Hydrochlorothiazide is a diuretic from the thiazide family, used medically for the treatment of edemas and hypertension. This drug acts by reducing the reabsorption of electrolytes, thereby increasing the excretion of sodium, potassium, chloride, and consequently water. In comparison to other diuretics, Hydrodiuril is stronger than the potassium sparing agent Aldactone® (spironolactone), but weaker then the loop agent Lasix (furosemide). While potassium excretion is much less pronounced than that seen with Lasix, the use of a potassium supplement (or a potassium rich diet) may still be necessary with this product. This is usually dependent on the dose and duration in which the drug is administered. Calcium excretion may also be pronounced with thiazides, but again, are weaker in this regard than Lasix.
The use of diuretics has been increasingly popular in a number of athletic disciplines. For starters, these drugs are very popular among bodybuilders who use them to shed subcutaneous water before a competition. The ability to have a winning physique often relies heavily on the definition that can result from diuretic use. The highly defined, super hard and shredded look common today in this sport is nearly impossible to achieve without the use of these drugs. Many athletes competing in sports with weight categories also utilize diuretics. Wrestlers and boxers, for example, might use diuretics to compete in a heavier weight class than would be dictated by an earlier weigh-in measurement. Given that the weight-in is usually done a day (or many hours) before a competition, the athlete can reduce water weight with diuretics, yet have enough time to restore fluids and bodyweight before the event. The result can be a shift of one or more weight categories, which can be a formidable advantage in these types sports.
Hydrochlorothiazide was developed during the 1950s. Given the widespread nature of diseases associated with high blood pressure and edema, the drug found a very large market, and quickly achieved large-scale acceptance and distribution. Hydrochlorothiazide became a fundamental form of therapy in this area of medicine, where it remains widely available today. Hydrochlorothiazide preparations are available in virtually all developed nations, and appear in literally hundreds of different brand name and generic products. SingleIngredient preparations (where hydrochlorothiazide is the only active drug) are far outnumbered by multi-ingredient preparations, where the drug is often mixed with other actives that focus on diuresis or blood pressure management.
Hydrochlorothiazide is most commonly supplied in tablets of 25 mg and 50 mg.
Hydrochlorothiazide is a diuretic and antihypertensive. It is the 3,4dihydro derivative of chlorothiazide, and has the chemical designation 6-chloro3,4-dihydro-2H-1,2,4-benzothiadiazine-7-sulfonamide 1,1dioxide.
Warnings (Dehydration, Death);
The misuse of diuretic drugs for physique- or performanceenhancing purposes is characterized as a high-risk practice. Diuretics may produce a life-threatening level of dehydration and electrolyte imbalance when administered without proper medical supervision. Many deaths have been associated with the misuse of these drugs.
Hydrochlorthiazide use may be associated with electrolyte imbalance. This may include potassium and sodium deficiency, as well as hypochloremic alkalosis (an increase in blood bicarbonate due to significant chloride loss). Signs of electrolyte imbalance include dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pain, muscle cramping, seizures, reduced urine volume, low blood pressure, and gastrointestinal disturbances. Other side effects may include reduced appetite, nausea, vomiting, constipation, diarrhea, inflammation of salivary gland(s), headache, dizziness, sensitivity to light, low blood pressure upon standing, skin irritation, impotence, visual disturbances, jaundice, pancreatitis, and inflammation of the lung(s). Additionally, some rare side effects characterized as hypersensitivity reactions have been reported including skin rash, fever, shock, pulmonary edema and respiratory distresses.
When used medically to treat hypertension, the usual initial dose in adults is 25 mg daily given as a single dose. The dose may be increased to 50 mg daily, often in two doses of 25 mg. Note that daily doses above 50 mg are often associated with marked reductions in serum potassium. Athletes and bodybuilders typically use this drug (off-label) for very brief periods (several days) of water adjustment. A common practice is to administer this drug once per day, after the morning meal. The athlete will monitor the level of water lost throughout the day, and adjust the dosage for the following day if necessary. The usual starting dosage is one 50 mg tablet. The user will adjust the effect by adding a 25 mg or 50 mg tablet each subsequent day. This practice is only followed for three or four days, until an optimal dosage is calculated. The total daily dosage will rarely exceed 100-200 mg (doses above 100 mg per day in a clinical setting are not commonly recommended).
If the application of hydrochlorothiazide is not producing the desired effect, many bodybuilders/athletes will choose to add another diuretic (mild) before moving to the stronger loop agents. A combination of a potassium sparing diuretic like Aldactone® (spironolactone) and Hydrodiuril is regarded as particularly useful by many, and is believed to slightly balance out the calcium and potassium loss associated with the use of hydrochlorothiazide. The dosage of each agent would be reduced considerably, usually starting with a 25 mg/25 mg application and working upwards.
It is important to note that the overuse of diuretics, aside from being potentially very dangerous, may result in too much water loss. This can lead to flat, ‘deflated’ looking muscles. A higher diuretic dosage, likewise, does not always equate to increased definition and muscularity. It is usually regarded as good advice by those in the athletic community to become familiar with the practice of using diuretics before using them during competition time. Otherwise, the user may be left to make frantic dosage adjustments at the last minute, which can be a dangerous and ineffective practice.
Hydrochlorothiazide is widely manufactured in both single ingredient and multi-ingredient drug preparations. Low cost and wide scale availability make this a poor financial target for counterfeiting.