of sodium and water, and reducing plasma volume.
| Metabolism | Hepatic CYP450 metabolism (minimal); not extensively metabolized; excreted primarily unchanged in urine. |
| Excretion | Renal (approximately 50% as unchanged drug) and hepatic metabolism to inactive metabolites; fecal elimination accounts for about 10%. |
| Half-life | Terminal elimination half-life is approximately 8-15 hours in patients with normal renal function; may be prolonged in renal impairment. |
| Protein binding | Highly bound to plasma proteins (>95%), primarily to albumin. |
| Volume of Distribution | Apparent volume of distribution is approximately 1 L/kg, suggesting extensive tissue distribution. |
| Bioavailability | Oral bioavailability is approximately 70% due to first-pass metabolism. |
| Onset of Action | Oral: diuresis begins within 1 hour; peak effect at 2-3 hours. |
| Duration of Action | Duration of diuretic effect is about 6-12 hours after oral administration. |
50–100 mg orally once daily, maximum 200 mg daily
| Dosage form | SYRUP |
| Renal impairment | GFR <15 mL/min: not recommended. GFR 15–29 mL/min: 25 mg once daily. GFR 30–59 mL/min: no adjustment. |
| Liver impairment | Child-Pugh A: no adjustment. Child-Pugh B: reduce dose by 50%. Child-Pugh C: not recommended. |
| Pediatric use | 1–2 mg/kg orally once daily; maximum 50 mg daily |
| Geriatric use | Start at 25 mg orally once daily; titrate to effect, max 100 mg daily, monitor electrolytes and renal function. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for HYDROPANE (HYDROPANE).
| Breastfeeding | Excreted into human milk; M/P ratio unknown. Avoid breastfeeding or use with caution due to potential adverse effects in the nursing infant. |
| Teratogenic Risk | First trimester: Not associated with major congenital malformations. Second and third trimesters: May cause fetal hypotension, renal impairment, oligohydramnios, and skull ossification defects. Avoid in pregnancy-induced hypertension due to reduced placental perfusion. |
| Fetal Monitoring |
■ FDA Black Box Warning
No FDA black box warning.
| Serious Effects |
["Anuria","Renal failure","Severe hepatic impairment","Hypersensitivity to hydrochlorothiazide or other sulfonamide-derived drugs"]
| Precautions | ["Hypokalemia","Hypomagnesemia","Hyperuricemia","Hyperglycemia","Hyperlipidemia","Volume depletion/hypotension","Sensitivity to sulfonamides (may cause sulfonamide allergy cross-reaction)","Renal impairment","Electrolyte monitoring required"] |
Loading safety data…
| Monitor maternal blood pressure, serum electrolytes, renal function, and fetal growth ultrasound for oligohydramnios. |
| Fertility Effects | No significant impact on fertility reported; reversible effects on reproductive function in animal studies at high doses. |