Diuretics for Hypertension
| DIURETICS FOR HYPERTENSION | ||||
|---|---|---|---|---|
| Generic & Class | Brand & Company | Strength | Formulations | Usual Dose |
| LOOP DIURETICS | ||||
| furosemide | Lasix
(Sanofi Aventis) |
20mg, 40mg+, 80mg | tabs | Adults: Initially 40mg twice daily. Adding to other
antihypertensives: initially reduce other agent's dose by 50%.
Children: not recommended. |
| torsemide | Demadex
(Roche) |
5mg, 10mg, 20mg, 100mg | scored tabs | Adults: 5mg once daily, may increase to 10mg once
daily. Give IV dose over a period of 2 minutes.
Children: not recommended. |
| (various) | 10mg/mL | injection | ||
| POTASSIUM SPARING DIURETICS | ||||
| amiloride | (various) | 5mg | tabs | Adults: Administer with kaliuretic and food. Initially 5mg/day;
5–10mg usually adequate. If hypokalemia persists, may increase to 15mg/day and then
20mg/day with careful electrolyte monitoring.
Children: not recommended. |
| eplerenone | Inspra
(Pfizer) |
25mg, 50mg | tabs | Adults: Initially 50mg once daily; may increase after 4 weeks to
max 50mg twice daily. Concomitant weak CYP3A4 inhibitors (eg, erythromycin, verapamil,
saquinavir, fluconazole): initially 25mg once daily. Adjust based on serum K+ (see
literature).
Children: not recommended. |
| spironolactone | Aldactone
(Pfizer) |
25mg, 50mg+, 100mg+ | tabs | Adults: Initially 50–100mg/day in single or divided doses.
Titrate at 2 week intervals.
Children: not recommended. |
| POTASSIUM SPARING DIURETICS + HYDROCHLOROTHIAZIDE | ||||
| amiloride/ hydrochlorothiazide |
(various) | 5mg /50mg | scored tabs | Adults: Initially 1 tab daily with food. May increase to 2 tabs
daily in single or divided doses.
Children: not recommended. |
| spironolactone/ hydrochlorothiazide |
Aldactazide
(Pfizer) |
25mg/25mg, 50mg/50mg+ | tabs | Adults: Usual maintenance: 50–100mg each of spironolactone
and HCTZ daily in single or divided doses.
Children: not recommended. |
| triamterene/ hydrochlorothiazide |
Dyazide
(GlaxoSmithKline) |
37.5mg/25mg | caps | Adults: 1–2 caps once daily.
Children: not recommended. |
| Maxzide-25mg
(Bertek) |
37.5mg/25mg | scored tabs | Adults: 1–2 tabs daily.
Children: not recommended. |
|
| Maxzide
(Bertek) |
75mg/50mg | Adults: 1 tab daily.
Children: not recommended. |
||
| THIAZIDE-LIKE DIURETICS | ||||
| chlorothiazide | (various) | 250mg, 500mg | scored tabs | Adults: 0.5–1g/day as single or divided doses;
max 2g/day.
Children: <6months: up to 15mg/lb per day in 2 divided doses. ≥6months: 10mg/lb per day in 2 divided doses. |
| chlorthalidone | Thalitone
(Pfizer) |
15mg | tabs | Adults: Initially 15mg once daily; may increase to 30mg and then to a single dose of
45–50mg. If additional control required, may add second antihypertensive. Maintenance: doses may be
lower than initial doses; individualize.
Children: Not established. |
| (various) | 25mg, 50mg | tabs | Adults: Initially 25mg once daily; if needed may increase to 50mg once daily. If
additional control needed, increase to 100mg once daily or add second antihypertensive. Maintenance: doses
should be lower than initial doses; individualize.
Children: Not established. |
|
| hydrochlorothiazide | (various) | 25mg, 50mg | scored tabs | Adults: Initially 25mg once daily; usual max 50mg/day in single
or divided doses.
Children: See literature. 1–2mg/kg per day in 1 or 2 divided doses. <6months: up to 3mg/kg per day in 2 divided doses. ≤2years: max 37.5mg/day. 2–12years: up to 100mg/day. |
| Microzide
(Actavis) |
12.5mg | caps | Adults: 12.5mg once daily; usual max 50mg/day.
Children: not recommended. |
|
| indapamide | (various) | 1.25mg, 2.5mg | tabs | Adults: Initially 1.25mg once daily in the AM. May adjust at
4 week intervals to 2.5mg then 5mg once daily.
Children: not recommended. |
| metolazone | Zaroxolyn
(UCB) |
2.5mg, 5mg, 10mg | tabs | Adults: 2.5–5mg once daily.
Children: not recommended. |
| NOTES | ||||
|
+ = scored tablets (Rev. 4/2013) |
||||