Dosing & Uses
Dosage Forms & Strengths
tablet
- 15mg
- 25mg
- 50mg
- 100mg
Hypertension
12.5-25 mg/day PO; may increase to 50 mg qDay after a suitable trial; not to exceed 100 mg/day; usual dose range is 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
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (8)
- aminolevulinic acid oral
aminolevulinic acid oral, chlorthalidone. 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
chlorthalidone 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.
- isocarboxazid
isocarboxazid, chlorthalidone. Other (see comment). Contraindicated. Comment: Additive hypotensive effects may be seen when MAOI's are combined with antihypertensives.
- lofexidine
lofexidine, chlorthalidone. 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
chlorthalidone, 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
chlorthalidone increases toxicity of squill by Other (see comment). Avoid or Use Alternate Drug. Comment: Potassium depletion may enhance toxicity of squill.
- tretinoin
chlorthalidone, tretinoin. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.
- tretinoin topical
chlorthalidone, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.
Monitor Closely (154)
- acebutolol
acebutolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aceclofenac
aceclofenac increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- acemetacin
acemetacin increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- albiglutide
chlorthalidone 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 chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- aldesleukin
aldesleukin increases effects of chlorthalidone by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- amifostine
amifostine, chlorthalidone. 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 chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- arformoterol
arformoterol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- aspirin
aspirin increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aspirin rectal
aspirin rectal increases and chlorthalidone 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 chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atenolol
atenolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- avanafil
avanafil increases effects of chlorthalidone by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- beclomethasone, inhaled
beclomethasone, inhaled increases toxicity of chlorthalidone by increasing elimination. Use Caution/Monitor. May increase the hypokalemic effects of thiazide diuretics.
- benazepril
benazepril, chlorthalidone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced hypotensive effects. Increased risk of nephrotoxicity. Monitor blood pressure and renal function.
- bendroflumethiazide
bendroflumethiazide and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- betaxolol
betaxolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bisoprolol
bisoprolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bretylium
chlorthalidone, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.
- bumetanide
bumetanide and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection decreases effects of chlorthalidone by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Opioids can reduce diuretic efficacy by inducing antidiuretic hormone release.
- calcifediol
chlorthalidone 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 chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- captopril
captopril, chlorthalidone. 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
chlorthalidone and carbenoxolone both decrease serum potassium. Use Caution/Monitor.
- carbidopa
carbidopa increases effects of chlorthalidone 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 chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- celecoxib
celecoxib increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- celiprolol
celiprolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
chlorthalidone decreases levels of celiprolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. - chlorothiazide
chlorothiazide and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- cholestyramine
cholestyramine decreases levels of chlorthalidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- choline magnesium trisalicylate
choline magnesium trisalicylate increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- cornsilk
cornsilk increases effects of chlorthalidone by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypokalemia (theoretical interaction).
- cyclopenthiazide
chlorthalidone and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.
- deflazacort
chlorthalidone and deflazacort both decrease serum potassium. Use Caution/Monitor.
- dichlorphenamide
dichlorphenamide and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- diclofenac
diclofenac increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diflunisal
diflunisal increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- digoxin
digoxin increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
chlorthalidone increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Hypokalemia increases digoxin effects. - dobutamine
dobutamine and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- dopexamine
dopexamine and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- drospirenone
drospirenone increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- empagliflozin
empagliflozin, chlorthalidone. 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.
- ephedrine
ephedrine and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- epinephrine
epinephrine and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- epinephrine racemic
epinephrine racemic and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- eprosartan
eprosartan increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- esmolol
esmolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ethacrynic acid
ethacrynic acid and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- etodolac
etodolac increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- exenatide injectable solution
chlorthalidone 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
chlorthalidone 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 chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fentanyl
fentanyl decreases effects of chlorthalidone 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 chlorthalidone 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 chlorthalidone 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 chlorthalidone 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 chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- formoterol
formoterol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- furosemide
furosemide and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- gentamicin
chlorthalidone and gentamicin both decrease serum potassium. Use Caution/Monitor.
- hydrochlorothiazide
chlorthalidone and hydrochlorothiazide both decrease serum potassium. Use Caution/Monitor.
