Dosing & Uses
Dosage Forms & Strengths
Not indicated for initial therapy
If the fixed dose combination represents the dose appropriate to the individual patient's needs, it may be more convenient than the separate components
Usual dose: 0.1-0.3 mg/15 mg PO qDay or q12hr
Maximum: 0.6 mg/30 mg PO qDay
Use caution in dosing/titrating patients with renal dysfunction
Cumulative effects of thiazides may develop with impaired renal function; dose adjustment may be necessary; azotemia may be precipitated
Use caution; not studied
Combination may be substituted for the titrated individual components
Withdraw gradually over a period of 2-4 days
Safety/efficacy not established
May benefit from lower initial dose
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
No adverse effects specific to the combination have been observed; adverse effects limited to those previously reported with clonidine and chlorthalidone
- Orthostatic hypotension
- Chest pain
- Atrioventricular block
- Anorexia, weight gain
- Dry mouth
- Abnormal LFTs
- Blurred vision, xanthopsia
- Electrolyte abnormalities
- Headache, vasculitis
- Loss of appetite
- Muscular spasticity, restlessness
- Photosensitivity, phototoxicity
Hypersensitivity to either component or sulfonamide derivatives
DM, hyperuricemia or gout, hypotension, SLE
Chlorthalidone may cause fluid or electrolyte imbalance including hyponatremia, hypochloremic alkalosis, or hypokalemia
History of depression
May aggravate digitalis toxicity
Patients allergic to sulfa may show cross-sensitivity
May impair ability to perform hazarous tasks
Risk of male sexual dysfunction
Severe coronary insufficiency, recent MI, conduction disturbances, cerebrovascular disease, chronic renal failure, Raynaud's disease, thromboangiitis obliteran
Sudden cessation of clonidine treatment has resulted in subjective symptoms such as nervousness, agitation and headache, accompanied or followed by a rapid rise in blood pressure and elevated catecholamine concentrations in the plasma
Pregnancy & Lactation
Pregnancy Category: C
Lactation: excreted in breast milk, use caution
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Clonidine/chlorthalidone is a fixed-combination tablet that combines a central alpha-2 stimulator, clonidine and a diuretic, chlorthalidone
Clonidine produces central alpha 2-adrenergic stimulation, which results in a decreased sympathetic outflow to the heart, kidneys, and peripheral vasculature; this results in decreased peripheral vascular resistance, decreased systolic and diastolic blood pressure, and decreased heart rate
Chlorthalidone, a monosulfonamyl diuretic, inhibits Na & Cl reabsorption in cortical-diluting segment of ascending loop of Henle
- Half-Life: 12-16 hr (normal renal function); 41 hr (impaired renal function)
- Onset: 0.51 hr
- Metabolism: Liver
- Excretion: Urine (40-60%)
- Duration: 6-10 hr
- Peak plasma time: 3-5 hr (immediate release); 7-8 hr (extended release)
- Vd: 2.1 L/kg
- Protein binding: 20-40%
- Bioavailability: 75-85% (immediate release); 89% (extended release)
- Duration: 24-72 hr
- Onset: 2-6 hr (peak effect)
- Metabolism: Liver
- Protein binding: 75%
- Bioavailability: 60-65%
- Excretion: Urine (50-65%)
- Half-life: 40-60 hr (normal renal function); prolonged in renal impairment; 81 hr (anuria)
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.