Side effects of hydrochlorothiazine taken for hypertension

[Steve]

Hello Everyone,
My Doctor has prescribed a low dosage of hydrochlorothiazine (water pill) for mild high blood pressure. Does anyone know of any detrimental efects to shooting from this medication? Since I started taking the pills, I've noticed a reduction in my scores and my ability to hold. I'm trying to determine if it's just coincidence or real. I shot 10 matched before medication, and 7 after so I think I have enough data to show a trend.

Any advice would be greatly appreciated.

Thanks, Steve

[Guest]

Hello Everyone,
My Doctor has prescribed a low dosage of hydrochlorothiazine (water pill) for mild high blood pressure. Does anyone know of any detrimental efects to shooting from this medication? Since I started taking the pills, I've noticed a reduction in my scores and my ability to hold. I'm trying to determine if it's just coincidence or real. I shot 10 matched before medication, and 7 after so I think I have enough data to show a trend.

Any advice would be greatly appreciated.

Thanks, Steve

Steve, I have noticed the same.

[RobStubbs]

Your best bet is to either talk to your GP (physician) or look up the side affect data on something like the FDA website (http://www.fda.gov/cder/ There should be something like a patient leaflet or such that will give you more details.

HTH,

Rob.

[Marilyn]

Hi Steve,

Another consideration regarding this medication is that it, (and about 2/3 of the prescription medication for hypertension), is on the banned drug list for competition.


I worked with my doctor to find a medication that would treat my hypertension and allow me to compete, but after a few years the 'allowed' ones no longer did the job. I was then put on hydrochlorothiazine (water pill) and I went through the process of having 2 physicians sign their license away in paperwork stating that I really needed the medication, (listing several years of records etc.) I submitted it to the review board and was given approval to use it for 2 years. Unfortunately, 2 days before I left for the World Cups in Europe last year, the approval was revoked. The ruling stated that "Since it cannot be fully ruled out that prohibited substances could also be eliminated faster from the body with such a substance, it was declared generally inadmissible by the IOC." So what that translates to is that it is NOT expected to enhance your performance BUT it could help you get something out of your system faster that does enhance your performance.

Hydrochlorothiazine has a pretty short half life and is out of your system in 2 to 3 days. As a result, I've worked out with my doctor to stop taking it 2 to 3 days before a competition and switch to Cozaar, (the one I took for 2 years), for the duration of the match. I have a blood pressure testing machine and use it daily to ensure that things stay at the acceptable levels. Unfortunately, due to the short notice I had for Europe, I spent the matches pretty stressed out and mentally felt unprepared. And did it ever show in my results!!

Marilyn

[funtoz]

Hi Steve,

Another consideration regarding this medication is that it, (and about 2/3 of the prescription medication for hypertension), is on the banned drug list for competition.

*****

Marilyn

I looked at the USADA documents yesterday and it looked like there was still an exemption available for clinical use of the diuretic. Of course granting that exemption is at the whim of the doping commissars, as you discovered. Ask your doctor about an ACE inhibitor, which is what I have been taking. Enalapril is also a recommended drug for diabetic, if that is of interest to you. It has some protective action on the kidneys for those of us with insulin problems.

Larry

[tenex]

Hi Everyone,
Thanks for the good advice. Since I primarily shoot NRA bullseye, I'm not really concerned about allowability for competition, just the side effects. If I can find a reasonable link between the blood pressure medication and my match scores, I'll ask my doctor for something else.

Thanks, Steve.

[David]

Tenex, It is quite possible that your medication (HCTZ) is causing or at least contributing to your lower scores. HCTZ can cause muscle weakness, and as a result of its effect, some dehydration is possible. It also causes your body to lose potassium which is vital to muscle function throughout the body. If you drink lots of orange juice, or eat bananas regularly, your potassium is likely ok. You might talk to your Dr. about having it checked(or god forbid, add another medication).

Good Luck

David Bartlett, Pharmacist, Maine USA

[tenex]

David,
My doctor did mention the potasium issue, and I take the pill with a small glass of orange juce every day. I also try to eat 2 or 3 bananas a week.

I know I don't drink enough fluids, I need to work on that. I have a match tomorrow, I'll try to drink a lot more during the day and see how it goes.

Thanks a lot,

Steve.

[RobStubbs]

Another possibility is to change the time of day when you take the drug (assuming it's OK to do so). I would not advocate changing medication a couple of days before a comp - you are still not meant to be taking banned substances anyway and can be tested in training etc. But more importantly your body needs to settle down to a new drug and this may take weeks or even months.

Rob.

[sodeman]

HCTZ does list weakness as one of the side effects. Regarding competition, the WADA (world anti doping agency) prohibits beta blockers, one class of antihypertensives, as they are used to reduce tremors, and bans diuretics as they can be used to increse the elimination of other naughty substances. In addition, they are used in wrestling, etc for weight loss and therefore have no therepeutic exemptions in those sports. The rules state that medical exemptions for diuretics do not count if another prohibited substance is found when testing an athlete.

Obviously, there are other options for control of hypertension that would fit within the rules, and wouldn't have the side effect profile of a diuretic. Unfortunately, pretty much everything in the hypertension field comes with one kind of side effect or another.

Also, yes I'm a doctor.



http://www.wada-ama.org/docs/web/standa ... d_2004.pdf

[tenex]

sodeman,

Thanks for the helpful information. Do have any alternative medications to recommend? I can discuss them with my doctor.

Thanks,

Steve.

[sodeman]

Standard options for hypertension can include the following

Beta blockers- these would give a competitive advantage in reducing nervous tremor, so they're out.

Angiotension converting enzyme inhibitors, or ACE inhibitors - they work well, the most problematic side effect is cough, which doesn't happen in everyone. Examples are captopril, enalapril, etc.

Angiotensin 2 receptor blockers, such as cozaar, avapro, etc.

Calcium channel blockers, such as cardizem.

Diuretics, such as lasix, bumex, HCTZ, etc.

After that, you start to get into the odder medications used when combinations of the above fail.

Hope that's somewhat helpful.

tom