- ibuprofen
ibuprofen increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ibuprofen IV
ibuprofen IV increases and chlorthalidone 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.
chlorthalidone will increase the level or effect of ibuprofen IV by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor. - indacaterol, inhaled
chlorthalidone, indacaterol, inhaled. serum potassium. Use Caution/Monitor. Combination may increase risk of hypokalemia.
indacaterol, inhaled, chlorthalidone. Other (see comment). Use Caution/Monitor. Comment: Caution is advised in the coadministration of indacaterol neohaler with non-potassium-sparing diuretics. - indapamide
chlorthalidone and indapamide both decrease serum potassium. Use Caution/Monitor.
- indomethacin
indomethacin increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- insulin degludec
chlorthalidone 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
chlorthalidone 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
chlorthalidone 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 chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- isoproterenol
isoproterenol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- juniper
juniper, chlorthalidone. 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 chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketorolac
ketorolac increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketorolac intranasal
ketorolac intranasal increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- labetalol
labetalol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levalbuterol
levalbuterol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- levodopa
levodopa increases effects of chlorthalidone by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.
- lily of the valley
chlorthalidone 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
chlorthalidone 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
chlorthalidone increases toxicity of lithium by decreasing elimination. Use Caution/Monitor.
- lornoxicam
lornoxicam increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- losartan
losartan increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lurasidone
lurasidone increases effects of chlorthalidone 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 chlorthalidone by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypokalemia (theoretical interaction).
- maraviroc
maraviroc, chlorthalidone. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.
- meclofenamate
meclofenamate increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mefenamic acid
mefenamic acid increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meloxicam
meloxicam increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaproterenol
metaproterenol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- methoxsalen
methoxsalen, chlorthalidone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive photosensitizing effects.
- methyclothiazide
chlorthalidone and methyclothiazide both decrease serum potassium. Use Caution/Monitor.
- methylphenidate transdermal
methylphenidate transdermal decreases effects of chlorthalidone by anti-hypertensive channel blocking. Use Caution/Monitor.
- metolazone
chlorthalidone and metolazone both decrease serum potassium. Use Caution/Monitor.
- metoprolol
metoprolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mometasone inhaled
mometasone inhaled increases toxicity of chlorthalidone by Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may increase hypokalemic effect of loop diuretics.
- mycophenolate
chlorthalidone will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- nabumetone
nabumetone increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nadolol
nadolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- naproxen
naproxen increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nebivolol
nebivolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nitazoxanide
nitazoxanide, chlorthalidone. Either increases levels of the other by Mechanism: plasma protein binding competition. Use Caution/Monitor.
- nitroglycerin rectal
nitroglycerin rectal, chlorthalidone. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Observe for possible additive hypotensive effects during concomitant use. .
- norepinephrine
norepinephrine and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- oliceridine
oliceridine decreases effects of chlorthalidone 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 chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- olodaterol inhaled
chlorthalidone and olodaterol inhaled both decrease serum potassium. Use Caution/Monitor.
- ospemifene
chlorthalidone, ospemifene. Either increases levels of the other by plasma protein binding competition. Modify Therapy/Monitor Closely.
- oxaprozin
oxaprozin increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- parecoxib
parecoxib increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- penbutolol
penbutolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pindolol
pindolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pirbuterol
pirbuterol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- piroxicam
piroxicam increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pivmecillinam
pivmecillinam, chlorthalidone. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- porfimer
chlorthalidone, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.
- potassium acid phosphate
potassium acid phosphate increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- potassium chloride
potassium chloride increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- potassium citrate
potassium citrate increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- probenecid
chlorthalidone will increase the level or effect of probenecid by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- propranolol
propranolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sacubitril/valsartan
sacubitril/valsartan increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- salicylates (non-asa)
salicylates (non-asa) increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- salmeterol
salmeterol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- salsalate
salsalate increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- shark cartilage
chlorthalidone, 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 chlorthalidone 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 chlorthalidone 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
chlorthalidone and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.
- sotalol
sotalol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- spironolactone
spironolactone increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- succinylcholine
succinylcholine increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sulfasalazine
sulfasalazine increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sulindac
sulindac increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tadalafil
tadalafil increases effects of chlorthalidone by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- telmisartan
telmisartan increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- temocillin
temocillin, chlorthalidone. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- terbutaline
terbutaline and chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- ticarcillin
ticarcillin, chlorthalidone. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- timolol
timolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolfenamic acid
tolfenamic acid increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolmetin
tolmetin increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolvaptan
tolvaptan increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- toremifene
chlorthalidone, 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 chlorthalidone both decrease serum potassium. Use Caution/Monitor.
