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Hydrochlorothiazide

Hydrochlorothiazide is a thiazide “water pill” (diuretic) used to treat high blood pressure and to reduce fluid buildup (edema) from conditions such as heart failure, liver cirrhosis and kidney disease.

Brand names MicrozideOreticEsidrixHydrodiurilZide +1 more
Drug class Thiazide Diuretic
Rx Forms 3
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026 Content updated Oct 2, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 162 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

Hydrochlorothiazide at a glance The quick version — the full detail is in the Patient Information Guide below.
Dr. Brian Staiger, PharmD, BCPS
The Pharmacist’s Take By · Clinical pharmacist · Written

Hydrochlorothiazide is a thiazide diuretic (a “water pill”) that helps the kidneys flush out extra salt and water, lowering high blood pressure and, in some products, easing swelling from heart failure, cirrhosis or kidney disease. On the market since the late 1950s and available generically, it is a familiar first choice and a common add-on. Most people tolerate it well, noticing mainly extra bathroom trips early on and some lightheadedness when standing up quickly. Watch for eye pain or sudden blurred vision in the first hours to weeks, a sign of angle-closure glaucoma (a sudden rise in eye pressure) that needs prompt medical care. Also report a severe rash or signs of dehydration promptly.

Clinical pearls

  • Take it in the morning so the extra urination happens during the day rather than waking you at night.
  • If you take lithium, every prescriber should know about this drug, since it can push lithium to toxic levels.
  • Use sunscreen and check your skin for new or changing growths, since it raises sun sensitivity and non-melanoma skin cancer risk.
  • Periodic blood tests check potassium and sodium, and regular NSAIDs such as ibuprofen can weaken its blood pressure effect.
How we write & review this content — our editorial policy →
How you get itPrescription only
Comes asTablet, Capsule, Oral suspension
Earliest FDA record1959
Companies listing it with the FDA39
FDA label last updatedDec 5, 2025
FDA’s strongest warning (boxed)None on the label

Patient information guide A plain-language walkthrough of Hydrochlorothiazide, written from its FDA label.

What Hydrochlorothiazide is used for

▾

Hydrochlorothiazide is used for high blood pressure and for edema, depending on the product.

  • High blood pressure: Inzirqo (oral suspension), hydrochlorothiazide tablets and hydrochlorothiazide capsules are used, alone or with other blood pressure medicines.
  • Edema: Inzirqo is used for edema from heart failure, liver cirrhosis and kidney disease including nephrotic syndrome, in adults and children.
  • Edema (tablets): Hydrochlorothiazide tablets are used as add-on therapy for edema from heart failure, liver cirrhosis, and corticosteroid and estrogen therapy. They are also useful for edema from kidney problems such as nephrotic syndrome, acute glomerulonephritis and chronic kidney failure.
  • Capsules: The capsule labels list high blood pressure only. They note capsules may be used when high potassium cannot be risked, including with ACE inhibitors.
  • Pregnancy: Diuretics may be used for edema caused by a disease process during pregnancy. They are not appropriate for routine swelling in normal pregnancy.

How Hydrochlorothiazide works

▾

Hydrochlorothiazide blocks the kidneys from reabsorbing sodium and chloride. More sodium and water leave the body in urine. Some of the extra sodium is swapped for potassium and hydrogen, which is why potassium can run low.

The drug also lowers blood volume at first. Over time, blood vessels become less resistant to flow.

Hydrochlorothiazide dosage

▾

Hydrochlorothiazide is taken by mouth, usually once daily. Some people take it in two doses. The amount depends on your condition, age and response.

  • For swelling, some people take it on alternate days or 3 to 5 days a week.
  • Taking it with food slightly lowers absorption.
  • Inzirqo comes as a powder that is mixed with water before it is dispensed.
  • Children’s doses are based on weight.

Follow your prescriber and the label. Ask your pharmacist what to do if you miss a dose.

Dosing details from the FDA-approved label

From the Hydrochlorothiazide prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.

