Chlorthalidone

What is Chlorthalidone?

• Chlorthalidone (Hygroton; Thalitone), is a thiazide-like diuretic.

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Chlortalidone

What are the uses of this medicine?

Chlorthalidone (Hygroton; Thalitone) is used:

• For the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.
• as adjunctive therapy in edema associated with heart failure, cirrhosis of the liver, and renal disease, including nephrotic syndrome

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Chlortalidone ball-and-stick

How does this medicine work?

• Chlorthalidone is a long-acting oral diuretic with antihypertensive activity.
• The diuretic effects of chlorthalidone and the benzothiadiazine (thiazide) diuretics appear to arise from similar mechanisms and the maximal effect of chlorthalidone and the thiazides appear to be similar.
• The site of the action appears to be the distal convoluted tubule of the nephron.
• Although the mechanism of action of chlorthalidone and related drugs is not wholly clear, sodium and water depletion appear to provide a basis for its antihypertensive effect.

Chlortalidone molecule spacefill from xtal

Who Should Not Use this medicine ?

This medicine cannot be used in patients with:

• anuria or hypersensitivity to chlorthalidone or other sulfonamide-derived drugs.

What drug interactions can this medicine cause?

• Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

Be sure to mention any of the following:

• other medicines for high blood pressure, anti-inflammatory medications such as [[]]ibuprofen (Motrin, Nuprin) or naproxen (Aleve), corticosteroids (e.g., prednisone), lithium (Eskalith, Lithobid), medications for diabetes, probenecid (Benemid), and vitamins.

• If you are taking cholestyramine or colestipol, take it at least 1 hour after chlorthalidone.

Is this medicine FDA approved?

• Chlortalidone was patented in 1957 and came into medical use in 1960.
• It is on the World Health Organization's List of Essential Medicines.
• It is available as a generic medication.
• In 2020, it was the 133rd most commonly prescribed medication in the United States, with more than 4 million prescriptions.

How should this medicine be used?

Recommended dosage:

For Hypertension:

• The initial recommended dose is 15 mg once daily with food.
• After 2 weeks, the dosage may be increased to a single daily dose of 25 mg if additional blood pressure reduction is needed.
• Doses above 25 mg are not expected to result in increased blood pressure reduction.

For Edema:

• The recommended initial dosage is 50 to 100 mg daily or 100 mg on alternate days.
• Depending on response, dosage can be decreased or increased up to a maximum of 200 mg daily.

Administration:

• Chlorthalidone comes as a tablet to take by mouth.
• It usually is taken once a day or every other day after a meal, preferably breakfast.
• It is best to take this medicine in the morning to avoid going to the bathroom during the night.
• Chlorthalidone controls high blood pressure but does not cure it.
• Continue to take chlorthalidone even if you feel well.
• Do not stop taking chlorthalidone without talking to your doctor.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Tablets: 15 mg and 25 mg

This medicine is available in fallowing brand namesː

• Hygroton; Thalitone

What side effects can this medication cause?

The most common side effects of this medicine include:

• hypotension, dizziness, renal dysfunction, Metabolic Disturbances, and electrolyte abnormalities

Less common, but serious side effects may include:

• Gastrointestinal System Reactions: anorexia, gastric irritation, nausea, vomiting, cramping, diarrhea, constipation, jaundice, pancreatitis.
• Central Nervous System Reactions: dizziness, paresthesias, headache.
• Hematologic Reactions: leukopenia, agranulocytosis, thrombocytopenia, aplastic anemia.
• Dermatologic-Hypersensitivity Reactions: purpura, photosensitivity, rash, urticaria, necrotizing angiitis, Lyell’s syndrome (toxic epidermal necrolysis).
• Cardiovascular Reaction: Orthostatic hypotension.
• Other Adverse Reactions: muscle spasm, weakness, restlessness, impotence, xanthopsia.

What special precautions should I follow?

• Chlorthalidone may cause symptomatic hypotension. If hypotension occurs, place the patient in the supine position and, if necessary, give intravenous normal saline. A transient hypotensive response is not a contraindication to further treatment, which usually can be continued without difficulty once the blood pressure has stabilized.
• Changes in renal function including acute renal failure can be caused by diuretics. Monitor renal function periodically. Consider withholding or discontinuing therapy in patients who develop a clinically significant decrease in renal function.
• Chlorthalidone can cause hypokalemia, hyponatremia, hypochloremic alkalosis, and hypomagnesemia. Correction of hypokalemia and any coexisting hypomagnesemia is recommended prior to the initiation of thiazides.
• Chlorthalidone may alter glucose tolerance.
• Chlorthalidone may raise serum levels of cholesterol and triglycerides.
• Chlorthalidone may raise the serum uric acid level due to reduced clearance of uric acid and may cause or exacerbate hyperuricemia and precipitate gout in susceptible patients.
• Chlorthalidone decreases urinary calcium excretion and may cause elevations of serum calcium. Monitor calcium levels in patients with hypercalcemia receiving Chlorthalidone.
• Patients should inform their doctor if they have had an allergic reaction to chlorthalidone or other diuretics; kidney disease; gout; been taking lithium carbonate.
• Patients should be cautioned to contact their physician if they experience any of the following symptoms of potassium loss: excess thirst, tiredness, drowsiness, restlessness, muscle pains or cramps, nausea, vomiting or increased heart rate or pulse.
• Patients should inform their doctor if they have symptoms of light-headedness or dizziness.
• Advise a pregnant woman of the potential risk to a fetus. Advise females of reproductive potential to inform their prescriber of a known or suspected pregnancy.
• Advise females not to breastfeed during treatment with chlorthalidone.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• Advise females not to breastfeed during treatment with chlorthalidone

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.
• There is no specific antidote but gastric lavage is recommended, followed by supportive treatment.
• Where necessary, this may include intravenous dextrose-saline with potassium, administered with caution.

Can this medicine be used in pregnancy?

• Available data over decades from observational studies and reports with chlorthalidone use in pregnant women have not identified a drug-associated risk of major birth defects or miscarriage.
• Advise pregnant women of the potential risk to a fetus.

Can this medicine be used in children?

• Safety and effectiveness in children have not been established.

What are the active and inactive ingredients in this medicine?

Active Ingredient:

• chlorthalidone

Inactive Ingredients:

• povidone
• lactose monohydrate
• cellulose, microcrystalline
• silicon dioxide
• magnesium stearate
• sodium starch glycolate type a potato

Who manufactures and distributes this medicine?

Manufactured for:

• Casper Pharma LLC
• East Brunswick, NJ

Made in India.

What should I know about storage and disposal of this medication?

• Store at 20o to 25oC (68o to 77oF).
• Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.

• Dailymed label info on Chlorthalidone
• FDA Chlorthalidone

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