- triamterene
triamterene increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- trientine
chlorthalidone decreases levels of trientine by increasing renal clearance. Use Caution/Monitor.
- umeclidinium bromide/vilanterol inhaled
umeclidinium bromide/vilanterol inhaled and chlorthalidone 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 chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- vilanterol/fluticasone furoate inhaled
vilanterol/fluticasone furoate inhaled and chlorthalidone 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
chlorthalidone 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 chlorthalidone by pharmacodynamic synergism. Use Caution/Monitor.
Minor (139)
- acarbose
chlorthalidone decreases effects of acarbose by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- aceclofenac
chlorthalidone will increase the level or effect of aceclofenac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- acemetacin
chlorthalidone will increase the level or effect of acemetacin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- acyclovir
chlorthalidone 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 chlorthalidone by pharmacodynamic synergism. Minor/Significance Unknown.
- albuterol
albuterol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- aminohippurate sodium
chlorthalidone will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- arformoterol
arformoterol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- aspirin
chlorthalidone will increase the level or effect of aspirin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- aspirin rectal
chlorthalidone 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
chlorthalidone 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
chlorthalidone 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 chlorthalidone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- birch
birch increases effects of chlorthalidone by pharmacodynamic synergism. Minor/Significance Unknown.
- bitter melon
bitter melon, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- brimonidine
brimonidine increases effects of chlorthalidone by pharmacodynamic synergism. Minor/Significance Unknown.
- budesonide
budesonide, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- calcitriol topical
calcitriol topical, chlorthalidone. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Potential additive hypercalcemia.
- calcium acetate
chlorthalidone increases levels of calcium acetate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- calcium carbonate
chlorthalidone increases levels of calcium carbonate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- calcium chloride
chlorthalidone increases levels of calcium chloride by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- calcium citrate
chlorthalidone increases levels of calcium citrate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- calcium gluconate
chlorthalidone increases levels of calcium gluconate by decreasing renal clearance. Minor/Significance Unknown. Risk of alkalosis, hypercalcemia.
- carbenoxolone
chlorthalidone, carbenoxolone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypokalemic effects.
- cefadroxil
cefadroxil will increase the level or effect of chlorthalidone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefamandole
cefamandole will increase the level or effect of chlorthalidone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefpirome
cefpirome will increase the level or effect of chlorthalidone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- celecoxib
chlorthalidone 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 chlorthalidone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorothiazide
chlorothiazide will increase the level or effect of chlorthalidone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorpropamide
chlorthalidone will increase the level or effect of chlorpropamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
chlorthalidone decreases effects of chlorpropamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose. - choline magnesium trisalicylate
chlorthalidone 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 chlorthalidone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- corticotropin
corticotropin, chlorthalidone. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.
- cortisone
cortisone, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- cosyntropin
cosyntropin, chlorthalidone. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.
- cyclopenthiazide
chlorthalidone will increase the level or effect of cyclopenthiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- deflazacort
deflazacort, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- dexamethasone
dexamethasone, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- diazoxide
diazoxide, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hyperglycemia.
- diclofenac
chlorthalidone will increase the level or effect of diclofenac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- diflunisal
chlorthalidone will increase the level or effect of diflunisal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- dobutamine
dobutamine, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- dopexamine
dopexamine, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- ephedrine
ephedrine, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- epinephrine
epinephrine, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- epinephrine racemic
epinephrine racemic, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- epoprostenol
epoprostenol increases effects of chlorthalidone by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
- etodolac
chlorthalidone will increase the level or effect of etodolac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- fenbufen
chlorthalidone will increase the level or effect of fenbufen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- fenoprofen
chlorthalidone will increase the level or effect of fenoprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- fludrocortisone
fludrocortisone, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- flurbiprofen
chlorthalidone 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 chlorthalidone by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia (theoretical).
- folic acid
chlorthalidone decreases levels of folic acid by increasing renal clearance. Minor/Significance Unknown.
- formoterol
formoterol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- forskolin
forskolin increases effects of chlorthalidone by pharmacodynamic synergism. Minor/Significance Unknown.
- ganciclovir
chlorthalidone will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- glimepiride
chlorthalidone decreases effects of glimepiride by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- glipizide
chlorthalidone decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- glyburide
chlorthalidone decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- goldenrod
goldenrod increases effects of chlorthalidone by pharmacodynamic synergism. Minor/Significance Unknown.
