Dosing & Uses
Dosage Forms & Strengths
oral suspension
- 250mg/5mL
powder for injection
- 500mg
tablet
- 250mg
- 500mg
Edema
0.5-1 g (10 to 20 mL) PO/IV qDay or q12hr;
Dosing consideration
- Many patients with edema respond to intermittent therapy (ie, administration on alternate days or 3-5 days each week; reduces risk of undesirable electrolyte imbalance)
Hypertension
0.5 -1 g (10-20 mL)/day PO/IV as single or divided dose; increase or decrease dosage based on blood pressure response
Renal Impairment
CrCl <10 mL/minute: Do not use
CrCl<30 mL/minute: Ineffective
Overdose Management
May use normal saline for volume replacement
May use dopamine or norepinephrine to treat hypotension
If dysrhythmia due to decreased K+ or Mg+ suspected replace aggressively
Discontinue treatment if no symptoms after 6hr
Other Indications & Uses
Edema associated with: CHF, cirrhosis, steroids, estrogen therapy, renal dysfunction
Off-label: Calcium nephrolithiasis, osteoporosis, diabetes insipidus
Dosage Forms & Strengths
oral suspension
- 250mg/5mL
powder for injection
- 500mg
tablet
- 250mg
- 500mg
Edema
10 to 20 mg/kg (5-10 mg/lb) qDay or divided q12hr, not to exceed 375 mg/day
Hypertension
10 to 20 mg/kg (5-10 mg/lb) qDay or divided q12hr, not to exceed 375 mg/day
Edema
0.5-1 g (10 to 20 mL) PO/IV qDay or q12hr; many patients with edema respond to intermittent therapy (ie, administration on alternate days or 3-5 days each week; reduces risk of undesirable electrolyte imbalance)
Hypertension
0.5 -1 g (10-20 mL)/day PO/IV as single or divided dose; increase or decrease dosage based on blood pressure response
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (9)
- aminolevulinic acid oral
aminolevulinic acid oral, chlorothiazide. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.
- aminolevulinic acid topical
chlorothiazide increases toxicity of aminolevulinic acid topical by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of photosensitizing drugs may enhance the phototoxic reaction to photodynamic therapy with aminolevulinic acid.
- darolutamide
darolutamide will increase the level or effect of chlorothiazide by Other (see comment). Avoid or Use Alternate Drug. Darolutamide is a BCRP inhibitor. Avoid coadministration with BCRP inhibitors. If use is unavoidable, closely monitor for adverse reactions and consider dose reduction of BCRP substrate drug (refer BCRP substrate prescribing information).
- leniolisib
leniolisib will increase the level or effect of chlorothiazide by Other (see comment). Avoid or Use Alternate Drug. Leniolisib, a BCRP inhibitor, may increase systemic exposure of BCRP substrates
- lofexidine
lofexidine, chlorothiazide. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.
- methyl aminolevulinate
chlorothiazide, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.
- squill
chlorothiazide increases toxicity of squill by Other (see comment). Avoid or Use Alternate Drug. Comment: Potassium depletion may enhance toxicity of squill.
- tretinoin
chlorothiazide, tretinoin. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.
- tretinoin topical
chlorothiazide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.
Monitor Closely (166)
- acalabrutinib
acalabrutinib increases levels of chlorothiazide by Other (see comment). Use Caution/Monitor. Comment: Acalabrutinib may increase exposure to coadministered BCRP substrates by inhibition of intestinal BCRP.
- acebutolol
acebutolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aceclofenac
aceclofenac increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- acemetacin
acemetacin increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- albiglutide
chlorothiazide decreases effects of albiglutide by pharmacodynamic antagonism. Use Caution/Monitor. Thiazide diuretics can decrease insulin sensitivity thereby leading to glucose intolerance and hyperglycemia. Monitor glycemic control especially when initiating, discontinuing, or increasing thiazide diuretic dose.
- albuterol
albuterol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- aldesleukin
aldesleukin increases effects of chlorothiazide by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- amifostine
amifostine, chlorothiazide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.
- amiloride
amiloride increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- amoxicillin
amoxicillin, chlorothiazide. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- apalutamide
apalutamide will decrease the level or effect of chlorothiazide by increasing elimination. Use Caution/Monitor. Apalutamide weakly induces BCRP and may decrease systemic exposure of drugs that are BCRP substrates.
- arformoterol
arformoterol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- aspirin
aspirin increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aspirin rectal
aspirin rectal increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atenolol
atenolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- beclomethasone, inhaled
beclomethasone, inhaled increases toxicity of chlorothiazide by increasing elimination. Use Caution/Monitor. May increase the hypokalemic effects of thiazide diuretics.
