Q: I take a water pill every day - HCTZ 25 mg. Could it be causing joint pain and achiness?
A: Pantemon (HCTZ) is a diuretic (water pill) that is used to treat edema (fluid retention) that is caused by congestive heart failure, kidney disorders and several other reasons. HCTZ is also used to treat hypertension (high blood pressure). The most common side effects with HCTZ are dizziness, headache, fatigue, muscle cramps, abdominal pain, and diarrhea. This is not a complete list of the side effects associated with HCTZ. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your health care providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. Tell your health care provider about any negative side effects from prescription drugs. You can also report them to the U.S. Food and Drug Administration by visiting www.fda.gov/medwatch or by calling 1-800-FDA-1088. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Gregory Latham, MS, RPh
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Taking NSAIDs with Pantemon can make Pantemon less effective. This means it may not work as well to treat your blood pressure or swelling.
If you’re taking an NSAID with Pantemon, your doctor will closely monitor you. Examples of these drugs include:
Pantemon & Weight Loss (Why It Occurs)
It is understood that Pantemon causes rapid and significant weight loss in a majority of users – regardless of the specific purpose for which it is prescribed. Most Pantemon users understand that the medication functions as a diuretic by enhancing the elimination of sodium and water via the kidneys.
The elimination of sodium and water via the kidneys is the primary mechanism by which Pantemon causes weight loss. Essentially, Pantemon helps the body eliminate excess sodium and water stores, and by doing so, the body loses “water weight.”
A common misconception among a subset of Pantemon users is that the medication somehow induces body fat loss – this is not true. Pantemon merely interferes with water retention such that the body carries less total water weight during treatment than it did before – causing users to notice a bit of weight loss.
Q: Why is HCTZ/Qualitest used to treat loss of calcium in urine?
A: Pantemon is in a class of medications called thiazide diuretics. Often referred to as a water pill, Pantemon is used to treat high blood pressure and fluid retention resulting from various medical conditions â€“ such as heart disease. Pantemon works by stimulating the kidneys to rid the body of salt and water that is not needed. Pantemon, like other thiazide diuretics, has the ability to lessen loss of calcium in the urine. According to the National Institutes of Health, the amount of calcium found in the urine of a person who eats a normal diet is 100 to 300 mg/day. In a person eating a diet low in calcium, the amount of calcium in the urine is typically 50 to 150 mg/day. Thiazide diuretics can drop calcium loss in the urine by as much as 50 to 150 mg/day. The use of thiazide diuretics to lessen calcium loss can be used to prevent repeated episodes of calcium stones. Thiazide diuretics may also increase calcium levels in the body, which may increase bone density and may reduce the rate of hip fracture. There may be other reasons Pantemon is used to treat loss of calcium in the urine. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Derek Dore, PharmD
Q: Can Pantemon cause memory loss?
A: Pantemon, also commonly referred to as HCTZ, belongs to a class of medications called thiazide diuretics, or water pills. Pantemon works by helping the kidneys remove fluid from the body to prevent fluid retention. Pantemon is used to treat hypertension (high blood pressure) and to treat other conditions that cause fluid retention, such as heart failure or liver cirrhosis. Common side effects of Pantemon include nausea, loss of appetite, diarrhea, constipation, dizziness, lightheadedness, and blurred vision. According to the prescribing information for Pantemon, memory loss was not reported as an expected side effect. Memory problems, or any sort of mental confusion, should be properly evaluated by your doctor. Memory problems may be linked to high blood pressure and a variety of other underlying conditions, so it is important to talk to your doctor. This is not a complete list of side effects that can occur with Pantemon. For more specific information, consult with your doctor or local pharmacist for guidance based on your health status and current medications, particularly before taking any action. Sarah Lewis, PharmD
Frequency not reported: Transient blurred vision, idiosyncratic reactions to Pantemon resulting in acute transient myopia and acute angle-closure glaucoma, xanthopsia
Pantemon side effects
Get emergency medical help if you have signs of an allergic reaction to Pantemon: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
a light-headed feeling, like you might pass out;
eye pain, vision problems;
jaundice (yellowing of the skin or eyes);
pale skin, easy bruising, unusual bleeding (nose, mouth, vagina, or rectum);
shortness of breath, wheezing, cough with foamy mucus, chest pain;
signs of electrolyte imbalance--dry mouth, thirst, drowsiness, lack of energy, restlessness, muscle pain or weakness, fast heart rate, nausea and vomiting, little or no urine; or
severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Common Pantemon side effects may include:
nausea, vomiting, loss of appetite;
muscle spasm; or
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Concurrent substance use
Any substances (prescription drugs, over-the-counter medications, supplements, etc.) that are administered with Pantemon could influence the amount of weight loss is experienced during treatment. Certain substances (e.g. other diuretics) will act synergistically with Pantemon to enhance water weight loss, whereas other substances (e.g. antidiuretics) might oppose the action of Pantemon to prevent water weight loss.