  • Hypertension in adults
    • Initial dose 25 mg orally daily given as a single dose
    • As needed, increase to 50 mg orally daily, given as a single or two divided doses
    • Maximum: Doses above 50 mg are often associated with marked reductions in serum potassium; total daily doses greater than 50 mg are not recommended (capsule labels)
    • Patients usually do not require doses in excess of 50 mg daily when used with other antihypertensive agents
  • Edema in adults
    • 25 mg to 100 mg orally daily as a single or divided dose
    • Consider intermittent therapy: administration on alternate days or on 3 to 5 days each week, to reduce risk of electrolyte imbalances
  • Hypertension and edema (diuresis) in pediatric patients / infants and children
    • 1 mg/kg to 2 mg/kg (0.5 mg to 1 mg per pound) per day in single or two divided doses
    • Maximum: Not to exceed 37.5 mg per day in patients less than 2 years of age or 100 mg per day in children 2 to less than 13 years of age (2 to 12 years in tablet label)
    • Infants less than 6 months of age may require doses up to 3 mg/kg (1.5 mg per pound) per day in two divided doses
  • Hypertension (hydrochlorothiazide capsules)
    • Adult initial dose is one capsule given once daily, alone or in combination with other antihypertensives
    • Maximum: Total daily doses greater than 50 mg are not recommended
Read the label’s full dosing text

DOSAGE AND ADMINISTRATION Therapy should be individualized according to patient response. Use the smallest dosage necessary to achieve the required response.

Adults For Edema The usual adult dosage is 25mg to 100 mg daily as a single or divided dose. Many patients with edema respond to intermittent therapy, i.e., administration on alternate days or on 3 to 5 days each week. With an intermittent schedule, excessive response and the resulting undesirable electrolyte imbalance are less likely to occur. For Control of 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, given as a single or two divided doses. Doses above 50 mg are often associated with marked reductions in serum potassium (see also PRECAUTIONS ). Patients usually do not require doses in excess of 50 mg of hydrochlorothiazide daily when used concomitantly with other antihypertensive agents.

Infants and Children For Diuresis and for Control of Hypertension The usual pediatric dosage is 0.5 mg to 1 mg per pound (1 to 2 mg/kg) per day in single or two divided doses, not to exceed 37.5 mg per day in infants up to 2 years of age or 100 mg per day in children 2 to 12 years of age. In infants less than 6 months of age, doses up to 1.5 mg per pound (3 mg/kg) per day in two divided doses may be required. (See PRECAUTIONS, Pediatric Use )

Read the full Dosage and Administration section on DailyMed →

Hydrochlorothiazide side effects

▾

Most people have mild effects, if any. Common ones include:

Common side effects

  • Dizziness or lightheadedness
  • Low blood pressure, especially when standing up
  • Nausea, vomiting or stomach upset
  • Diarrhea or constipation
  • Headache
  • Weakness
  • Muscle spasm
  • Sensitivity to sunlight
  • Sun sensitivity

When to get medical help

  • Eye pain or sudden blurred or decreased vision, which can signal acute angle-closure glaucoma (a sudden rise in eye pressure) that may cause permanent vision loss
  • Severe skin reactions such as widespread rash, blistering or peeling
  • Signs of a severe allergic reaction, such as trouble breathing or swelling
  • Severe stomach pain (possible pancreatitis) or yellowing of the skin or eyes
  • Unusual bruising, fever or frequent infections, which can signal blood problems
  • Signs of too little potassium or sodium or of dehydration, such as heavy weakness, muscle cramps or irregular heartbeat
  • Any new or changing skin growths or lesions

Call your doctor for eye pain or vision changes, severe rash or blistering, signs of allergic reaction, severe stomach pain, yellow skin or eyes, or unusual bruising or infections. The label says dosage should be reduced or therapy withdrawn if reactions are moderate or severe.

Hydrochlorothiazide warnings and precautions

▾
  • Eye problems: Sudden vision changes or eye pain can signal acute angle-closure glaucoma. It can cause permanent vision loss if untreated. A sulfa or penicillin allergy may raise the risk.
  • Electrolyte loss: Potassium, sodium and chloride can drop. Higher doses are often tied to marked potassium loss.
  • Kidney and liver disease: Use with caution. Thiazides may worsen kidney test results (azotemia) and may trigger hepatic coma in liver disease.
  • Lupus: It may worsen or activate systemic lupus erythematosus.
  • Skin cancer: It is linked to a higher risk of non-melanoma skin cancer, mainly squamous cell carcinoma.
  • Allergic reactions: They can occur even without a history of allergy or asthma.