- benazepril
benazepril, chlorothiazide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Ehanced hypotensive effects. Increased risk of nephrotoxicity. Monitor blood pressure and renal function.
- bendroflumethiazide
bendroflumethiazide and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- betaxolol
betaxolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bisoprolol
bisoprolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bretylium
chlorothiazide, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.
- bumetanide
bumetanide and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection decreases effects of chlorothiazide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Opioids can reduce diuretic efficacy by inducing antidiuretic hormone release.
- calcifediol
chlorothiazide increases toxicity of calcifediol by Other (see comment). Use Caution/Monitor. Comment: Thiazide diuretics may increase serum calcium by decreasing urinary calcium excretion.
- candesartan
candesartan increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- captopril
captopril, chlorothiazide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Increased risk of nephrotoxicity. Monitor blood pressure and renal function.
- carbenoxolone
chlorothiazide and carbenoxolone both decrease serum potassium. Use Caution/Monitor.
- carbidopa
carbidopa increases effects of chlorothiazide by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.
- carvedilol
carvedilol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- celecoxib
celecoxib increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- celiprolol
celiprolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
chlorothiazide decreases levels of celiprolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. - chlorthalidone
chlorothiazide and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- cholestyramine
cholestyramine decreases levels of chlorothiazide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- choline magnesium trisalicylate
choline magnesium trisalicylate increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- citalopram
chlorothiazide, citalopram. pharmacodynamic synergism. Use Caution/Monitor. Possible additive hyponatremia.
- cornsilk
cornsilk increases effects of chlorothiazide by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypokalemia (theoretical interaction).
- cyclopenthiazide
chlorothiazide and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.
- deflazacort
chlorothiazide and deflazacort both decrease serum potassium. Use Caution/Monitor.
- dichlorphenamide
dichlorphenamide and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- diclofenac
diclofenac increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dicloxacillin
dicloxacillin, chlorothiazide. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- diflunisal
diflunisal increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- digoxin
digoxin increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
chlorothiazide increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Hypokalemia increases digoxin effects. - dobutamine
dobutamine and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- dopexamine
dopexamine and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- drospirenone
drospirenone increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- eluxadoline
eluxadoline increases levels of chlorothiazide by decreasing metabolism. Use Caution/Monitor. Eluxadoline may increase the systemic exposure of coadministered BCRP substrates.
- empagliflozin
empagliflozin, chlorothiazide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of empagliflozin with diuretics results in increased urine volume and frequency of voids, which might enhance the potential for volume depletion.
- encorafenib
encorafenib will increase the level or effect of chlorothiazide by Other (see comment). Modify Therapy/Monitor Closely. Encorafenib (a BCRP inhibitor) may increase the concentration and toxicities of BCRP substrates. Closely monitor for signs and symptoms of increased exposure and consider adjusting the dose of these substrates.
- ephedrine
ephedrine and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- epinephrine
epinephrine and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- epinephrine racemic
epinephrine racemic and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- eprosartan
eprosartan increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- esmolol
esmolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ethacrynic acid
ethacrynic acid and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- etodolac
etodolac increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- exenatide injectable solution
chlorothiazide decreases effects of exenatide injectable solution by pharmacodynamic antagonism. Use Caution/Monitor. Thiazide diuretics can decrease insulin sensitivity thereby leading to glucose intolerance and hyperglycemia. Monitor glycemic control especially when initiating, discontinuing, or increasing thiazide diuretic dose.
- exenatide injectable suspension
chlorothiazide decreases effects of exenatide injectable suspension by pharmacodynamic antagonism. Use Caution/Monitor. Thiazide diuretics can decrease insulin sensitivity thereby leading to glucose intolerance and hyperglycemia. Monitor glycemic control especially when initiating, discontinuing, or increasing thiazide diuretic dose.
- fenoprofen
fenoprofen increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fentanyl
fentanyl decreases effects of chlorothiazide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).
- fentanyl intranasal
fentanyl intranasal decreases effects of chlorothiazide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).
- fentanyl transdermal
fentanyl transdermal decreases effects of chlorothiazide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).
- fentanyl transmucosal
fentanyl transmucosal decreases effects of chlorothiazide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Fentanyl can reduce the efficacy of diuretics by inducing antidiuretic hormone release. Fentanyl may also lead to acute urinary retention by causing bladder sphincter spasm (particularly in men with enlarged prostates).
- flurbiprofen
flurbiprofen increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- formoterol
formoterol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- fostemsavir
fostemsavir will increase the level or effect of chlorothiazide by Other (see comment). Modify Therapy/Monitor Closely. Fostemsavir inhibits BCRP transporters. If possible, avoid coadministration or modify dose of BCRP substrate coadministered with fostemsavir.
