Prescription
Prescription RequiredCompoundedHydrochlorothiazide Suspension
Hydrochlorothiazide oral suspension is a prescription medicine used to help lower high blood pressure and reduce fluid swelling (edema). This liquid form may be helpful for children or others who have trouble swallowing tablets. It works by helping the kidneys remove extra salt and water through the urine. Use only for the condition your prescriber is treating and follow the dosing plan given.
Requires a valid prescription from your provider. Not sure if it's right for you? Ask a pharmacist.
These statements have not been evaluated by the Food and Drug Administration. Compounded products are not FDA-approved and are not intended to diagnose, treat, cure, or prevent any disease. Individual results may vary. This information is for educational purposes only and is not medical advice — always consult your healthcare provider before starting any new treatment.
Clinical information
Medication information for patients and providers.
Use as directed by your child’s healthcare provider. Shake well before each dose and measure doses with an oral syringe or dosing cup (not a kitchen spoon). If you miss a dose, give it as soon as you remember unless it is close to the next dose; do not give two doses at the same time. Your healthcare provider will decide the right dose and how long to use it based on your child’s weight, kidney function, and response.
Hydrochlorothiazide is a “water pill” that works in the kidneys. It blocks a salt-transport process in a part of the kidney that normally pulls salt back into the body. When less salt is pulled back, more salt and water leave the body in the urine, which can lower swelling and help lower blood pressure. It often starts to increase urination within about 2 hours, has its strongest effect around 4 hours, and the effect can last about 6 to 12 hours. Benefits you may notice include less swelling and, over time, improved blood pressure readings as directed by your healthcare provider.
Do not use if your child is allergic to hydrochlorothiazide, other thiazide “water pills,” or any ingredient in the suspension (risk of serious allergic reaction). Do not use if your child cannot make urine (anuria), because the medicine will not work and may cause harm. Do not use without prescriber approval if your child has severe kidney disease, severe liver disease, very low sodium or potassium levels, high calcium levels, or dehydration, because hydrochlorothiazide can worsen these problems. Tell the prescriber right away if your child is pregnant, could become pregnant, or is breastfeeding; the prescriber will weigh benefits and risks and choose the safest option.
Hydrochlorothiazide may interact with other medicines and supplements. Higher risk interactions include: Lithium (Eskalith, Lithobid) may build up and cause toxicity; your prescriber may avoid the combination or monitor closely. Other blood pressure medicines (ACE inhibitors like lisinopril, ARBs like losartan, and beta blockers like metoprolol) can increase the chance of low blood pressure or dizziness, especially when starting or changing doses. Medicines that lower potassium (some asthma medicines like albuterol in high doses, stimulant laxatives, or corticosteroids like prednisone) can raise the risk of low potassium. NSAID pain relievers (ibuprofen, naproxen) may reduce the blood pressure and water-removal effect and can increase kidney risk; ask before using. Diabetes medicines (insulin, metformin, some oral diabetes pills) may need adjustment because hydrochlorothiazide can raise blood sugar in some people. Digoxin (Lanoxin) has a higher risk of side effects if potassium or magnesium becomes low. Cholestyramine or colestipol can reduce absorption of hydrochlorothiazide; dosing may need to be separated. Herbal products that affect blood pressure or fluid balance (such as licorice, dandelion, or “water loss” supplements) may increase side effects; check with the prescriber first.
Common side effects include increased urination, mild stomach upset, decreased appetite, constipation or diarrhea, headache, dizziness, and sensitivity to sunlight (sunburn more easily). Electrolyte changes can occur, such as low potassium, low sodium, or low magnesium; signs may include muscle cramps, weakness, unusual tiredness, fast or uneven heartbeat, or confusion—contact the prescriber if these happen. Less common effects include high uric acid (may trigger gout in people at risk), higher blood sugar, or higher cholesterol on lab tests. Rare but serious reactions include severe dehydration (very dry mouth, very little urine, fainting), serious skin rash or blistering, eye pain or sudden blurry vision, pancreatitis (severe belly pain with vomiting), or a severe allergic reaction (hives, swelling of face/lips/tongue, trouble breathing)—get emergency help right away. Many mild side effects improve as the body adjusts, but ongoing or severe symptoms should be reported.
Store at room temperature (68-77 degrees F / 20-25 degrees C) unless your pharmacy label says otherwise. Keep tightly closed and protect from heat, moisture, and direct sunlight; do not store in the bathroom or near a kitchen sink. Shake well before each use. Keep out of reach of children and pets. Do not use after the beyond-use date on the pharmacy label; for disposal, use a pharmacy take-back program when available or follow your local guidance for medicine disposal.
Frequently asked questions.
Use an oral syringe or the dosing device provided by the pharmacy. Do not use a kitchen spoon because it can give the wrong dose. If you did not get a dosing device, ask the pharmacy for one.
This medicine can increase urination, especially when first started or after a dose increase. Ask the prescriber if the dose timing can be adjusted to help avoid nighttime urination. Contact the prescriber if your child has signs of dehydration like very dry mouth, dizziness, or much less urine.
It often starts working within a few hours by increasing urine output, so swelling may improve the same day or within a few days. Blood pressure control may take longer and is checked over time. Keep follow-up visits so the prescriber can adjust the plan if needed.
Often yes, especially early in treatment or if the dose changes. Blood tests may be used to check salts in the blood (like sodium and potassium) and kidney function. Follow the lab schedule given by your child’s healthcare provider.
NSAID pain relievers like ibuprofen and naproxen can sometimes make this medicine work less well and may increase kidney risk. Ask your child’s healthcare provider before using them, especially for more than a day or two. Acetaminophen may be an option for fever or pain, but confirm the right choice for your child.
If vomiting happens right after the dose, call your child’s healthcare provider or pharmacist for advice because the next step depends on timing and symptoms. Do not automatically repeat the dose. Seek urgent care if your child cannot keep fluids down or shows signs of dehydration.
More in Pediatrics
View all →
Bring this to the bench.
Transfer an existing prescription, or have your prescriber send a new one.