- hydrochlorothiazide
chlorthalidone will increase the level or effect of hydrochlorothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- hydrocortisone
hydrocortisone, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- ibuprofen
chlorthalidone will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- indapamide
chlorthalidone will increase the level or effect of indapamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- indomethacin
chlorthalidone will increase the level or effect of indomethacin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- insulin aspart
chlorthalidone decreases effects of insulin aspart by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- insulin detemir
chlorthalidone decreases effects of insulin detemir by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- insulin glargine
chlorthalidone decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- insulin glulisine
chlorthalidone decreases effects of insulin glulisine by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- insulin lispro
chlorthalidone decreases effects of insulin lispro by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- insulin NPH
chlorthalidone decreases effects of insulin NPH by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- insulin regular human
chlorthalidone decreases effects of insulin regular human by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- isoproterenol
isoproterenol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- ketoprofen
chlorthalidone will increase the level or effect of ketoprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketorolac
chlorthalidone will increase the level or effect of ketorolac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketorolac intranasal
chlorthalidone will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- L-methylfolate
chlorthalidone decreases levels of L-methylfolate by increasing renal clearance. Minor/Significance Unknown.
- levalbuterol
levalbuterol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- lornoxicam
chlorthalidone will increase the level or effect of lornoxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- magnesium chloride
chlorthalidone decreases levels of magnesium chloride by increasing renal clearance. Minor/Significance Unknown.
- magnesium citrate
chlorthalidone decreases levels of magnesium citrate by increasing renal clearance. Minor/Significance Unknown.
- magnesium hydroxide
chlorthalidone decreases levels of magnesium hydroxide by increasing renal clearance. Minor/Significance Unknown.
- magnesium oxide
chlorthalidone decreases levels of magnesium oxide by increasing renal clearance. Minor/Significance Unknown.
- magnesium sulfate
chlorthalidone decreases levels of magnesium sulfate by increasing renal clearance. Minor/Significance Unknown.
- meclofenamate
chlorthalidone will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- mefenamic acid
chlorthalidone will increase the level or effect of mefenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- meloxicam
chlorthalidone will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- mesalamine
chlorthalidone will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- metaproterenol
metaproterenol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- metformin
chlorthalidone decreases effects of metformin by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- methyclothiazide
chlorthalidone will increase the level or effect of methyclothiazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- methylprednisolone
methylprednisolone, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- metolazone
chlorthalidone will increase the level or effect of metolazone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- miglitol
chlorthalidone decreases effects of miglitol by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- minoxidil
chlorthalidone increases effects of minoxidil by pharmacodynamic synergism. Minor/Significance Unknown.
- nabumetone
chlorthalidone will increase the level or effect of nabumetone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- naproxen
chlorthalidone will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- nateglinide
chlorthalidone 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 chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- norepinephrine
norepinephrine, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- octacosanol
octacosanol increases effects of chlorthalidone by pharmacodynamic synergism. Minor/Significance Unknown.
- oxaprozin
chlorthalidone will increase the level or effect of oxaprozin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- parecoxib
chlorthalidone will increase the level or effect of parecoxib by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- pioglitazone
chlorthalidone decreases effects of pioglitazone by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- pirbuterol
pirbuterol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- piroxicam
chlorthalidone will increase the level or effect of piroxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- prednisolone
prednisolone, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- prednisone
prednisone, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- reishi
reishi increases effects of chlorthalidone by pharmacodynamic synergism. Minor/Significance Unknown.
- repaglinide
chlorthalidone 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 chlorthalidone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- rosiglitazone
chlorthalidone decreases effects of rosiglitazone by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- salicylates (non-asa)
chlorthalidone will increase the level or effect of salicylates (non-asa) by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- salmeterol
salmeterol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
- salsalate
chlorthalidone will increase the level or effect of salsalate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- saxagliptin
chlorthalidone 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, chlorthalidone. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.
- sitagliptin
chlorthalidone decreases effects of sitagliptin by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- sulfadiazine
chlorthalidone increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- sulfamethoxazole
chlorthalidone increases levels of sulfamethoxazole by unspecified interaction mechanism. Minor/Significance Unknown.
chlorthalidone, sulfamethoxazole. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of hyponatremia. - sulfasalazine
chlorthalidone will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- sulfisoxazole
chlorthalidone increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.
- sulindac
chlorthalidone will increase the level or effect of sulindac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- terbutaline
terbutaline, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.
chlorthalidone, terbutaline. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypokalemic effects. - tizanidine
tizanidine increases effects of chlorthalidone by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.