- furosemide
furosemide and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- gentamicin
chlorothiazide and gentamicin both decrease serum potassium. Use Caution/Monitor.
- hydrochlorothiazide
chlorothiazide and hydrochlorothiazide both decrease serum potassium. Use Caution/Monitor.
- ibuprofen
ibuprofen increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ibuprofen IV
ibuprofen IV increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. NSAIDs may decrease the therapeutic effects of thiazide-like diuretics; may also enhance nephrotoxic effects.
chlorothiazide will increase the level or effect of ibuprofen IV by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor. - indacaterol, inhaled
chlorothiazide, indacaterol, inhaled. serum potassium. Use Caution/Monitor. Combination may increase risk of hypokalemia.
indacaterol, inhaled, chlorothiazide. Other (see comment). Use Caution/Monitor. Comment: Caution is advised in the coadministration of indacaterol neohaler with non-potassium-sparing diuretics. - indapamide
chlorothiazide and indapamide both decrease serum potassium. Use Caution/Monitor.
- indomethacin
indomethacin increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- insulin degludec
chlorothiazide decreases effects of insulin degludec by Other (see comment). Use Caution/Monitor. Comment: Diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, possibly by diuretic-induced hpokalemia.
- insulin degludec/insulin aspart
chlorothiazide decreases effects of insulin degludec/insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, possibly by diuretic-induced hpokalemia.
- insulin inhaled
chlorothiazide decreases effects of insulin inhaled by Other (see comment). Use Caution/Monitor. Comment: Diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, possibly by diuretic-induced hpokalemia.
- irbesartan
irbesartan increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- isoproterenol
isoproterenol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- juniper
juniper, chlorothiazide. Other (see comment). Use Caution/Monitor. Comment: Juniper may potentiate or interfere with diuretic therapy. Juniper has diuretic effects, but may cause kidney damage at large doses.
- ketoprofen
ketoprofen increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketorolac
ketorolac increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketorolac intranasal
ketorolac intranasal increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- labetalol
labetalol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levalbuterol
levalbuterol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- levodopa
levodopa increases effects of chlorothiazide by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.
- lily of the valley
chlorothiazide increases toxicity of lily of the valley by Other (see comment). Use Caution/Monitor. Comment: Increased risk of cardiac toxicity due to K+ depletion.
- liraglutide
chlorothiazide decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Thiazide diuretics can decrease insulin sensitivity thereby leading to glucose intolerance and hyperglycemia. Monitor glycemic control especially when initiating, discontinuing, or increasing thiazide diuretic dose.
- lithium
chlorothiazide increases toxicity of lithium by decreasing elimination. Use Caution/Monitor.
- lornoxicam
lornoxicam increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- losartan
losartan increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lurasidone
lurasidone increases effects of chlorothiazide by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.
- maitake
maitake increases effects of chlorothiazide by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypokalemia (theoretical interaction).
- maraviroc
maraviroc, chlorothiazide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.
- meclofenamate
meclofenamate increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mefenamic acid
mefenamic acid increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meloxicam
meloxicam increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaproterenol
metaproterenol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- methoxsalen
methoxsalen, chlorothiazide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive photosensitizing effects.
- methyclothiazide
chlorothiazide and methyclothiazide both decrease serum potassium. Use Caution/Monitor.
- methylphenidate transdermal
methylphenidate transdermal decreases effects of chlorothiazide by anti-hypertensive channel blocking. Use Caution/Monitor.
- metolazone
chlorothiazide and metolazone both decrease serum potassium. Use Caution/Monitor.
- metoprolol
metoprolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mometasone inhaled
mometasone inhaled increases toxicity of chlorothiazide by Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may increase hypokalemic effect of loop diuretics.
- mycophenolate
chlorothiazide will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- nabumetone
nabumetone increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nadolol
nadolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- naproxen
naproxen increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nebivolol
nebivolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nitroglycerin rectal
nitroglycerin rectal, chlorothiazide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Observe for possible additive hypotensive effects during concomitant use. .
- norepinephrine
norepinephrine and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- oliceridine
oliceridine decreases effects of chlorothiazide by Other (see comment). Use Caution/Monitor. Comment: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. Monitor for signs of diminished diuresis and/or effects on blood pressure and increase dosage of the diuretic as needed. .
- olmesartan
olmesartan increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- olodaterol inhaled
chlorothiazide and olodaterol inhaled both decrease serum potassium. Use Caution/Monitor.
- oteseconazole
oteseconazole will increase the level or effect of chlorothiazide by Other (see comment). Modify Therapy/Monitor Closely. Otesezonale, a BCRP inhibitor, may increase the effects and risk of toxicities of BCRP substrates. Use lowest starting dose of BCRP substrate, or consider reducing BCRP substrate dose.
