Acute Porphyria Drugs

C03AA03 - Hydrochlorothiazide

Propably not porphyrinogenic
PNP

Rationale
Hydrochlorothiazide is not metabolized by CYP enzymes and does not induce or inhibit these enzymes. It is therefore regarded as probably not porphyrinogenic.
Chemical description
Sulfonamide congener.
Therapeutic characteristics
Hydrochlorothiazide is a thiazide diuretic that inhibits reabsorption of electrolytes in the distal tubule, leading to increased excretion of water, sodium, chloride, potassium, magnesium and other electrolytes. It is administered orally.
Metabolism and pharmacokinetics
Hydrocholorothiazide is not metabolized, but is eliminated mainly unchanged in the urine. The plasma half-life is about 9,4 – 13 hours (Beermann 1976, Drugbank, SPC).
Preclinical data
In an in ovo study of chick embryo livers, methyclothiazide, another thiazide drug, was found to have potential for induction of ALAS, whereas hydroclorothiazide and other thiazides was found not to have these effects (Anderson 1981). The results from these types of animal studies are not directly transferable to human, and cannot be given weight in the judgement of porphyrinogeniciry of drugs (Hift 2011).
Personal communication
Thunell, patient report (n=1): tolerated. Andersson, patient reports (n=10): tolerated. Peters: On basis of clinical experience probably not porphyrinogenic.
IPNet drug reports
Uneventful use reported in 9 patients with acute porphyria.
Similar drugs
Explore alternative drugs in similar therapeutic classes C03A / C03AA or go back.
References
# Citation details PMID
*Scientific articles
1. Induction of hepatic delta-aminolevulinate synthase and cytochrome P-450 by a thiazide diuretic. [Journal] Hepatology. Vol. 1(5)(pp 1A), 1981.
Anderson KE. Kappas A.
2. Absorption, metabolism, and excretion of hydrochlorothiazide.
Beermann B, Groschinsky-Grind M, et al. Clin Pharmacol Ther. 1976 May;19(5 Pt 1):531-7.
*Other sources
3. DrugBank. Hydrochlorothiazide.

Tradenames

Hydrochloorthiazide Esidrex · Hydrochlorothiazide Drine · Esidrex · Hidroclorotiazida · Hidrosaluretil Hypothiazid Esidrex · Idroclorotiazide Nefrix Esidrex Hydrochlorothiazide · Hydrosaluric Hydrochlorothiazide · Hydrochlorthiazid · Hydromed Esidrex · Hydrochlorothiazide · Hydroklortiazid Esidrex · Hydrochlorothiazide · Hydroklortiazid · Hydromed Hydrochlorothiazide · Hydrochlorothiazidum Hidroclorotiazida Hydrochlorothiazide Hydromed Hydrex Hypothiazid Hypothiazid Hypothiazid Diunorm Hidroklortiazid Hydrochlorothiazid
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