Hydrochlorothiazide interactions

▾

Several medicines can change how hydrochlorothiazide works or raise its risks.

  • Lithium: levels can rise to toxic amounts.
  • Alcohol, barbiturates, narcotics: can worsen dizziness on standing.
  • Other blood pressure drugs: additive effect.
  • Diabetes medicines and insulin: dose may need changing.
  • Cholestyramine and colestipol: reduce absorption of hydrochlorothiazide.
  • Corticosteroids and ACTH: can deepen potassium loss.
  • NSAIDs: can weaken its diuretic and blood pressure effects.
  • Muscle relaxants and pressor amines: responses may change.

Interactions listed in the FDA-approved label

From the Hydrochlorothiazide prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.

  • Alcohol, barbiturates, or narcotics: Potentiation of orthostatic hypotension may occur.
  • Antidiabetic drugs (oral agents and insulin): Dosage adjustment of the antidiabetic drug may be required. Dosage adjustment of the antidiabetic drug may be required
  • Other antihypertensive drugs: Additive effect or potentiation.
  • Cholestyramine and colestipol resins: The resins bind hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85 and 43 percent, respectively.
  • Corticosteroid, ACTH: Intensified electrolyte depletion, particularly hypokalemia.
  • Pressor amines (e.g., norepinephrine): Possible decreased response to pressor amines but not sufficient to preclude their use.
  • Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine): Possible increased responsiveness to the muscle relaxant.
  • Lithium: Diuretic agents reduce the renal clearance of lithium and greatly increase the risk of lithium toxicity. Generally should not be given with diuretics; refer to the lithium package insert before use with hydrochlorothiazide
  • Non-steroidal anti-inflammatory drugs: In some patients, an NSAID can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics. Observe patients closely to determine if the desired effect of the diuretic is obtained
  • Drug/Laboratory Test Interactions (parathyroid function tests): Thiazides may interfere with tests for parathyroid function. Thiazides should be discontinued before carrying out tests for parathyroid function
Read the label’s full interactions text

Drug Interactions: When given concurrently the following drugs may interact with thiazide diuretics: Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. Antidiabetic drugs - (oral agents and insulin) dosage adjustment of the antidiabetic drug may be required. Other antihypertensive drugs - additive effect or potentiation. Cholestyramine and colestipol resins - Cholestyramine and colestipol resins bind the hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85 and 43 percent, respectively. Corticosteroid, ACTH – intensified electrolyte depletion, particularly hypokalemia. Pressor amines (e.g., norepinephrine) - possible decreased response to pressor amines but not sufficient to preclude their use. Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine) - possible increased responsiveness to the muscle relaxant. Lithium - generally should not be given with diuretics. Diuretic agents reduce the renal clearance of lithium and greatly increase the risk of lithium toxicity. Refer to the package insert for lithium preparations before use of such preparations with hydrochlorothiazide. Non-steroidal anti-inflammatory drugs - In some patients, the administration of a non-steroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics. When hydrochlorothiazide and non-steroidal anti-inflammatory agents are used concomitantly, the patients should be observed closely to determine if the desired effect of the diuretic is obtained. Drug/Laboratory Test Interactions - Thiazides should be discontinued before carrying out tests for parathyroid function (see PRECAUTIONS, General ).

Excerpted — the section continues on the label. Read the full Drug Interactions section on DailyMed →

Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.

🌿230 supplements and herbs with documented Hydrochlorothiazide interactions, ranked by severity Check Hydrochlorothiazide against a supplement or herb →

Before taking Hydrochlorothiazide

▾
  • Do not use it if you cannot produce urine (anuria).
  • Do not use it if you are allergic to hydrochlorothiazide or other sulfa drugs.
  • Tell your prescriber about kidney or liver disease, lupus, asthma or allergy history.
  • Tell your prescriber if you are pregnant. Routine use for normal pregnancy swelling is not appropriate.
  • Children can use Inzirqo and the tablets with weight-based dosing.
  • Tell your prescriber before parathyroid function tests, since thiazides should be stopped before them.