- oxaprozin
oxaprozin increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- parecoxib
parecoxib increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- penbutolol
penbutolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pindolol
pindolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pirbuterol
pirbuterol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- piroxicam
piroxicam increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pivmecillinam
pivmecillinam, chlorothiazide. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- ponatinib
ponatinib increases levels of chlorothiazide by Other (see comment). Use Caution/Monitor.
- porfimer
chlorothiazide, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.
- potassium acid phosphate
potassium acid phosphate increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- potassium chloride
potassium chloride increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- potassium citrate
potassium citrate increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- probenecid
chlorothiazide will increase the level or effect of probenecid by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- propranolol
propranolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- regorafenib
regorafenib will increase the level or effect of chlorothiazide by Other (see comment). Modify Therapy/Monitor Closely. Regorafenib likely inhibits BCRP (ABCG2) transport. Coadministration with a BCRP substrate may increase systemic exposure to the substrate and related toxicity.
- sacubitril/valsartan
sacubitril/valsartan increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- safinamide
safinamide will increase the level or effect of chlorothiazide by Other (see comment). Use Caution/Monitor. Safinamide and its major metabolite may inhibit intestinal BCRP. Monitor BCRP substrates for increased pharmacologic or adverse effects.
- salicylates (non-asa)
salicylates (non-asa) increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- salmeterol
salmeterol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- salsalate
salsalate increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- shark cartilage
chlorothiazide, shark cartilage. Other (see comment). Use Caution/Monitor. Comment: May lead to hypercalcemia (theoretical).
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of chlorothiazide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of chlorothiazide by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
chlorothiazide and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.
- sofosbuvir/velpatasvir
sofosbuvir/velpatasvir will increase the level or effect of chlorothiazide by Other (see comment). Use Caution/Monitor. Velpatasvir is an inhibitor of the drug transporter BCRP. Coadministration may increase systemic exposure of drugs that are BCRP substrates.
- sotalol
sotalol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- spironolactone
spironolactone increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- stiripentol
stiripentol will increase the level or effect of chlorothiazide by Other (see comment). Modify Therapy/Monitor Closely. Stiripentol is a BCRP transport inhibitor. Consider dosage reduction for BCRP substrates if adverse effects are experienced when coadministered.
- succinylcholine
succinylcholine increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sulfasalazine
sulfasalazine increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sulindac
sulindac increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tafamidis
tafamidis will increase the level or effect of chlorothiazide by Other (see comment). Use Caution/Monitor. Tafamidis inhibits breast cancer resistant protein (BCRP) in vitro and may increase exposure of BCRP substrates following tafamidis or tafamidis meglumine administration. Dosage adjustment of these BCRP substrates may be necessary.
- tafamidis meglumine
tafamidis meglumine will increase the level or effect of chlorothiazide by Other (see comment). Use Caution/Monitor. Tafamidis inhibits breast cancer resistant protein (BCRP) in vitro and may increase exposure of BCRP substrates following tafamidis or tafamidis meglumine administration. Dosage adjustment of these BCRP substrates may be necessary.
- telmisartan
telmisartan increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- temocillin
temocillin, chlorothiazide. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- terbutaline
terbutaline and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- ticarcillin
ticarcillin, chlorothiazide. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- timolol
timolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolfenamic acid
tolfenamic acid increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolmetin
tolmetin increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolvaptan
tolvaptan increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- toremifene
chlorothiazide, toremifene. Other (see comment). Use Caution/Monitor. Comment: Thiazide diuretics decrease renal calcium excretion and may increase risk of hypercalcemia in patients taking toremifene.
- torsemide
torsemide and chlorothiazide both decrease serum potassium. Use Caution/Monitor.
- triamterene
triamterene increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- trientine
chlorothiazide decreases levels of trientine by increasing renal clearance. Use Caution/Monitor.
- umeclidinium bromide/vilanterol inhaled
umeclidinium bromide/vilanterol inhaled and chlorothiazide both decrease serum potassium. Modify Therapy/Monitor Closely. Electrocardiographic changes and/or hypokalemia associated with non?potassium-sparing diuretics may worsen with concomitant beta-agonists, particularly if recommended dose is exceeded
- valsartan
valsartan increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- vilanterol/fluticasone furoate inhaled
vilanterol/fluticasone furoate inhaled and chlorothiazide both decrease serum potassium. Modify Therapy/Monitor Closely. Beta-agonists may acutely worsen ECG changes and/or hypokalemia resulting from non-potassium-sparing diuretics
- vitamin D
chlorothiazide increases effects of vitamin D by Other (see comment). Use Caution/Monitor. Comment: Combination may increase hypercalcemic effect of vitamin D analogs. Use with caution.