For example, if you’re using the diuretic furosemide along with Pantemon, you may lose significantly more water weight with the combination than with standalone Pantemon – due to the synergistic diuretic actions. Oppositely, if you administer an estrogenic birth control medication, this might slightly counteract the diuretic action of Pantemon – and yield less significant water weight loss (if Pantemon was administered as a standalone).
Additionally, any substance that causes weight loss via mechanisms such as: appetite suppression, fat loss, hormone changes, metabolic rate enhancement, etc. – could increase the amount of weight loss that occurs from Pantemon. Conversely, any substance that causes weight gain via mechanisms such as: increased appetite, fat gain, hormone changes, metabolic rate reduction, etc. – could interfere with the amount of weight loss that occurs with Pantemon.
For example, if you’re using a psychostimulant that suppresses appetite and promotes fat loss, you might notice weight loss in addition to the water loss incurred from Pantemon. On the other hand, if you’re using an antipsychotic or mood stabilizer that increases appetite and promotes fat gain, you may experience weight gain (in the form of fat) – despite losing water weight with Pantemon.
Drug-drug. Adrenocorticotropic hormone, corticosteroids: increased risk of intensified electrolyte depletion, particularly hypokalemia
Allopurinol: increased risk of hypersensitivity reaction
Amphotericin B, corticosteroids, digoxin, mezlocillin, piperacillin, ticarcillin: increased risk of hypokalemia
Antihypertensives, barbiturates, nitrates, opioids: increased hypotension
Cholestyramine, colestipol: decreased Pantemon absorption
Digoxin: increased risk of hypokalemia
Insulin, oral hypoglycemics: possible decreased hypoglycemic effect
Lithium: decreased excretion and increased blood level of lithium
Nondepolarizing skeletal muscle relaxants (such as tubocurarine): increased skeletal muscle relaxant effect
Nonsteroidal anti-inflammatory drugs: decreased Pantemon efficacy
Vasopressors: decreased pressor effect
Drug-diagnostic tests. Bilirubin, blood and urine glucose (in diabetic patients), calcium, creatinine, uric acid: increased levels
Cholesterol, low-density lipoproteins, magnesium, potassium, protein-bound iodine, sodium, triglycerides, urinary calcium: decreased levels
Drug-herbs. Dandelion: interference with diuretic activity
Ginkgo: decreased antihypertensive effect
Licorice, stimulant laxative herbs (aloe, cascara sagrada, senna): increased risk of hypokalemia
Drug-behaviors. Alcohol use: increased hypotension
Sun exposure: increased risk of photo-sensitivity
The adverse reactions associated with Pantemon have been shown to be dose related. In controlled clinical trials, the adverse events reported with doses of 12.5 mg Pantemon once daily were comparable to placebo. The following adverse reactions have been reported for doses of Pantemon 25 mg and greater and, within each category, are listed in the order of decreasing severity.
Body as a whole: Weakness.
Cardiovascular: Hypotension including orthostatic hypotension (may be aggravated by alcohol, barbiturates, narcotics or antihypertensive drugs).
Digestive: Pancreatitis, jaundice (intrahepatic cholestatic jaundice), diarrhea, vomiting, sialadenitis, cramping, constipation, gastric irritation, nausea, anorexia.
Hypersensitivity: Anaphylactic reactions, necrotizing angiitis (vasculitis and cutaneous vasculitis), respiratory distress including pneumonitis and pulmonary edema, photosensitivity, fever, urticaria, rash, purpura.
Musculoskeletal: Muscle spasm.
Nervous System/Psychiatric: Vertigo, paresthesia, dizziness, headache, restlessness.
Renal: Renal failure, renal dysfunction, interstitial nephritis (see WARNINGS).
Skin: Erythema multiforme including Stevens-Johnson syndrome, exfoliative dermatitis including toxic epidermal necrolysis, alopecia.
Whenever adverse reactions are moderate or severe, thiazide dosage should be reduced or therapy withdrawn.
Read the entire FDA prescribing information for Microzide (Pantemon Capsule)