Hydrochlorothiazide overdose

▾

Too much can cause low potassium, sodium and chloride, and dehydration from heavy urination. Low potassium can worsen irregular heartbeat if you also take digitalis. Treatment is supportive: correct the dehydration and electrolyte imbalance, and treat low blood pressure. Seek emergency help or call Poison Control right away.

What Hydrochlorothiazide does in the body

▾

Hydrochlorothiazide increases salt and water loss and lowers calcium and uric acid excretion. It lowers blood pressure only in people with high readings. It starts working within about 2 hours, peaks near 4 hours and can last up to 24 hours.

How your body processes Hydrochlorothiazide

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About 65% to 75% of an oral dose is absorbed. Peak levels come 1 to 5 hours after a dose, and food delays and slightly reduces absorption. The half-life is about 6 to 15 hours. Most of the drug leaves unchanged in urine, so levels build up in kidney disease.

How to store Hydrochlorothiazide

▾

Dispense in a well-closed container as defined in the USP, with a child-resistant closure (as required). Store at 20° to 25°C (68° to 77°F) .

Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →

230

Supplements & herbs that interact with Hydrochlorothiazide

230 supplements and herbal products have documented interactions with Hydrochlorothiazide in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 10
  • Moderate · 195
  • Minor · 25
ACTIVATED CHARCOAL Major AMERICAN HELLEBORE Major AMERICAN MISTLETOE Major ASARABACCA Major DOLOMITE Major LITHIUM Major OLEANDER Major SIBERIAN COCKLEBUR Major +222 more
Every supplement checked against Hydrochlorothiazide — ranked by severity The full interaction hub: 10 major · 195 moderate · 25 minor · every one linked to its full report. Check Hydrochlorothiazide against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

8

Nutrient depletion considerations

Hydrochlorothiazide has been associated with lower levels of 8 nutrients in the clinical literature. This does not mean a deficiency will occur — it means these may be worth discussing with your pharmacist or healthcare provider, especially with long-term use.

Evidence & significance mix
  • Higher significance · 2
  • Moderate · 3
  • Unrated · 3
POTASSIUM Major Depletion VITAMIN C Insignificant Depletion MAGNESIUM Moderate Depletion THIAMINE Moderate Depletion ZINC Moderate Depletion COENZYME Q10 Insufficient Evidence FOLIC ACID Insufficient Evidence SODIUM Insufficient Evidence
See the full Hydrochlorothiazide nutrient depletion report

Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.

Hydrochlorothiazide: pharmacist answers to common questions

Quick, plain-English answers to the questions patients ask most about Hydrochlorothiazide — the kind of thing our pharmacy team would talk through with you at the counter.

What is hydrochlorothiazide for?

▾
It lowers high blood pressure, which helps reduce the risk of strokes and heart attacks. Some products, such as Inzirqo and the tablets, are also used for swelling from conditions like heart failure, liver cirrhosis and kidney disease. The capsule labels list only high blood pressure.

How should I take it?

▾
Take it by mouth exactly as prescribed, usually once a day. For swelling, your prescriber may have you take it only some days of the week. Food slightly lowers absorption, so ask me how to be consistent.

What side effects should I expect?

▾
Dizziness, lightheadedness when standing, stomach upset, headache and weakness are the usual ones. Stand up slowly, and be careful with alcohol since it can worsen dizziness. Use sun protection since it can cause sun sensitivity.

When should I call my doctor right away?

▾
Call for eye pain or sudden vision changes, severe rash or blistering, trouble breathing, severe stomach pain, yellow skin or eyes, or unusual bruising or infections. Also call for heavy weakness, muscle cramps or irregular heartbeat, which can signal low electrolytes.

Can I take it with my other medicines?

▾
Many medicines interact, so check with me first. Lithium is a big one, since levels can become toxic. NSAIDs can weaken its effect, and diabetes medicines may need adjusting. If you take cholestyramine or colestipol, ask me about timing.

Is it safe in pregnancy?

