Lasix Vs Hydrochlorothiazide

Introduction

Hypertension, also referred to as high blood pressure, is a condition that causes the blood to push hard against the walls of the arteries. The arteries transport blood from the heart to other parts of the body. A high blood pressure can force the heart to work harder to transport blood throughout the body. This may increase the thickness of the left ventricle and lead to sudden cardiac death.

High blood pressure is a very common condition in the US and affects nearly half of all adults. Two of the most popular treatments for high blood pressure include Lasix (Furosemide) and hydrochlorothiazide. Both medications help the kidney by getting rid of extra fluids and electrolytes such as potassium and sodium. This, in turn, reduces the swelling and cases of blood pressure.

About Lasix and Hydrochlorothiazide

What is Lasix?

Lasix belongs to a family of medicines known as loop diuretics (also referred to as water pills). The medicine is very effective at treating hypertension, but it does have its fair share of side effects, including an electrolyte imbalance and dehydration. Lasix is also used to treat liver disease, kidney disorders, and congestive heart failure.

The drug is made of furosemide, a chlorobenzoic acid with the chemical formula of C12H11ClN2O5S. The 4-chlorobenzoic acid is substituted by a (furan-2-ylmethyl)amino and a sulfamoyl group at positions 2 and 5, respectively.

Lasix may be taken orally as a tablet or as an oral solution before eating food. For example, patients are usually asked to take Lasix one or two hours before eating food. This is because food can interfere with the absorption of Lasix.

What conditions is Lasix approved to treat?

Lasix is used for reducing blood pressure, swelling of the legs and lungs, edema of the kidney and liver, as well as treating serious kidney problems. The act of removing excess fluid and edema from the patient has a beneficial effect and is particularly effective on patients who are on dialysis.

How does Lasix work for High Blood Pressure?

Lasix increases the secretion of water and electrolytes by preventing them from being absorbed by the proximal and distal tubes, as well as the Loop of Henle in the renal tubule Jackson. Many people refer to Lasix as a high ceiling diuretic because it has been shown to be more effective than other diuretics. Lasix can reduce the reabsorption of salts such as sodium, potassium, and chloride from the tubule.

A second mechanism of action for Lasix is through prostaglandin synthesis. Lasix can increase the production of internal prostaglandin, which improves renal blood flow. The terminal half-life of Lasix is about 120 minutes. Each dose of Lasix can work for about 6 hours before it is removed from the body.

Note that because Lasix clears out extra fluid, it could make the patient feel light-headed or sick if they don’t drink enough water. The sudden drop in blood pressure and dehydration can cause the patient to feel unwell. These conditions should subside, but if you continue to feel unwell, you should report this to your doctor.

What is Hydrochlorothiazide?

Hydrochlorothiazide is a medication that belongs to a class of drugs known as thiazide diuretics that are used to treat high blood pressure. By treating hypertension, hydrochlorothiazide can prevent heart attacks, and strokes, reduce swelling and help with kidney problems. It causes the body to make more urine, which helps it get rid of extra salts and fluids.

Hydrochlorothiazide also reduces extra fluid in the body (edema) caused by conditions such as liver disease, kidney disease, and heart failure. It can also treat various symptoms, such as swelling in the feet or ankles and shortness of breath.

Hydrochlorothiazide should be taken by mouth as directed by your healthcare provider, usually once in the morning, with or without food. It is not advised to take this drug before bedtime because it may cause you to wake up to pass urine. The best time to take this drug is at least 4 to 5 hours before your bedtime. The dosage of hydrochlorothiazide is based on your medication conditions.

The most common side effects of Hydrochlorothiazide include muscle cramps, changes in the skin, and pain. It may also interact with other blood pressure medications, such as Lasix.

What conditions is Hydrochlorothiazide approved to treat?

Hydrochlorothiazide is used to treat high blood pressure. If left untreated, hypertension can lead to severe problems with the heart and disrupt the function of arteries.

How does Hydrochlorothiazide work for High Blood Pressure?

Hydrochlorothiazide works by blocking the reabsorption of salt ions (chloride and sodium), which increases the quantity of sodium in the distal tubule and the volume of fluid excreted. It takes anywhere from 2 to 4 hours for the drug to work and lasts for about 12 hours.

This medication helps you get rid of extra fluid in the body caused by conditions such as kidney disease, liver disease, and heart failure. Hydrochlorothiazide is usually taken in the morning after breakfast.

Effectiveness

How effective are Lasix and Hydrochlorothiazide for treating High Blood Pressure?

Both hydrochlorothiazide and Lasix are extremely effective at treating hypertension. Of the two, Lasix has proven to be more efficient and is often known as a high-ceiling diuretic because of its superior results compared to other drugs.

Lasix can start working in just under 1 hour after taking an initial dose orally. However, peak effect is observed at about 2-3 hours, and activity persists for up to 8 hours. Most patients may have to wait at least one week for the drug to show its results. The average bioavailability of Lasix tablets is about 60% to 64%, depending on which form you take.

