Hydrochlorothiazide crosses the placental but not the blood-brain barrier and is excreted in breast milk. At least 61 percent of the oral dose is eliminated unchanged within 24 hours. When plasma levels have been followed for at least 24 hours, the plasma half-life has been observed to vary between 5.6 and 14.8 hours. ![]() Hydrochlorothiazide is not metabolized but is eliminated rapidly by the kidney. Natriuresis may be accompanied by some loss of potassium and bicarbonate.Īfter oral use diuresis begins within 2 hours, peaks in about 4 hours and lasts about 6 to 12 hours. Hydrochlorothiazide increases excretion of sodium and chloride in approximately equivalent amounts. At maximal therapeutic dosage all thiazides are approximately equal in their diuretic efficacy. Hydrochlorothiazide affects the distal renal tubular mechanism of electrolyte reabsorption. Hydrochlorothiazide does not usually affect normal blood pressure. The mechanism of the antihypertensive effect of thiazides is unknown.
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