▾
Diuretics are not appropriate for routine swelling in a normal pregnancy. They can be used when swelling is caused by a disease process. Talk with your prescriber if you are pregnant or planning to be.

Is Hydrochlorothiazide available over the counter?

▾
No. Hydrochlorothiazide is a prescription medicine: every Hydrochlorothiazide product listed with the FDA is prescription only, so it is not sold over the counter. Your prescriber decides whether it is appropriate for you, and your pharmacist dispenses it.

When was Hydrochlorothiazide first available?

▾
The earliest FDA record we hold for Hydrochlorothiazide is from 1959: its first approval in Drugs@FDA or its earliest product listing in the NDC Directory, whichever is older. Many older medicines were in use before their first formal FDA approval, so this is the earliest date on record, not necessarily when Hydrochlorothiazide was first used.

Who makes Hydrochlorothiazide?

▾
39 companies currently list Hydrochlorothiazide products in the FDA's NDC Directory, including A-S Medication Solutions, Bryant Ranch Prepack, Proficient Rx LP. That count includes repackagers and distributors as well as manufacturers (companies that sell only the raw ingredient are not counted), so fewer companies actually make it; the label on your bottle names the one that supplied yours.

Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →

More about Hydrochlorothiazide on HelloPharmacist

📊Hydrochlorothiazide supplement interactions230 checked — ranked by severity 🌿Drug & Supplement CheckerHydrochlorothiazide vs. vitamins & herbs 💬Ask a PharmacistFree answer, usually < 24h 🔎NDC & pricing lookupFind Hydrochlorothiazide NDCs & costs 🅰️Browse Drugs A–ZLook up any medication
Detailed data & references for Hydrochlorothiazide Forms & strengths, pricing, billing codes, manufacturers, safety reports and sourcing — the data behind the page. Most people can stop here. Each section below opens on a tap.

Hydrochlorothiazide forms and strengths (how it comes)

Hydrochlorothiazide is available in 3 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Tablet

By mouth
How this form is used
What it may be used for
  • Hydrochlorothiazide tablets are used as add-on treatment for edema from heart failure, liver cirrhosis, and corticosteroid and estrogen therapy.
  • Hydrochlorothiazide tablets are also useful for edema from kidney problems such as nephrotic syndrome, acute glomerulonephritis and chronic kidney failure.
  • Hydrochlorothiazide tablets are used to manage high blood pressure alone or with other blood pressure medicines.
Important instructions
  • Hydrochlorothiazide tablets are dosed to your response, using the smallest amount that works.
  • Hydrochlorothiazide tablets for edema may be taken on alternate days or 3 to 5 days a week.
  • Hydrochlorothiazide tablets for high blood pressure are usually started once daily and can be given as one or two doses.
Available strengths 3 strengths
12.5 mg 25 mg 50 mg
252 FDA-listed product records ⓘ

Capsule

By mouth
How this form is used
What it may be used for
  • Hydrochlorothiazide capsules are used to manage high blood pressure, alone or with other blood pressure medicines.
  • Hydrochlorothiazide capsules may be used when high potassium (hyperkalemia) cannot be risked, including in people taking ACE inhibitors.
Important instructions
  • Hydrochlorothiazide capsules are started in adults as one capsule once daily, alone or with other blood pressure medicines.
  • Hydrochlorothiazide capsules are not recommended above a total daily amount of 50 mg.
Available strengths 1 strength
12.5 mg
80 FDA-listed product records ⓘ

Oral suspension

By mouth
Brands Inzirqo
How this form is used
What it may be used for
  • Inzirqo is used to treat high blood pressure in adults and children.
  • Inzirqo is used to treat edema from heart failure, liver cirrhosis and kidney disease, including nephrotic syndrome, in adults and children.
Important instructions
  • Inzirqo is taken by mouth as a single daily dose or divided into two doses.
  • Inzirqo for edema may be given on an intermittent schedule to lower the risk of electrolyte imbalance.
  • Inzirqo children’s doses are based on body weight and follow age-based limits set by the prescriber.
Available strengths 1 strength
10 mg/mL
1 FDA-listed product record ⓘ

Hydrochlorothiazide on the U.S. market: products, makers and brands

How Hydrochlorothiazide appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

39 companies list 169 Hydrochlorothiazide product records with the FDA, mostly as tablet, capsule, oral suspension; the earliest marketing or approval year on record is 1959. Brand names on the directory include Microzide, Oretic, Esidrix and 3 more; the rest are generics.