Oral tablets have been found to have a higher bioavailability. When used to treat edema, Lasix may be taken daily or on certain days of the week. However, if you want to treat high blood pressure, you may have to take Lasix around the same time every day.

Hydrochlorothiazide takes a bit longer to work, with the onset of action occurring within 2 hours of oral dosing. Activity peaks out in 4 hours and will last for about 12 hours. Most of the drug is excreted from the body through urine without having interacted with anything. This makes Lasix more effective than hydrochlorothiazide in the short run.

It is worth mentioning that hydrochlorothiazide can lower the excretion of calcium, while Lasix has the reverse effect.

Dosage information

How is Lasix administered for High Blood Pressure?

The standard dosing for Lasix is about 20 to 80 mg once a day as a singular dose; it can be divided and taken twice a day. Consumption of Lasix should not exceed 200 mg per dose.

Side Effects

What are the most-common side effects of Lasix?

Here is a look at some of the most common side effects of Lasix:

• Nausea
• Vomiting
• Stomach ache
• Vertigo (as if the room is spinning)
• Headache
• Blurry vision
• Rash or itching
• Excessive urination
• Constipation
• Diarrhea

Are there any potential serious side effects of Lasix?

* If you experience any of these serious side effects, seek medical help immediately

• Dry mouth
• Feeling thirsty
• Severe vomiting and nausea
• Pain when you eat or drink
• Fever
• Yellowing of the skin
• Yellowing of the whites of the eyes
• Ringing in the ear
• Hearing loss
• Blistering or peeling skin
• Allergic reaction
• Orthostatic hypotension
• Fatigue
• Feeling restlessness
• Muscle pain or muscle cramps
• Less frequent urination
• Drowsiness
• Abnormal heartbeat

What are the most-common side effects of Hydrochlorothiazide?

Here are the most common side effects of hydrochlorothiazide:

• Dizziness
• Fatigue
• Weakness
• Headache
• High blood sugar levels
• Low blood pressure
• Electrolyte imbalance
• Difficulty getting an erection and having low libido
• Increased skin sensitivity upon exposure to sunlight
• Muscle aches and cramps with occasional pain

Are there any potential serious side effects of Hydrochlorothiazide?

* If you experience any of these serious side effects, seek medical help immediately

• Dry mouth
• Pancreatitis
• Excessive fatigue
• Lower frequency of urination
• Seizures
• Excessive thirst
• Dizziness
• Not being alert
• Blurred visions
• Difficulty reading
• Eye pain
• Excessive vomiting

Contraindications and interactions

Warnings and general precautions for Lasix and Hydrochlorothiazide

There is a Black Box warning for Lasix because the medicine is a potent diuretic, which can cause excessive dehydration through loss of electrolytes and water, causing a severe imbalance of electrolytes in the patient. The drug has been associated with adverse side effects such as hypomagnesemia, hyperuricemia, loss of appetite, and several others.

Furthermore, it is also possible for a person to overdose on Lasix. The most common indicators of overdosing on Lasix include dehydration, reduction in blood volume, and an electrolyte imbalance.

Hydrochlorothiazide has Black Box Warnings for pregnant patients. Consumption of the drug must be discontinued as soon as pregnancy has been detected. Hydrochlorothiazide can cause severe injury to the fetus as well as death. The drug is contraindicated for patients with anuria and kidney disease.

Here are a few precautions when taking Lasix:

• Wear protective clothing to shield yourself from sun rays
• Apply sunscreen when going outdoors
• Avoid tanning
• Report to a doctor if you notice an allergic reaction to Lasix

Here are a few precautions when taking hydrochlorothiazide:

• Do not perform activities that require cognitive control, such as driving
• Do not drink alcohol
• Do not take narcotics
• Try not to take diabetes drugs
• Keep monitoring your electrolyte levels regularly

Contraindications and important interactions for Lasix and Hydrochlorothiazide

Contraindications

Lasix

• Individuals who are allergic to furosemide
• Ototoxicity
• Patients who are at a higher risk of losing excessive amounts of fluid and electrolytes
• Patients at high risk for radiocontrast-induced nephropathy
• Individuals who have a history of urinary retention
• Taking high doses of Lasix
• Hypoalbuminemia, comorbid illnesses
• Individuals who have severe renal impairment

Hydrochlorothiazide

Hydrochlorothiazide is contraindicated in patients with hypersensitivity to the drug, severe renal, hepatic failure, Addison’s disease, hypercalcemia, and anuria.