- xipamide
xipamide increases effects of chlorothiazide by pharmacodynamic synergism. Use Caution/Monitor.
Minor (145)
- acarbose
chlorothiazide decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- aceclofenac
chlorothiazide will increase the level or effect of aceclofenac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- acemetacin
chlorothiazide will increase the level or effect of acemetacin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- acyclovir
chlorothiazide will increase the level or effect of acyclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- agrimony
agrimony increases effects of chlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown.
- albuterol
albuterol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- aminohippurate sodium
chlorothiazide will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ampicillin
chlorothiazide increases levels of ampicillin by decreasing renal clearance. Minor/Significance Unknown.
- arformoterol
arformoterol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- aspirin
chlorothiazide will increase the level or effect of aspirin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- aspirin rectal
chlorothiazide will increase the level or effect of aspirin rectal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- aspirin/citric acid/sodium bicarbonate
chlorothiazide will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- balsalazide
chlorothiazide will increase the level or effect of balsalazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- bendroflumethiazide
bendroflumethiazide will increase the level or effect of chlorothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- birch
birch increases effects of chlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown.
- bitter melon
bitter melon, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- brimonidine
brimonidine increases effects of chlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown.
- budesonide
budesonide, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- calcitriol topical
calcitriol topical, chlorothiazide. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Potential additive hypercalcemia.
- calcium acetate
chlorothiazide increases levels of calcium acetate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- calcium carbonate
chlorothiazide increases levels of calcium carbonate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- calcium chloride
chlorothiazide increases levels of calcium chloride by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- calcium citrate
chlorothiazide increases levels of calcium citrate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- calcium gluconate
chlorothiazide increases levels of calcium gluconate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- carbenoxolone
chlorothiazide, carbenoxolone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypokalemic effects.
- cefadroxil
cefadroxil will increase the level or effect of chlorothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefamandole
cefamandole will increase the level or effect of chlorothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefpirome
cefpirome will increase the level or effect of chlorothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefprozil
cefprozil will increase the level or effect of chlorothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- celecoxib
chlorothiazide will increase the level or effect of celecoxib by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cephalexin
cephalexin will increase the level or effect of chlorothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorpropamide
chlorothiazide will increase the level or effect of chlorpropamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
chlorothiazide decreases effects of chlorpropamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose. - chlorthalidone
chlorothiazide will increase the level or effect of chlorthalidone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- choline magnesium trisalicylate
chlorothiazide will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- colestipol
colestipol decreases levels of chlorothiazide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- corticotropin
corticotropin, chlorothiazide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.
- cortisone
cortisone, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- cosyntropin
cosyntropin, chlorothiazide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.
- cyclopenthiazide
chlorothiazide will increase the level or effect of cyclopenthiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- deflazacort
deflazacort, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- dexamethasone
dexamethasone, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- diazoxide
diazoxide, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hyperglycemia.
- diclofenac
chlorothiazide will increase the level or effect of diclofenac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- diflunisal
chlorothiazide will increase the level or effect of diflunisal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- dobutamine
dobutamine, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- dopexamine
dopexamine, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- ephedrine
ephedrine, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- epinephrine
epinephrine, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- epinephrine racemic
epinephrine racemic, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- epoprostenol
epoprostenol increases effects of chlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
- etodolac
chlorothiazide will increase the level or effect of etodolac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- fenbufen
chlorothiazide will increase the level or effect of fenbufen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- fenoprofen
chlorothiazide will increase the level or effect of fenoprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- fludrocortisone
fludrocortisone, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- flurbiprofen
chlorothiazide will increase the level or effect of flurbiprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- fo-ti
fo-ti increases effects of chlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia (theoretical).
- folic acid
chlorothiazide decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- formoterol
formoterol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- forskolin
forskolin increases effects of chlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown.
- ganciclovir
chlorothiazide will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- glimepiride
chlorothiazide decreases effects of glimepiride by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- glipizide
chlorothiazide decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- glyburide
chlorothiazide decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- goldenrod
goldenrod increases effects of chlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown.