3
Dose forms ⓘ
39
Labelers (makers, repackagers, distributors)
2
Brand names
169
FDA-listed product records ⓘ
1959
Earliest FDA record ⓘ

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Also listed with the FDA, not a patient dose form: Powder (14) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

A-S Medication Solutions12%
Bryant Ranch Prepack10%
Proficient Rx LP9%
Northwind Health Company, LLC7%
NuCare Pharmaceuticals,Inc.7%
Aphena Pharma Solutions - Tennessee, LLC5%
Other makers50%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

How widely Hydrochlorothiazide is used (Medicaid data)

A general measure of how commonly Hydrochlorothiazide is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Hydrochlorothiazide is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

3,216,975
Medicaid prescriptions filled (Q1–Q4 2025)
$25.1M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Hydrochlorothiazide prescribed? Of the 1,601 medications we measure, Hydrochlorothiazide ranks #67 by Medicaid prescriptions — more than 96% of them.

Where Hydrochlorothiazide ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5
Total prescriptions — #67 of 1,601
#62 Lidocaine 3,379,243 Rx #63 Budesonide / Formotero... 3,326,951 Rx #64 Meloxicam 3,321,801 Rx #65 Folic Acid 3,298,551 Rx #66 Metronidazole 3,247,421 Rx #67 Hydrochlorothiazide 3,216,975 Rx #68 Hydrocortisone 3,162,599 Rx #69 Divalproex 3,122,967 Rx #70 Tirzepatide injection 3,083,095 Rx #71 Tirzepatide 3,083,095 Rx #72 Levetiracetam 3,055,070 Rx

Utilization by Hydrochlorothiazide product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 25 mg oral tablet is the most-dispensed Hydrochlorothiazide product — about 60% of these Medicaid prescriptions.

hydrochlorothiazide 25 MG Oral Tablet Most dispensed

1,943,243 Medicaid prescriptions (Q1–Q4 2025) 60% of Hydrochlorothiazide prescriptions shown $14M gross reimbursement (before rebates) ≈ $7.20 per prescription (gross)

Summed across the 17 of 337 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 310798

hydrochlorothiazide 12.5 MG Oral Tablet

756,724 Medicaid prescriptions (Q1–Q4 2025) 24% of Hydrochlorothiazide prescriptions shown $6.7M gross reimbursement (before rebates) ≈ $8.80 per prescription (gross)

Summed across the 13 of 63 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 429503

hydrochlorothiazide 12.5 MG Oral Capsule

393,924 Medicaid prescriptions (Q1–Q4 2025) 12% of Hydrochlorothiazide prescriptions shown $3.3M gross reimbursement (before rebates) ≈ $8.48 per prescription (gross)

Summed across the 15 of 150 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 199903

hydrochlorothiazide 50 MG Oral Tablet

122,743 Medicaid prescriptions (Q1–Q4 2025) 4% of Hydrochlorothiazide prescriptions shown $982,252 gross reimbursement (before rebates) ≈ $8.00 per prescription (gross)

Summed across the 16 of 200 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 197770

hydrochlorothiazide 800 MG Powder for Oral Suspension

341 Medicaid prescriptions (Q2–Q4 2025) <1% of Hydrochlorothiazide prescriptions shown $143,514 gross reimbursement (before rebates) ≈ $421 per prescription (gross)

Summed across the 1 of 1 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2704012

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Hydrochlorothiazide, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 62 of 751 listed Hydrochlorothiazide NDCs with Medicaid activity.

Compare Hydrochlorothiazide products

A representative set of FDA-listed product records for Hydrochlorothiazide — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 99 of 169 products — FDA National Drug Code Directory. See every product, package size and price: browse all 169 Hydrochlorothiazide NDCs →

Hydrochlorothiazide side effects reported to the FDA (FAERS)

After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Hydrochlorothiazide — a signal of what to watch for, not proof the drug caused it.

