The cheapest medicine for high blood pressure

How much do you think will the cheapest drug for high blood pressure cost? P40? P20? No, much lower. P10? Still lower. It’s only P5.85 per day, and with the 20-percent senior citizen discount, this goes down to P4.80 per day.

But that’s not all, some patients only need to take half a tablet per day. So their daily budget for medicines will only be P2.40 a day!

The Best-Kept Secret

Are you ready for the best-kept secret in cheap medicines? It’s called hydrochlorothiazide, or HCTZ for short (brand name Hytaz from Unilab). It belongs to the family of thiazide diuretics. In layman’s term, diuretics are so-called water pills that act by decreasing the fluid and salt in one’s body. Similarly, doctors advise patients to reduce their salt intake to decrease their blood pressure.

Well, I’m sure you’re wondering, what’s the catch? If it’s cheap, then it must be low in quality, right? Absolutely not! I can cite a litany of medical studies plus the endorsement of the American-based Joint National Committee (JNC) that HCTZ is really effective and safe. In fact, there are hundreds of studies showing that the thiazide diuretics are effective in reducing blood pressure and its complications.

A few years ago, I went to Massachusetts General Hospital to further train in cardiology under Dr. Richard Liberthson, a renowned American cardiologist. I remember that Dr. Liberthson always prescribes HCTZ first for hypertension, and only adds other drugs if the blood pressure is not yet controlled.

It’s The Favorite Add-on Drug

Hydrocholorothiazide (HCTZ) is so effective that this drug is the favorite add-on to the expensive drugs you’re taking. If you’re taking any of these famous drugs (Micardis Plus, Pritor Plus, Combizaar, CoApprovel, CoRenitec), then you are already taking HCTZ.

So if HCTZ is good, safe, and affordable, then why are doctors not prescribing it? Well, probably because this drug is so cheap, that is why there is little budget for marketing and promotion.

The Biggest Scientific Trial

For our doctors who haven’t used thiazide diuretics yet, let me remind them of the battle waged between the underdog class of diuretics (represented by Chlorthalidone, in the same family as HCTZ) and the champion drug Amlodipine. It’s pretty much like David versus Goliath.

Historically, this was the largest battle of all time (with a world-record number of 42,418 patients recruited) pitting two medicines for high blood pressure. This megastudy, called ALLHAT, took eight years to finish and the final results were released in the prestigious Journal of the American Medical Association in 2002.

Majority thought Amlodipine would knock out the cheaper and presumably less effective diuretics. Surprise, surprise! The results show that the diuretics (like HCTZ) fought the champion (Amlodipine) to a draw and held their own in terms of lowering blood pressure, preventing heart attacks, reducing hospitalization, and saving lives. David had fought Goliath to a standstill. The medical community was shocked.

The researchers of ALLHAT therefore had no choice but to conclude that doctors should prescribe thiazide-type diuretics (like HCTZ) as the first-line treatment for high blood pressure. Moreover, thiazide-type of diuretics should be one of the drugs used for patients with more severe forms of hypertension.

Given the results of ALLHAT, then why, oh why, are very few doctors prescribing HCTZ? (You may check out ALLHAT’s patient-friendly website at http://allhat.sph.uth.tmc.edu/.)

Savior For Both Poor and Rich Patients

Several years ago, MSD had distributed HCTZ under the name of Dichlotride. However, they stopped carrying HCTZ because of what I believe are low sales. To be honest, I was so sad when HCTZ was withdrawn in the late 1990s. Such a great loss for our poor patients.

That is why I can’t help but rejoice when recently Therapharma, a division of Unilab, decided to bring back my long-lost friend, my favorite drug — hydrochlorothiazide (HCTZ). It’s now called Hytaz. Hytaz but low-priced.

Last year, we had a dilemma in our Pasay Filipino-Chinese Charity Health Center, where we see 400 patients per medical mission. Through the years, I have accumulated around 100 hypertensive patients who always tell me, “Doc, we can’t afford the expensive drugs. Please help us.”

Well, starting this month, our Charity Center (founded by my dad Co Tec Tai in 1991) bought 2,000 tablets of Hytaz at 20-percent discount from Therapharma. When the company found out it was for charity, they gave another 500 tablets for free!

And of course, I have given Hytaz to my number one patient, my dad, at 25 mg, half tablet a day, which ends up costing only P2.40 a day.

My dad asked how much this new drug is.

“It’s 2.40 a day,” I replied excitedly.

“P240 a tablet? So expensive!” he shouted in Chinese.

“Just 2.40 a day, Dad. Just take it and trust me.”

So if your medicines for high blood pressure are too expensive, ask your doctor if Hytaz is right for you. Better yet, inform your doctor about it.

* * *

E-mail comments to drwillieong@gmail.com.