Besides the above, the drug is contraindicated in patients with

• Severe hyponatremia,
• Azotemia
• Hepatic coma

Drug/Medication Interactions

Lasix

• Aliskiren
• Carbamazepine
• Cephaloridine
• Clofibrate
• Colestipol
• Cyclosporine
• Dibekacin
• Fludrocortisone
• Germanium
• Ginseng
• Cholestyramine
• Aceclofenac
• Acemetacin
• Albuterol
• Amikacin
• Amikacin Liposome
• Amtolmetin Guacil
• Arsenic Trioxide
• Aspirin
• Azilsartan
• Azilsartan Medoxomil
• Balsalazide
• Benazepril
• Bepridil
• Bismuth Subsalicylate
• Bromfenac
• Bufexamac
• Candesartan
• Capreomycin
• Captopril
• Cefepime
• Ceftazidime
• Celecoxib
• Chloral Hydrate
• Choline Salicylate
• Cisplatin
• Clonixin
• Dasabuvir
• Dexibuprofen
• Dexketoprofen
• Dichlorphenamide
• Diclofenac
• Diflunisal
• Digitoxin
• Dipyrone
• Dofetilide
• Droperidol
• Droxicam
• Enalapril
• Enalaprilat
• Eprosartan
• Ethacrynic Acid
• Etodolac
• Etofenamate
• Etoricoxib
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Fexinidazole
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Foscarnet
• Fosinopril
• Gentamicin
• Ibuprofen
• Indomethacin
• Irbesartan
• Kanamycin
• Ketanserin
• Ketoprofen
• Ketorolac
• Leflunomide
• Levomethadyl
• Levothyroxine
• Liothyronine
• Lisinopril
• Lithium
• Lornoxicam
• Losartan
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Mesalamine
• Methotrexate
• Metolazone
• Moexipril
• Morniflumate
• Nabumetone
• Naproxen
• Neomycin
• Nepafenac
• Netilmicin
• Niflumic Acid
• Nimesulide
• Spectinomycin
• Streptomycin
• Sulfasalazine
• Sulindac
• Telmisartan
• Tenoxicam
• Teriflunomide
• Tiaprofenic Acid
• Tobramycin
• Tolfenamic Acid
• Tolmetin
• Trandolapril
• Trolamine Salicylate
• Valdecoxib
• Valsartan
• Gossypol
• Licorice
• Pancuronium
• Tubocurarine
• Nimesulide Beta Cyclodextrin
• Nitisinone
• Norepinephrine
• Olmesartan
• Olsalazine
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Paromomycin
• Perindopril
• Phenylbutazone
• Piketoprofen
• Piroxicam
• Plazomicin
• Proglumetacin
• Propyphenazone
• Proquazone
• Quinapril
• Ramipril
• Rofecoxib
• Salicylic Acid
• Salsalate
• Sodium Salicylate
• Sotalol

Hydrochlorothiazide

• Aminolevulinic Acid
• Bepridil
• Cholestyramine
• Ginkgo
• Gossypol
• Licorice
• Topiramate
• Carbamazepine
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Albuterol
• Amphetamine
• Amtolmetin Guacil
• Arsenic Trioxide
• Aspirin
• Benzphetamine
• Bromfenac
• Bufexamac
• Celecoxib
• Choline Salicylate
• Clonixin
• Deslanoside
• Desmopressin
• Dexibuprofen
• Dexketoprofen
• Ketanserin
• Ketoprofen
• Ketorolac
• Levomethadyl
• Lisdexamfetamine
• Lithium
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Methamphetamine
• Methotrexate
• Metildigoxin
• Morniflumate
• Nabumetone
• Naproxen
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Ouabain
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Phenylbutazone
• Tenoxicam
• Tiaprofenic Acid
• Tolfenamic Acid
• Tolmetin
• Valdecoxib
• Dextroamphetamine
• Diclofenac
• Diflunisal
• Digitalis
• Digitoxin
• Digoxin
• Dipyrone
• Droperidol
• Proscillaridin
• Rofecoxib
• Salicylic Acid
• Salsalate
• Sodium Salicylate
• Sotalol
• Sulindac
• Droxicam
• Etodolac
• Etofenamate
• Etoricoxib
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Flecainide
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Ibuprofen
• Indomethacin
• Piketoprofen
• Piroxicam
• Porfimer
• Proglumetacin
• Propyphenazone
• Proquazone

Food/Beverage/Supplement Interactions

Lasix

Foods to be avoided:

• Extra salt
• Processed foods

Drinks to avoid:

• Alcohol

Supplements to avoid:

• Cholestyramine
• Colestipol
• Sucralfate

Hydrochlorothiazide

Foods to be avoided:

• Grapefruit

Drinks to avoid:

• Grapefruit juice
• Alcohol

Talk to your healthcare provider if you are taking supplements with hydrochlorothiazide.

Cost Comparison

How much do Lasix and Hydrochlorothiazide cost?

The price of Lasix is about $9 for a supply of 30 tablets, with each tablet containing 20 mg of furosemide. By comparison, Hydrochlorothiazide costs about $15 for a supply of 30 tablets containing 25 mg of the drug. Both medicines are covered by most insurance plans.

Popularity of Lasix and Hydrochlorothiazide

Lasix (Furosemide) had 26.8 million prescriptions in the US in 2020 alone, as reported by ClinCalc, compared to 41.5 million for hydrochlorothiazide. This makes the latter almost twice as popular.

Conclusion

Takeaway

So there you have it, a detailed guide comparing Lasix with Hydrochlorothiazide. Both drugs have a comparable safety provider and have successfully treated many cases of hypertension. Always consult with your healthcare provider before taking these drugs and changing your dosages.