The effects most often named in FDA reports that mention Hydrochlorothiazide are fatigue, nausea, diarrhoea; about 67% of the reports were classed as serious. These are voluntary reports, so they show what people report, not how often it happens.

209,388
Reports mentioning it
67%
Reported as serious
12
Distinct effects shown
Most reported effects
Fatigue
13,774
Nausea
13,719
Diarrhoea
11,762
Dizziness
11,240
Headache
10,767
Dyspnoea
10,499
Pain
10,314
Arthralgia
8,171
Asthenia
7,912
Fall
7,822
Age groups
Elderly · 14,690Adult · 11,981Neonate · 132Infant · 58Child · 56Adolescent · 53

Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Hydrochlorothiazide in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.

Hydrochlorothiazide FDA approval history

How Hydrochlorothiazide went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.

Hydrochlorothiazide was first approved by the FDA in 1959 (Brand: ESIDRIX · Novartis); the first generic version was approved in 1973. It remains available in U.S. pharmacies today.

1959
Brand approved
Brand: ESIDRIX · Novartis
1973
First generic approved
Lower-cost ANDA competition begins
2026
Available today
Active in U.S. pharmacies

Source: Drugs@FDA.

Hydrochlorothiazide recall history

A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.

The FDA’s enforcement reports list no Hydrochlorothiazide recalls since July 2021.

✅No Hydrochlorothiazide recalls on record since July 2021

Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Hydrochlorothiazide RxCUI 5487 3 dose forms · 5 strengths
  1. Dose form (SCDF) Oral Capsule RxCUI 370636 In current FDA listings
    Clinical drug / strength (SCD) 12.5 MG RxCUI 199903
  2. Dose form (SCDF) Oral Tablet RxCUI 370635 In current FDA listings
    Clinical drug / strength (SCD) 12.5 MG RxCUI 429503 25 MG RxCUI 310798 50 MG RxCUI 197770
  3. Dose form (SCDF) Powder for Oral Suspension RxCUI 2704011 In current FDA listings
    Clinical drug / strength (SCD) 800 MG RxCUI 2704012

Look up RxCUI 5487 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

Hydrochlorothiazide supply and shortage status

Whether Hydrochlorothiazide is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.

Hydrochlorothiazide is currently listed in shortage by the FDA (8 presentations on record).

⚠️Currently in shortage (FDA) — Hydrochlorothiazide
Current Quinapril/Hydrochlorothiazide, Tablet, 25 mg; 20 mg (NDC 62135-669-90)
Chartwell Molecular Holdings LLC · Since 01/19/2023 · Updated 09/15/2026
Current Quinapril/Hydrochlorothiazide, Tablet, 12.5 mg; 10 mg (NDC 62135-667-90)
Chartwell Molecular Holdings LLC · Since 01/19/2023 · Updated 09/15/2026
Current Quinapril/Hydrochlorothiazide, Tablet, 12.5 mg; 20 mg (NDC 62135-668-90)
Chartwell Molecular Holdings LLC · Since 01/19/2023 · Updated 09/15/2026
Current Quinapril Hydrochloride And Hydrochlorothiazide, Tablet, 12.5 mg; 20 mg (NDC 65862-162-90)
Aurobindo Pharma USA · Since 01/19/2023 · Updated 06/02/2026
Reason: Discontinuation of the manufacture of the drug
Current Quinapril Hydrochloride And Hydrochlorothiazide, Tablet, 25 mg; 20 mg (NDC 65862-163-90)
Aurobindo Pharma USA · Since 01/19/2023 · Updated 06/02/2026
Reason: Discontinuation of the manufacture of the drug
Current Quinapril Hydrochloride And Hydrochlorothiazide, Tablet, 12.5 mg; 10 mg (NDC 65862-161-90)
Aurobindo Pharma USA · Since 01/19/2023 · Updated 06/02/2026
Reason: Discontinuation of the manufacture of the drug
To be discontinued Microzide, Capsule, 12.5 mg (NDC 0591-0347-05)
Teva Pharmaceuticals USA, Inc. · Since 11/19/2025 · Updated 11/19/2025
To be discontinued Microzide, Capsule, 12.5 mg (NDC 0591-0347-01)
Teva Pharmaceuticals USA, Inc. · Since 11/19/2025 · Updated 11/19/2025

Source: openFDA, from the FDA Drug Shortages database.

