methyclothiazide (Rx)

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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 2.5mg
  • 5mg
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Hypertension

2.5-5 mg PO qDay; if not controlled after 8-12 weeks, consider adding another antihypertensive agent

Edema

Indicated to relieve edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy

2.5 mg PO qDay; if needed, may increase, not to exceed 10 mg PO qDay

Renal Impairment

Contraindicated in anuria

Use with renal impairment may cause azotemia

Safety and efficacy not established

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Interactions

Interaction Checker

and methyclothiazide

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Adverse Effects

            Frequency Not Defined

            Body as a whole: Headache, cramping, weakness

            Cardiovascular: Orthostatic hypotension

            Gastrointestinal: Pancreatitis, jaundice (intrahepatic cholestatic), sialadenitis, vomiting, diarrhea, nausea, gastric irritation, constipation, anorexia

            Hematologic: Aplastic anemia, hemolytic anemia, agranulocytosis, leukopenia, thrombocytopenia

            Hypersensitivity Reactions: Anaphylactic reactions, necrotizing angiitis (vasculitis, cutaneous vasculitis), Stevens-Johnson syndrome, respiratory distress including pneumonitis and pulmonary edema, fever, purpura, urticaria, rash, photosensitivity

            Metabolic and Nutritional Disorders: Hyperglycemia, hyperuricemia, electrolyte imbalance

            Neurologic: Vertigo, dizziness, paresthesias, muscle spasm, restlessness

            Special senses: Transient blurred vision, xanthopsia

            Urogenital: Glycosuria

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            Warnings

            Contraindications

            Hypersensitivity to methyclothiazide or sulfonamide-derivatives

            Anuria

            Cautions

            Rare cases of sensitivity reactions have occurred with history of allergy or bronchial asthma

            May cause hypokalemia

            Fluid/electrolyte imbalance may occur

            Caution with renal disease or significant impairment of renal function, since azotemia may occur

            Hyponatremia/hypochloremia: Caution with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma

            Possibility of exacerbation or activation of systemic lupus erythematosus has been reported

            May precipitate hyperuricemia or frank gout

            Latent diabetes mellitus may become manifest during thiazide administration

            May cause increased concentrations of total serum cholesterol, total triglycerides, and low-density lipoproteins in some patients

            May decrease urinary calcium excretion

            Antihypertensive effects enhanced in postsympathectomy patient

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            Pregnancy & Lactation

            Pregnancy Category: B; diuretics not recommended during pregnancy

            Lactation: Distributed in breast milk; diuresis may affect breast milk production; not recommended

            Pregnancy Categories

            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.

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            Pharmacology

            Absorption: rapid oral absorption

            Onset of action: 2 hr

            Peak effect: 6 hr

            Duration of action: 24 hr

            Excretion: urine; primarily as inactive metabolite

            Mechanism of Action

            Thiazide diuretic; inhibits renal tubular reabsorption of electrolytes; sodium and chloride excretion is greatly enhanced; potassium excretion also enhanced

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            Formulary

            FormularyPatient Discounts

            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.
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            • Compare formulary status to other drugs in the same class.
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            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.

            Tier Description
            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.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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