NEO-URIZIDE - HYDROFLUMETHIAZIDE

Adults:

Oedema: 50 to 200 mg daily, depending upon the severity of the oedema, as a single dose in the morning. The daily dose should be given early enough to complete diuresis by bedtime. Antihypertensive: 25 to 50 mg daily; when given as an adjunct to other antihypertensive agents the dose of the latter should be halved.

Maintenance:

Doses of 25 to 50 mg on alternate days are usually adequate for maintenance therapy.

Children over 12 years:

Daily dosage in children will be at the discretion of the physician; 1 mg per kg of bodyweight has been suggested as suitable for most cases.

Elderly:

The adult dosage of NEO-URIZIDE may need to be reduced in the elderly, particularly when renal function is impaired because of the possibility of electrolyte imbalance.

Route of administration:

Oral

Impotence. Mild anorexia or indigestion may be avoided by taking dose after meals. The following have also been reported as undesirable effects of thiazide diuretics: postural hypotension, hypokalaemia, hyponatraemia, hypomagnesaemia, hypercalcaemia, hypochloraemic alkalosis, gout, hyperuricaemia, hyperglycaemia, altered plasma lipid concentrations, skin rashes, photosensitivity, blood disorders (including neutropenia and thrombocytopenia), hypersensitivity reactions, pancreatitis, intrahepatic cholestasis, bone marrow depression.

Cases of choroidal effusion with visual field defect have been reported after the use of thiazide and thiazide-like diuretics. Gastrointestinal disorders, not known (frequency cannot be estimated from the available data): diarrhoea

NEO-URIZIDE may precipitate or aggravate diabetes and may impair control of diabetes in patients receiving sulphonylureas. Supplementary potassium is strongly recommended in patients receiving digitalis who require prolonged diuretic treatment.

May cause hypokalaemia, which may be corrected with potassium or a potassium- sparing drug. Renal function should be monitored. Increased risk of hypomagnesaemia in alcoholic cirrhosis. May aggravate gout. Serum uric acid levels may be raised with or without gout in some patients.

Treat with caution in hepatic or renal impairment (avoid if severe). May aggravate systemic lupus erythematosus. Blood dyscrasias and pancreatitis have been reported. Patients on long-term treatment and elderly patients need blood tests to monitor blood electrolyte levels and blood dyscrasias.

Expectant mothers who receive thiazide diuretics may be at increased risk from acute haemorrhagic pancreatitis; thrombocytopenia has been reported in newborn infants following antepartum use of thiazides. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Choroidal effusion, acute myopia and secondary angle-closure glaucoma:

Sulfonamide or sulfonamide derivative drugs can cause an idiosyncratic reaction resulting in choroidal effusion with visual field defect, transient myopia and acute angle-closure glaucoma. Symptoms include acute onset of decreased visual acuity or ocular pain and typically occur within hours to weeks of drug initiation.

Untreated acute angle-closure glaucoma can lead to permanent vision loss, the primary treatment is to discontinue drug intake as rapidly as possible. Prompt medical or surgical treatments may need to be considered if the intraocular pressure remains uncontrolled.

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy.

Hypersensitivity, severe renal or hepatic failure, Addisons disease, hypercalcaemia, symptomatic hyperuricaemia, refractory hypokalaemia, hyponatraemia and concurrent lithium therapy.