Chlorthalidone

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Belgium: Chlorthalidone, Hygroton; Bulgaria: Saluretin; Germany: Hygroton; Italy: Igroton; Portugal: Hygroton; Spain: Higrotona; UK: Hygroton.

North America

Canada: Chlorthalidone; USA: Chlorthalidone, Thalitone.

Latin America

Argentina: Eurético, Hygroton; Brazil: Clortalidona, Clortalil, Clortil, Higroton, Neolidona; Mexico: Anilid, Bioralin, Clortalidona, Hidrona, Hidropharm, Higroton, Lortal, Sinhidron, Tensoral.

Asia

Japan: Hygroton.

Drug combinations

Chlorthalidone and Amiloride

Chlorthalidone and Atenolol

Chlorthalidone and Clonidine

Chlorthalidone and Metoprolol

Chlorthalidone and Oxprenolol

Chlorthalidone, Atenolol, and Hydralazine

Chlorthalidone, Hydralazine, and Oxprenolol

Chemistry

Chlorthalidone: C~14~H~11~ClN~2~O~4~S. Mw: 338.77. (1) Benzenesulfonamide, 2-chloro-5-(2,3-dihydro-1-hydroxy-3-oxo-1H-isoindol-1-yl)-; (2) 2-Chloro-5-(1-hydroxy-3-oxo-1-isoindolinyl)benzenesulfonamide. CAS-77-36-1 (1961).

Pharmacologic Category

Diuretics; Thiazide-like Diuretics. (ATC-Code: C03BA04).

Mechanism of action

Sulfonamide-derived diuretic which inhibits sodium and chloride reabsorption in the cortical-diluting segment of the ascending loop of Henle. Enhances urinary excretion of potassium. Increases urinary bicarbonate excretion. Hypocalciuric effect as result of decrease in extracellular fluid volume. Slight or intermittent elevations in serum calcium concentration. Augments action of other hypotensive agents.

Therapeutic use

Management of mild-to-moderate hypertension. Edema associated with congestive heart failure or nephrotic syndrome. Systolic hypertension in the elderly.

Pregnancy and lactiation implications

Diuretics not recommended for pregnancy-induced hypertension (maternal hypovolemia enhances risk of decreased placental perfusion). Diuretics are considered second-line agents for control of chronic hypertension in pregnant women. Thiazides should not be used as routine therapy in pregnant women with mild edema who are otherwise healthy. Distributed into breast milk.

Unlabeled use

Pediatric hypertension. Diabetes insipidus. Renal tubular acidosis. Prophylaxis of renal calculus formation associated with hypercalciuria.

Contraindications

Hypersensitivity to chlorthalidone or any component of the formulation. Cross-sensitivity with other thiazides or sulfonamides. Anuria. Renal decompensation. Pregnancy.

Warnings and precautions

Hypokalemia, hypochloremic alkalosis and hyponatremia can occur. May cause photosensitization. Its use in thiazide or sulfonamide allergy is specifically contraindicated. Use with caution in prediabetes or diabetes mellitus. May precipitate gout. Use with caution in severe hepatic dysfunction (in cirrhosis, avoid electrolyte and acid/base imbalances). Use with caution in moderate or high cholesterol concentrations. Avoid in severe renal disease (ineffective). Can cause systemic lupus erythematosus exacerbation or activation.

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