💵 What Hydrochlorothiazide costs pharmacies (NADAC benchmark)

The national average invoice price pharmacies pay for the drug itself, from CMS's NADAC survey (data as of Sep 30, 2026). This is a supply-cost benchmark — not a retail price and not what you'd pay at the counter.

FormStrengthPharmacy acquisition benchmark
Tablet · Oral 25 mg $0.012 per tablet NDC details & price history
Tablet · Oral 50 mg $0.032 per tablet NDC details & price history
Tablet · Oral 12.5 mg $0.034 per tablet NDC details & price history
Capsule, Gelatin Coated · Oral 12.5 mg $0.028 per capsule NDC details & price history
Tablet 25 mg $0.012 per tablet NDC details & price history
Tablet 50 mg $0.032 per tablet NDC details & price history
Capsule, Gelatin Coated 12.5 mg $0.028 per capsule NDC details & price history
Why show this? Your out-of-pocket cost depends on insurance, pharmacy markup, and discounts — but the acquisition benchmark tells you whether the medication itself is inexpensive or costly, which strengths cost more per dose, and whether a cash-price quote is in a reasonable range. Each row links to the NDC-level record with its full price history.

Source: CMS National Average Drug Acquisition Cost (NADAC), a survey of retail pharmacy invoice prices. Benchmarks shown are the range across package sizes of a representative product for each form and strength — other manufacturers' products may differ.

Hydrochlorothiazide brand names

Hydrochlorothiazide is sold under 6 brand names in the FDA directory — Microzide, Oretic, Esidrix, Hydrodiuril and others. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.

Microzide Oretic Esidrix Hydrodiuril Zide Inzirqo

Who makes Hydrochlorothiazide: manufacturers and labelers

39 companies list Hydrochlorothiazide products with the FDA. By number of product records, the largest are A-S Medication Solutions, Bryant Ranch Prepack, Proficient Rx LP. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.

A-S Medication Solutions 21 Bryant Ranch Prepack 17 Proficient Rx LP 15 Northwind Health Company, LLC 11 NuCare Pharmaceuticals,Inc. 11 Aphena Pharma Solutions - Tennessee, LLC 9 Remedyrepack Inc. 9 PD-Rx Pharmaceuticals, Inc. 6 Preferred Pharmaceuticals Inc. 6 QPharma, Inc. 5 Unichem Pharmaceuticals (USA), Inc. 4 Accord Healthcare Inc. 3 American Health Packaging 3 Aurobindo Pharma Limited 3 Chartwell RX, LLC 3 Golden State Medical Supply, Inc. 3 Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc. 3 Leading Pharma, LLC 3 NCS HealthCare of KY, LLC dba Vangard Labs 3 ScieGen Pharmaceuticals, Inc. 3 Teva Pharmaceuticals USA, Inc. 3 Actavis Pharma, Inc. 2 Direct Rx 2 Exelan Pharmaceuticals Inc. 2

…and 15 more on the FDA NDC directory.

Hydrochlorothiazide drug class (RxNorm)

Hydrochlorothiazide belongs to the Thiazide Diuretic class.

Pharmacologic class Thiazide Diuretic
Drug family (ATC) Renin-inhibitors, Thiazides, plain

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

Sources for this Hydrochlorothiazide page

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Dec 5, 2025
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Hydrochlorothiazide.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Hydrochlorothiazide after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
162
Finished products in the current FDA directory
169
Companies listing them (makers, repackagers, distributors)
39
FDA labeler codes behind them ⓘ
50
Linked representative label ⓘ
QPharma Inc
Linked label effective
Dec 5, 2025
Composite sections available
16
Linked SPL Set ID
5bacc909-6b02-4815-85ef-55fd25b1b1f7
Linked SPL Document ID
45b3f838-dc1b-489f-e063-6294a90a55c2
Open the linked representative label on DailyMed ↗
NDC package records associated with this linked SPL 1

How this page is built

HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. QPharma Inc is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →