Moxonidine + Hydrochlorothiazide Pharmacology

Moxonidine + Hydrochlorothiazide

About Moxonidine + Hydrochlorothiazide
Mechanism of Action of Moxonidine + Hydrochlorothiazide
Pharmacokinets of Moxonidine + Hydrochlorothiazide
Onset of Action for Moxonidine + Hydrochlorothiazide
Duration of Action for Moxonidine + Hydrochlorothiazide
Half Life of Moxonidine + Hydrochlorothiazide
Side Effects of Moxonidine + Hydrochlorothiazide
Contra-indications of Moxonidine + Hydrochlorothiazide
Special Precautions while taking Moxonidine + Hydrochlorothiazide
Pregnancy Related Information
Old Age Related Information
Use with caution
Breast Feeding Related Information
Children Related Information
Indications for Moxonidine + Hydrochlorothiazide
Interactions for Moxonidine + Hydrochlorothiazide
Typical Dosage for Moxonidine + Hydrochlorothiazide
Schedule of Moxonidine + Hydrochlorothiazide
Storage Requirements for Moxonidine + Hydrochlorothiazide
Effects of Missed Dosage of Moxonidine + Hydrochlorothiazide
Effects of Overdose of Moxonidine + Hydrochlorothiazide


About Moxonidine
Centrally-acting antihypertensive.
Mechanism of Action of Moxonidine
Moxonidine is a centrally-acting antihypertensive. It acts in the brainstem through stimulation of central imidazoline receptors to reduce sympathetic tone. Moxonidine also has a low affinity for ?2-adrenoceptors.
Pharmacokinets of Moxonidine
Absorption: Absorbed rapidly from the GI tract
Distribution: Plasma protein binding around 7%; present in breast milk
Excretion: Excreted in the urine (78% as unchanged drug)
Onset of Action for Moxonidine
Duration of Action for Moxonidine
Half Life of Moxonidine
Side Effects of Moxonidine
1.Dry mouth
6.Sleep disturbances
9.Skin reactions
14.Parotid pain
15.Vivid dreams
16.Impotence and loss of libido
17.Urinary retention or incontinence
18.Slight orthostastic hypotension
19.Fluid retention
Contra-indications of Moxonidine
1.Conduction disorders
3.Severe arrhythmias
4.Severe heart failure
5.Severe ischaemic heart disease
6.History of angioedema
7.Severe liver or renal impairment
8.Raynaud's syndrome
9.Intermittent claudication
12.Parkinson's disease
Special Precautions while taking Moxonidine
1.Renal impairment
2.Avoid abrupt withdrawal (if concomitant treatment with ?-blocker has to be stopped, discontinue ?-blocker first, then moxonidine after few days)
Pregnancy Related Information
Old Age Related Information
Breast Feeding Related Information
Children Related Information
Contra indicatedaged under 18 years.
Indications for Moxonidine
Interactions for Moxonidine
1.Additive effects with other antihypertensives
2.May increase sedative effects of benzodiazepines
3.Effects may be antagonised by TCAS
Typical Dosage for Moxonidine
Hypertension:Oral:Adult: 200 mcg once daily, increase if necessary after 3 wk to 400 mcg daily as single or in 2 divided doses. If necessary, after a further 3 wk, increase to 600 mcg daily in 2 divided doses. Max: 600 mcg daily.
Schedule of Moxonidine
Storage Requirements for Moxonidine
Do not store above 25?C.
Effects of Missed Dosage of Moxonidine
If you miss a dose ignore it and take the next dose at the normal time. Do not take two doses together to make up for the one you have missed.
Effects of Overdose of Moxonidine
1.Taking too much moxonidine may cause the following: sedation (confusion and sleepiness), low or high blood pressure, dizziness, fainting, sickness, dry mouth, slowing of heart rate, shortness of breath, narrowing of the pupil of the eye (miosis) and coma.
2.People who have taken too much moxonidine should call a doctor or go to the nearest hospital casualty department immediately.


About Hydrochlorothiazide
Thiazide derivatibve, Diuretic.
Mechanism of Action of Hydrochlorothiazide
It is thiazide diuretic which exerts its action by acting at site-3(central dilating segment of early distal tubule). It binds to Na+Cl- symporter and inhibits Na+Cl- symport at the luminal membrane. It has additional carbonic anhydrase inhibitory actions in proximal tubules. It increases natriuresis, kaliuresis and diuresis. It decreases Ca2+ excretion and increases Mg2+excretion. It also has minor carbonic anhydrase inhibitory action. It also causes direct arteriolar vasodilatation and decreases total peripheral resistance. The antihypertensive actions of the drug may be attributable to depletion of sodium and subsequent reduction in plasma volume and a decrease in peripheral resistance. Decrease in peripheral resistance is due to either the loss of sodium from the arteriolar wall or a direct action on the vascular bed. It is an effective drug in edema associated with congestive heart failure.
Vertigo: Diuretics are used in vertigo in assumption that vertigo is due to endolymphatic hydrops. They reduce labyrinthine fluid pressure

Pharmacokinets of Hydrochlorothiazide
Absorption: It is absorbed after oral administration.
Metabolism: It is not metabolized in the body.
Excretion: Excreted unchanged in urine.

Onset of Action for Hydrochlorothiazide
1 to 3 hours
Duration of Action for Hydrochlorothiazide
12 to 16 hours
Half Life of Hydrochlorothiazide
5 to 15 hours
Side Effects of Hydrochlorothiazide
1. Dizziness
2. Blurred vision
3. Confusion
4. Tingling fingers
5. Dry mouth
6. Nausea
7. Diarrhoea
8. Constipation
9. Vomiting
10. Weakness
11. Hypokalaemia
12. Hyponatraemia
13. Hyperuricaemia
14. Elevated levels of glucose, calcium and lipids
15. Gastro intestinal disturbances
16. Polyuria
17. Electrolyte imbalance
18. Jaundice
19. Rashes
20. Photosensitivity
21. Fever
22. Itching
23. Myalgia
24. Muscle cramps
25. Arthralgia
26. Blood dyscrasias
27. Ototoxicity

Contra-indications of Hydrochlorothiazide
1. Hyper uricaemia
2. Hyper calcaemia
3. Renal impairment
4. Hepatic impairment
5. Anuria
6. Hypersensitivity to the drug
7. Hyper sensitivity to sulfonamides
8. Fluid and electrolyte imbalance

Special Precautions while taking Hydrochlorothiazide
1. Gout
2. Diabetes mellitus
3. Renal impairment
4. Hepatic impairment
5. Monitor and correct Fluid and electrolyte imbalance
6. Hyper parathyroidism
7. Cirrhosis

Pregnancy Related Information
Old Age Related Information
Use with caution
Breast Feeding Related Information
Children Related Information
May be used
Indications for Hydrochlorothiazide
1. Hypertension
2. Oedema associated with heart failure
3. Oedema due to renal and hepatic diseases
4. Diabetes insipidus
5. Idiopathic hypercalciurea.
6. Vertigo
Interactions for Hydrochlorothiazide
Cholestyramine & Colestipol: decrease absorption of hydrochlorothiazide.
Diazoxide: Additive action - may cause hyperglycemia, hyperuricaemia and hypotension.
Digitalis: Diuretics induced hypokalaemia may precipitate digitalis toxicity.
Lithium: Hydrochlorothiazide potentiates therapeutic and toxic effects by increasing its renal excretion.
Frusemide: Synergy leading to profound diuresis and greater than predicted electrolyte loss.
Non-depolarizing muscle relaxants: Diuretics induced hypokalaemia enhances efficacy.
Sulfonylureas: Efficacy decreased due to hydrochlorothiazide induced glucose intolerance.
Chlorpropamide: Hypokalaemia.
Propantheline: Bioavailability of hydrochlorothiazide increased.
Metoclopramide: Bioavailability of hydrochlorothiazide decreased.
NSAIDs: Natriuretic effect of hydrochlorothiazide decreased.
Typical Dosage for Hydrochlorothiazide
Hypertension: 25mg once daily or in divided doses. Increased to 50mg if required; depending up on the patient`s response.
Children: 1mg/kg single daily dose.
Starts with 25 to 50mg. Increased the dose until desired response is obtained.
Maximum dose: 200mg/day
Maintenance dosage: 25 to 100mg daily or on alternate days.
Children: 1mg/kg single daily dose or 1 to 3mg/kg/day in two divided doses

Schedule of Hydrochlorothiazide
Storage Requirements for Hydrochlorothiazide
Store at room temperature in a well closed container and protected from light.
Effects of Missed Dosage of Hydrochlorothiazide
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose.Continue the regular schedule.Do not double the dose.
Effects of Overdose of Hydrochlorothiazide
Treatment is supportive and symptomatic. Remove drug from the body by induced emesis and gastric lavage. Monitor and assist respiratory, cardiovascular, and renal function as indicated. Monitor and support fluid and electrolyte balance.

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