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chlorthalidone (Rx)Brand and Other Names:Hygroton, Thalitone, more...Chlorthalid

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 15mg
  • 25mg
  • 50mg
  • 100mg
more...

Hypertension

25-100 mg/day PO; usual range, 12.5-25 mg/day

Edema

50-100 mg/day PO or 100 mg PO every other day; not to exceed 200 mg/day

Heart Failure

12.5-25 mg/day PO; not to exceed 100 mg/day

Dosing Considerations

Administered in the morning with food

Overdose management

  • Normal saline may be used for volume replacement
  • Dopamine or norepinephrine may be used to treat hypotension
  • If dysrhythmia due to decreased potassium or magnesium is suspected, replace aggressively
  • If no symptoms are noted after 6 hours, discontinue treatment

Dosing Modifications

Renal impairment

  • CrCl <10 mL/min: Ineffective; do not use
  • CrCl >10 mL/min: Dose adjustment not necessary

Dosage Forms & Strengths

tablet

  • 15mg
  • 25mg
  • 50mg
  • 100mg
more...

Hypertension (Off-label)

0.3 mg/kg/day PO initially; may be increased to 2 mg/kg/day; not to exceed 50 mg/day 

Potential for electrolyte imbalance in elderly; monitor serum electrolytes

Diuresis

12.5-25 mg/day PO or 12.5-25 mg PO every other day; dosages >25 mg/day offer only minimal advantage

Hypertension

25-100 mg/day PO; usual range, 12.5-25 mg/day

Edema

50-100 mg/day PO or 100 mg PO every other day; not to exceed 200 mg/day

Heart Failure

12.5-25 mg/day PO; not to exceed 100 mg/day

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Interactions

Interaction Checker

chlorthalidone and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Common

            Cardiovascular: Hypotension, vasculitis

            Dermatologic: Photosensitivity, phototoxicity

            Endocrine/metabolic: Electrolyte abnormalities, hyperglycemia, hyperuricemia

            Gastrointestinal: Constipation, diarrhea, loss of appetite, nausea, vomiting

            Musculoskeletal: Spasticity

            Neurologic: Dizziness, headache, paresthesia

            Ophthalmologic: Blurred vision, xanthopsia

            Psychiatric: Restlessness

            Reproductive: Impotence

            Serious

            Cardiovascular: Cardiac dysrhythmia (rare)

            Dermatologic: Scaling eczema (rare), Stevens-Johnson syndrome (rare), toxic epidermal necrolysis (rare)

            Gastrointestinal: Pancreatitis (rare)

            Hematologic: Disorder of hematopoietic structure (rare)

            Hepatic: Hepatotoxicity (rare)

            Immunologic: Systemic lupus erythematosus (rare)

            Respiratory: Pulmonary edema (rare)

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            Warnings

            Contraindications

            Documented hypersensitivity to chlorthalidone or sulfonamides

            Anuria

            Cautions

            Use with caution in diabetes mellitus, fluid or electrolyte imbalance, hypercholesterolemia, hyperuricemia or gout, hypotension, systemic lupus erythematosus, liver disease, severe renal disease, advanced age, history of allergy or bronchial asthma

            Avoid concurrent use with lithium (reduction of lithium dosage by 50% may be necessary)

            May aggravate digitalis toxicity

            Patients allergic to sulfa drugs may show cross-sensitivity

            Risk of male sexual dysfunction

            Photosensitization may occur

            Electrolyte disturbances (eg, hypokalemia, hyponatremia, hypochloremic alkalosis) may occur

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            Pregnancy & Lactation

            Pregnancy category: B; D (expert analysis); possible hazards include fetal or neonatal jaundice, thrombocytopenia, and other adverse reactions that have occurred in adults

            Lactation: Drug enters breast milk; not recommended (American Academy of Pediatrics states that it is "compatible with nursing")

            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.

            more...
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            Pharmacology

            Mechanism of Action

            Similar to thiazide diuretics; inhibits sodium and chloride reabsorption in cortical diluting segment of ascending loop of Henle, causing increased excretion of sodium, chloride, and water

            Absorption

            Bioavailability: 65%

            Onset: 2-6 hr

            Duration: 24-72 hr

            Peak plasma time: 1.5-6 hr

            Distribution

            Protein bound: 75%

            Metabolism

            Metabolized in liver

            Elimination

            Half-life: Normal renal function, 40-60 hr; anuria, 81 hr

            Dialyzable: No

            Total body clearance: 53-145 mL/min

            Excretion: Urine (50-65%), feces

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            Images

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            Formulary

            FormularyPatient Discounts

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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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