- hydrochlorothiazide
chlorothiazide will increase the level or effect of hydrochlorothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- hydrocortisone
hydrocortisone, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- ibuprofen
chlorothiazide will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- indapamide
chlorothiazide will increase the level or effect of indapamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- indomethacin
chlorothiazide will increase the level or effect of indomethacin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- insulin aspart
chlorothiazide decreases effects of insulin aspart by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- insulin detemir
chlorothiazide decreases effects of insulin detemir by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- insulin glargine
chlorothiazide decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- insulin glulisine
chlorothiazide decreases effects of insulin glulisine by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- insulin lispro
chlorothiazide decreases effects of insulin lispro by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- insulin NPH
chlorothiazide decreases effects of insulin NPH by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- insulin regular human
chlorothiazide decreases effects of insulin regular human by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- isoproterenol
isoproterenol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- ketoprofen
chlorothiazide will increase the level or effect of ketoprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketorolac
chlorothiazide will increase the level or effect of ketorolac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketorolac intranasal
chlorothiazide will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- L-methylfolate
chlorothiazide decreases levels of L-methylfolate by increasing renal clearance. Minor/Significance Unknown.
- levalbuterol
levalbuterol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- lornoxicam
chlorothiazide will increase the level or effect of lornoxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- magnesium chloride
chlorothiazide decreases levels of magnesium chloride by increasing renal clearance. Minor/Significance Unknown.
- magnesium citrate
chlorothiazide decreases levels of magnesium citrate by increasing renal clearance. Minor/Significance Unknown.
- magnesium hydroxide
chlorothiazide decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.
- magnesium oxide
chlorothiazide decreases levels of magnesium oxide by increasing renal clearance. Minor/Significance Unknown.
- magnesium sulfate
chlorothiazide decreases levels of magnesium sulfate by increasing renal clearance. Minor/Significance Unknown.
- meclofenamate
chlorothiazide will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- mefenamic acid
chlorothiazide will increase the level or effect of mefenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- meloxicam
chlorothiazide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- mesalamine
chlorothiazide will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- metaproterenol
metaproterenol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- metformin
chlorothiazide decreases effects of metformin by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- methyclothiazide
chlorothiazide will increase the level or effect of methyclothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- methylprednisolone
methylprednisolone, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- metolazone
chlorothiazide will increase the level or effect of metolazone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- miglitol
chlorothiazide decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- minoxidil
chlorothiazide increases effects of minoxidil by pharmacodynamic synergism. Minor/Significance Unknown.
- nabumetone
chlorothiazide will increase the level or effect of nabumetone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- nafcillin
chlorothiazide increases levels of nafcillin by decreasing renal clearance. Minor/Significance Unknown.
- naproxen
chlorothiazide will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- nateglinide
chlorothiazide decreases effects of nateglinide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- noni juice
noni juice increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- norepinephrine
norepinephrine, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- octacosanol
octacosanol increases effects of chlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown.
- oxaprozin
chlorothiazide will increase the level or effect of oxaprozin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- parecoxib
chlorothiazide will increase the level or effect of parecoxib by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- penicillin G aqueous
chlorothiazide increases levels of penicillin G aqueous by decreasing renal clearance. Minor/Significance Unknown.
- penicillin VK
chlorothiazide increases levels of penicillin VK by decreasing renal clearance. Minor/Significance Unknown.
- pioglitazone
chlorothiazide decreases effects of pioglitazone by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- piperacillin
chlorothiazide increases levels of piperacillin by decreasing renal clearance. Minor/Significance Unknown.
- pirbuterol
pirbuterol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- piroxicam
chlorothiazide will increase the level or effect of piroxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- prednisolone
prednisolone, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- prednisone
prednisone, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- reishi
reishi increases effects of chlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown.
- repaglinide
chlorothiazide decreases effects of repaglinide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- rose hips
rose hips will increase the level or effect of chlorothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- rosiglitazone
chlorothiazide decreases effects of rosiglitazone by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- salicylates (non-asa)
chlorothiazide will increase the level or effect of salicylates (non-asa) by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- salmeterol
salmeterol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- salsalate
chlorothiazide will increase the level or effect of salsalate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- saxagliptin
chlorothiazide decreases effects of saxagliptin by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- shepherd's purse
shepherd's purse, chlorothiazide. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.
- sitagliptin
chlorothiazide decreases effects of sitagliptin by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- sulfadiazine
chlorothiazide increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- sulfamethoxazole
chlorothiazide increases levels of sulfamethoxazole by unspecified interaction mechanism. Minor/Significance Unknown.
chlorothiazide, sulfamethoxazole. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of hyponatremia. - sulfasalazine
chlorothiazide will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- sulfisoxazole
chlorothiazide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.
- sulindac
chlorothiazide will increase the level or effect of sulindac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- terbutaline
terbutaline, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
chlorothiazide, terbutaline. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypokalemic effects. - tizanidine
tizanidine increases effects of chlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.
- tolazamide
chlorothiazide decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- tolbutamide
chlorothiazide decreases effects of tolbutamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- tolfenamic acid
chlorothiazide will increase the level or effect of tolfenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- tolmetin
chlorothiazide will increase the level or effect of tolmetin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- treprostinil
treprostinil increases effects of chlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- trilostane
trilostane, chlorothiazide. Other (see comment). Minor/Significance Unknown. Comment: Trilostane reduces K+ loss while maintaining the natriuretic effect. Mechanism: inhibition of mineralocorticoid steroid synthesis.
