Clortalidona (Chlorthalidone)

Active Ingredient: Chlorthalidone
Dosage: 50 mg
Route of Administration: Oral
Dosage Form: Tablets
Quantity per package: 20 tablets per pack
Availability: Out of stock

Chlortalidone is a diuretic and antihypertensive drug which is used to treat high blood pressure and fluid retention (edema) that due to heart failure, liver failure, nephrotic syndrome, diabetes insipidus, and renal tubular acidosis. In hypertension, this is a first-line treatment. It can also be used to prevent calcium-based kidney stones. Improvement is generally observed within 3 hours and lasts for up to 3 days.

The product is currently out of stock but you can find a similar diuretic on this page.

Indications

• Edema due to different causes;
• Primary arterial hypertension.

Dosage and administration

The drug is administered orally.

• Adults: For the treatment of high blood pressure, the initial dose is 15 mg in a single daily dose. If the response is inadequate, the dose can be increased to 30, 45 and 50 mg, depending on the patient’s response. For edema, the indicated doses are 30 to 60 mg / day or 60 mg every third day. Some patients may require up to 120 mg / day;
• In renal failure, thiazides may not work properly. When used in patients with mild to moderate renal impairment, doses can be adjusted at 24-hour intervals;
• In patients with severe renal impairment, the dose is adjusted in 48-hour intervals. It should not be used if the patient has blood creatinine values ​​or ureic nitrogen levels greater than 2.5 mg / dl;
• Geriatric patients: The indicated doses of 25 to 50 mg / day can be used. In this patient group, special care must be taken with the hydroelectrolytic alterations that thiazide diuretics can cause. In these patients the elimination of the active substance is slower than in young subjects, so close clinical surveillance should be maintained in this population;
• Children: The weight dose of the drug is 2 mg / kg three times a week, or 1 to 2 mg / kg / day. The safety and efficacy of this diuretic in children has not been established.

Contraindications

Chlorthalidone is contraindicated in patients with a history of allergic reaction tics and to sulfonamides in general. It should it be administered in patients with anuria. In diabetic patients controlled with hypoglycemic agents or insulin, this drug should be administered with extreme caution and, if necessary, the doses of hypoglycemic agents or insulin should be adjusted. Care should also be taken in patients with hypokalemia, hyponatremia, hypomagnesemia, hypercalcemia and hypophosphatemia; with liver disease, hyperuricemia or lupus erythematosus. This drug can enhance the effects of digitalis poisoning, as well as hypotension due to other antihypertensives. It can trigger azoemia in patients with kidney disease.

Side effects

• Hematologic: neutropenia, leukopenia, agranulocytosis, thrombocytopenia and aplastic anemia;
• Cardiovascular: Arrhythmia, necrotizing vasculitis and drug-induced periarteritis nodosa;
• Endocrine and metabolic disorders: hyperglycemia, hyperuricemia, hyponatremia, hypokalemia, hypercalcemia, increased secretion of antidiuretic hormone, hypercholesterolemia, increased LDL, cholesterol and blood triglycerides, hypomagnesemia;
• Gastrointestinal: mild nausea, vomiting and abdominal pain; acute hemorrhagic pancreatitis (very rare);
• Genitourinary: sexual impotence and decreased libido;
• Visual disturbances: Blurred vision, myopia, headaches, eye pain, periorbital edema and conjunctival infections;
• Skin: psoriasiform rash, pseudoporphyria, photosensitization;
• Musculoskeletal: paraesthesia, paralysis and muscle weakness associated with hypokalemia.

Overdose

The symptoms associated with Chlorthalidone overdose are dizziness, nausea, drowsiness, hypovolemia, hypotension and hydroelectrolytic disorders, which can cause arrhythmias or alterations in muscle depolarization. If the patient is conscious, it is recommended to induce vomiting or administer activated carbon (if there are no contraindications).

It is necessary to closely monitor and correct any alteration in the level of plasma fluids and electrolytes.

Interaction

Chlorthalidone administered together with ACE inhibitor drugs may potentiate the hypotensive effects of the latter, producing postural hypotension.

The association of thiazides with bepridil can induce hypokalemia and subsequent cardiotoxicity. If calcium carbonate or other calcium supplements are given together with Chlorthalidone, hypercalcemia, metabolic alkalosis and renal failure can be induced.

It also enhances diazoxide-induced hyperglycemia, further decreasing the hypoglycemic effectiveness of chlorpropamide. Similarly, the administration of non-steroidal anti-inflammatories decreases the diuretic effect of the drug.