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Dr. Banita Sehgal
Internal Medicine Physician
My approach to healthcare is rooted in building genuine partnerships with my patients.
Taking the time to understand their needs and goals helps us collaborate effectively and find the best path forward together. What I love most about my work is being someone they can count on — familiar, accessible, and focused on their well-being.
Frequently asked questions
Hydrochlorothiazide may be right for you if you have high blood pressure or fluid retention (edema) due to conditions like heart failure, kidney disease, or cirrhosis. Your doctor will determine if it's appropriate based on:
- Your blood pressure levels
- Kidney function
- The presence of other conditions like gout, diabetes, or electrolyte imbalances (e.g., low potassium)
- Any history of allergies to sulfa drugs
If you’ve been prescribed hydrochlorothiazide, your LifeMD-affiliated healthcare provider will monitor you for potential side effects, like dehydration or electrolyte imbalances. It’s important to follow their guidance and discuss any concerns or pre-existing conditions.
You should not take hydrochlorothiazide if you have:
- Allergic reactions to sulfa drugs (HCTZ is a sulfonamide)
- Severe kidney problems, as it can worsen kidney function
- Anuria (the inability to urinate)
- Severe liver disease (such as cirrhosis) with electrolyte imbalances
- Gout, as it can increase uric acid levels
- Low blood pressure (hypotension) or dehydration
- Electrolyte imbalances like low potassium (hypokalemia) or sodium (hyponatremia)
Be sure to speak to your healthcare provider before starting hydrochlorothiazide to determine if it’s a safe and effective choice for you.
Hydrochlorothiazide typically stays in your system for about one to two days after you take it, with a half-life of around six to 15 hours. This means it takes about this long for half the dose to be cleared from your body.
However, its effects on lowering blood pressure and reducing fluid retention can last much longer, and the medication may continue to have an impact even after it’s cleared from your system.
The time it stays in your body can vary depending on factors like your kidney function and dosage. If you have kidney issues or other health conditions, the drug may linger longer.
Hydrochlorothiazide usually does not cause weight gain. If anything, it’s more likely to cause a slight weight loss at first due to fluid loss (since it’s a diuretic or “water pill”). However, if you experience unexpected weight gain while taking it, it could signal:
- Fluid retention that isn’t being managed effectively
- Electrolyte imbalances
- A reaction to another medication you're taking alongside it
Hair loss is not a common side effect of hydrochlorothiazide, but it has been reported in rare cases. If it happens, it's usually mild and temporary, possibly linked to:
- Stress on the body from electrolyte imbalances or dehydration
- Sensitivity to the drug
- Interaction with other medications
If you notice hair thinning or shedding after starting hydrochlorothiazide, talk to your LifeMD-affiliated healthcare provider. They can help determine whether the medication is the cause or if something else – like thyroid issues, iron deficiency, or another drug – is contributing.
When you stop taking hydrochlorothiazide, a few things can happen depending on why you were taking it and your overall health:
- If you were using it for high blood pressure, your blood pressure may rise again (sometimes gradually, sometimes quickly).
- If it was prescribed for fluid retention (edema), swelling may return as your body holds onto more water and salt.
- If you stop it suddenly without medical advice, you might experience fluid buildup, especially if you have heart or kidney issues.
There usually aren’t withdrawal symptoms, but the underlying condition it was treating can come back or worsen. Be sure to always check with your healthcare provider before stopping hydrochlorothiazide – they may want to taper the dose or switch you to another medication.
No, HCTZ is not a potassium-sparing diuretic. It’s a thiazide diuretic, which means it helps your body get rid of extra fluid and salt. But, it can also cause your body to lose potassium in the process. Because of this, your healthcare provider may
- Monitor your potassium levels with blood tests
- Recommend potassium-rich foods (like bananas or spinach)
- Prescribe a potassium supplement or a potassium-sparing diuretic (like spironolactone) if needed
If you’re on hydrochlorothiazide and feel weak, tired, or have muscle cramps, it could be a sign of low potassium – so be sure to let your LifeMD-affiliated provider know.
Hydrochlorothiazide usually starts working within two hours after you take it, with the peak effect around four to six hours. Its diuretic (water-reducing) effects can last up to 12 hours.
If you’re taking it for high blood pressure, it may take a few days to a few weeks of daily use to see the full blood pressure–lowering benefits.
You may not feel any different right away, but that doesn't mean it's not working – so it’s important to keep taking it as prescribed and follow up with your healthcare provider to monitor your progress.
The most common side effects of hydrochlorothiazide are typically mild. They can include
- Frequent urination, especially early in treatment
- Low potassium (which may cause muscle cramps, fatigue, or weakness)
- Dizziness or lightheadedness, particularly when standing up quickly
- Headache
- Increased sensitivity to sunlight (photosensitivity)
- Elevated blood sugar or uric acid levels (which can affect people with diabetes or gout)
Less commonly, it can cause low sodium, low magnesium, or mild digestive issues. If you notice any unusual symptoms – especially signs of dehydration, confusion, or an irregular heartbeat – be sure to check in with your provider.
LifeMD offers patients access to licensed healthcare providers who can offer guidance on healthcare concerns. Through our virtual platform, you can schedule same-day appointments and meet with a medical professional from the comfort of your home.
Your healthcare provider may prescribe you a medication if appropriate, and order it to your local pharmacy for your convenience. Skip the waiting room with LifeMD, make an appointment today to get started.