- trimethoprim
chlorothiazide, trimethoprim. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of hyponatremia.
- valganciclovir
chlorothiazide will increase the level or effect of valganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- verteporfin
chlorothiazide, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- vildagliptin
chlorothiazide decreases effects of vildagliptin by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- willow bark
chlorothiazide will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Adverse Effects
<1%
Scaling eczema
Stevens-Johnson syndrome
Toxic epidermal necrolysis
Disorder of hematopoietic structure
Hepatotoxicity
Systemic lupus erythematosus
Frequency Not Defined
Hypotension
Alopecia
Photosensitivity
Phototoxicity
Rash
Urticaria
Hyperglycemia
Hyperuricemia
Constipation
Diarrhea
Loss of appetite
Nausea and vomiting
Electrolytes abnormal
Spasticity
Dizziness
Headache
Blurred vision
Xanthopsia
Impotence
Warnings
Contraindications
Hypersensitivity to chlorothiazide or sulfonamides
Anuria
Cautions
May aggravate digitalis toxicity
Sensitivity reactions may occur with or without history of allergy or asthma
Patients allergic to sulfa may show cross-sensitivity
May deleteriously alter lipid/glucose metabolism
Risk of male sexual dysfunction
Use with caution in severe renal disease. In patients with renal disease, thiazides may precipitate azotemia; cumulative effects of drug may develop in patients with impaired renal function.
Thiazides should be used with caution in patients with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma
Thiazides may add to or potentiate the action of other antihypertensive drugs
Sensitivity reactions may occur in patients with or without a history of allergy or bronchial asthma; the possibility of exacerbation or activation of systemic lupus erythematosus has been reported
Lithium generally should not be given with diuretics
Although any chloride deficit is generally mild and usually does not require specific treatment except under extraordinary circumstances (as in liver disease or renal disease), chloride replacement may be required in the treatment of metabolic alkalosis
Dilutional hyponatremia may occur in edematous patients in hot weather; appropriate therapy is water restriction, rather than administration of salt, except in rare instances when the hyponatremia is life-threatening; in actual salt depletion, appropriate replacement is therapy of choice
Hyperuricemia may occur or acute gout may be precipitated in certain patients receiving thiazides
In diabetic patients dosage adjustments of insulin or oral hypoglycemic agents may be required; hyperglycemia may occur with thiazide diuretics; latent diabetes mellitus may become manifest during thiazide therapy
The antihypertensive effects of drug may be enhanced in the post-sympathectomy patient
If progressive renal impairment becomes evident, consider withholding or discontinuing diuretic therapy;
Thiazides have been shown to increase the urinary excretion of magnesium; this may result in hypomagnesemia
Thiazides may decrease urinary calcium excretion; thiazides may cause intermittent and slight elevation of serum calcium in absence of known disorders of calcium metabolism; marked hypercalcemia may be evidence of hidden hyperparathyroidism; thiazides should be discontinued before carrying out tests for parathyroid function
Increases in cholesterol and triglyceride levels may be associated with thiazide diuretic therapy
Hypokalemia
- Hypokalemia may develop, especially with brisk diuresis, when severe cirrhosis is present or after prolonged therapy; interference with adequate oral electrolyte intake will contribute to hypokalemia
- Hypokalemia may cause cardiac arrhythmias and may also sensitize or exaggerate response of heart to toxic effects of digitalis (eg, increased ventricular irritability)
- Hypokalemia may be avoided or treated by use of potassium-sparing diuretics or potassium supplements such as foods with a high potassium content
Electrolyte imbalance
- All patients receiving diuretic therapy should be observed for evidence of fluid or electrolyte imbalance, including, hyponatremia, hypochloremic alkalosis, and hypokalemia
- Serum and urine electrolyte determinations are particularly important when patient is vomiting excessively or receiving parenteral fluids
- Warning signs or symptoms of fluid and electrolyte imbalance, irrespective of cause, include dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, confusion, seizures, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, and gastrointestinal disturbances such as nausea and vomiting
Pregnancy & Lactation
Pregnancy Category: C; D (expert analysis). Chlorothiazide may cause fetal or neonatal jaundice, thrombocytopenia, and possibly other adverse reactions which have occurred in the adult. Use of diuretics for pregnancy-induced hypertension should be avoided due to risk of decreased placental perfusion.
Lactation: enters breast milk/not recommended (AAP states "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.Pharmacology
Mechanism of Action
Thiazide diuretic that inhibits Na reabsorption in distal renal tubules resulting in increased excrertion of Na+ and water, also K+ and H+ ions
Pharmacokinetics
Half-Life: 145-120 min
Onset: initial effect: 2 hr, max effect: 4 hr
Duration: 6-12 hr
Peak Plasma Time: IV: 30 min; PO: 4 hr
Bioavailability: Very limited
Metabolism: Does not appear to be metabolized
Excretion: Urine (96%)
Dialyzable: No
Administration
IV Incompatibilities
Additive: amikacin, chlorpromazine, hydralazine, insulin regular, levorphanol, morphine sulfate, norepinephrine bitartrate, polymyxin B sulfate, procaine, prochlorperazine, promazine, promethazine, streptomycin, triflupromazine, vancomycin
Other: multivitamins
IV Compatibilities
Solution: D5W, D10W, dextrose/saline, dextrose/LR, dextrose/Ringers, Ringers, LR, NS, ½NS, Na-lactate 1/6M
Additive: Cimetidine, lidocaine, nafcillin, ranitidine
IV Administration
Administer IV by direct injection or infusion
Do not administer IM or SC
Storage
Intact vials at 2-25°C
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Diuril oral - | 250 mg/5 mL suspension |  |
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Patient Handout
chlorothiazide oral
CHLOROTHIAZIDE - ORAL
(KLOR-oh-THYE-a-zide)
COMMON BRAND NAME(S): Diuril
USES: This medication is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Chlorothiazide is a "water pill" (diuretic) that causes you to make more urine. This helps your body get rid of extra salt and water.This medication is also used to decrease swelling (edema) caused by conditions such as cancer, congestive heart failure, liver disease, and kidney disease. This effect can help your kidneys work better and lessen symptoms such as trouble breathing and swelling in your ankles, feet, hands, or belly.
HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually once or twice a day. If you take this drug too close to bedtime, you may need to wake up to urinate. It is best to take this medication at least 4 hours before your bedtime.If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Shake the bottle well before each dose.The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on age and weight.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.Cholestyramine and colestipol can decrease the absorption of chlorothiazide. If you are taking either of these drugs, take them at least 4 hours before or after taking chlorothiazide.Tell your doctor if your condition does not get better or if it gets worse (your blood pressure readings remain high or increase).
SIDE EFFECTS: Dizziness, lightheadedness, headache, blurred vision, loss of appetite, stomach upset, diarrhea, or constipation may occur as your body adjusts to the medication. You may also experience decreased sexual ability. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication can cause dehydration and electrolyte imbalance. Tell your doctor right away if you have any symptoms of dehydration or electrolyte imbalance, such as confusion, unusual dry mouth/thirst, fast/irregular heartbeat, severe dizziness/lightheadedness, or seizures.Tell your doctor right away if you have any serious side effects, such as: nausea/vomiting that doesn't stop, stomach/abdominal pain, yellowing eyes/skin, dark urine, signs of infection (such as sore throat that doesn't go away, fever, chills, cough), joint pain (such as big toe pain), numbness/tingling of the arms/legs, easy bruising/bleeding, unusual tiredness, signs of kidney problems (such as change in the amount of urine).Get medical help right away if you have any very serious side effects, such as: decrease in vision, eye pain.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, such as: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking chlorothiazide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, untreated salt/mineral imbalance (such as imbalance of sodium, potassium, calcium, magnesium), dehydration, gout, lupus, certain recent nerve surgery (sympathectomy).If you have diabetes, chlorothiazide may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.This drug may make you dizzy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Severe sweating, diarrhea, or vomiting can increase the risk for dehydration. Report prolonged diarrhea or vomiting to your doctor. To prevent dehydration, drink plenty of fluids unless your doctor directs you otherwise.This drug may decrease your potassium levels. Ask your doctor about foods high in potassium (such as bananas, orange juice) or about using a salt substitute containing potassium. A potassium supplement may be prescribed by your doctor.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery, tell your doctor or dentist about all the products you use (such as prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially dizziness.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: See also How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (such as prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: dofetilide, lithium.Some products have ingredients that could raise your blood pressure or worsen your swelling. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).This product may interfere with certain lab tests. Make sure lab personnel and all your doctors know you use this drug.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, severe weakness, fainting.
NOTES: Do not share this medication with others.Lifestyle changes that may help this medication work better include exercising, stopping smoking, and eating a low-cholesterol/low-fat diet. Consult your doctor for more details.Lab and/or medical tests (such as potassium levels, kidney function tests) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.Have your blood pressure checked regularly while taking this medication. Learn how to monitor your own blood pressure at home, and share the results with your doctor.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Do not freeze the liquid form of this medication. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised October 2021. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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