- tolazamide
chlorthalidone decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- tolbutamide
chlorthalidone decreases effects of tolbutamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- tolfenamic acid
chlorthalidone will increase the level or effect of tolfenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- tolmetin
chlorthalidone 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 chlorthalidone by pharmacodynamic synergism. Minor/Significance Unknown.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypokalemia, especially with strong glucocorticoid activity.
- trilostane
trilostane, chlorthalidone. Other (see comment). Minor/Significance Unknown. Comment: Trilostane reduces K+ loss while maintaining the natriuretic effect. Mechanism: inhibition of mineralocorticoid steroid synthesis.
- trimethoprim
chlorthalidone, trimethoprim. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of hyponatremia.
- valganciclovir
chlorthalidone will increase the level or effect of valganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- verteporfin
chlorthalidone, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- vildagliptin
chlorthalidone decreases effects of vildagliptin by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- willow bark
chlorthalidone will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
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)
Warnings
Contraindications
Documented hypersensitivity to chlorthalidone or sulfonamides
Anuria
Cautions
Therapy may alter glucose tolerance; raise serum levels of cholesterol and triglycerides, raise the serum uric acid level due to reduced clearance of uric acid and may cause or exacerbate hyperuricemia and precipitate gout in susceptible patients; drug decreases urinary calcium excretion and may cause elevations of serum calcium; monitor calcium levels in patients with hypercalcemia receiving therapy
Use with caution in diabetes mellitus, fluid or electrolyte imbalance, hypercholesterolemia, hypotension, systemic lupus erythematosus, liver disease, severe renal disease, advanced age, history of allergy or bronchial asthma
Use with caution in patients with hyperuricemia or gout; gout can be precipiated in patients with history of gout, familial predisposition to gout or chronic renal failure; risk can be increased with doses ≥25 mg (in hydrochlorothiazide equivalents)
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; however, recent reports have suggested that cross reactivity between antibiotic sulfonamides and nonantibiotic sulfonamides may not occur or at very least, potential if extremely low
Risk of male sexual dysfunction
Photosensitization may occur
Electrolyte disturbances (eg, hypokalemia, hyponatremia, hypochloremic alkalosis) may occur; electrolyte distrubances can be minimized when used in combination with electrolyte sparing antihypertensives (eg, ACE inhibitors or angiotensin receptor blockers); correct hypokalemia before initiating therapy; use with caution
Avoid use of diuretics in the treatment of elevated blood pressure in patients with primary adrenal insufficiency; adjustment of glucocorticoid/ mineralocorticoid therapy and/or use of other antihypertensive agents should be considered to treat hypertension
Prolonged use of thiazide diuretics reported to reduce calcium excretion; pathologic changes in parathyroid glands with hypercalcemia and hypophosphatemia reported with prolonged therapy
Therapy may cause exacerbation or activation of systemic lupus erythematosus
Pregnancy & Lactation
Pregnancy
Available data over decades from observational studies and reports with chlorthalidone use in pregnant women have not identified a drug-associated risk of major birth defects or miscarriage; however, adverse fetal outcomes, including fetal or neonatal jaundice, thrombocytopenia, hypoglycemia, and electrolyte abnormalities reported following maternal use of thiazide diuretics
Drug not for use as first-line therapy to treat hypertension in pregnancy; advise pregnant women of potential risk to fetus
Hypertension in pregnancy increases maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (eg, need for cesarean section, and post-partum hemorrhage); hypertension increases fetal risk for intrauterine growth restriction and stillbirth
Thiazides can cross placenta, and concentrations reached in umbilical vein approach those in maternal plasma; thiazides, like other diuretics, can cause placental hypoperfusion
Use of thiazides during pregnancy associated with risk of fetal or neonatal jaundice, thrombocytopenia, hypoglycemia, and electrolyte abnormalities; thiazides do not prevent or alter course of EPH (Edema, Proteinuria, Hypertension) gestosis (pre-eclampsia) and should not be used as first-line therapy to treat hypertension in pregnant women
Lactation
Drug is present in human milk; there is no information regarding effects of on breastfed infant or on milk production; because of potential for drug accumulation which may lead to serious adverse reactions in breastfed infant (such as jaundice, thrombocytopenia, hyperglycemia, electrolyte abnormalities), advise patients that breastfeeding is not recommended during therapy
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
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
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| chlorthalidone oral - | 25 mg tablet |  | |
| chlorthalidone oral - | 25 mg tablet |  | |
| chlorthalidone oral - | 25 mg tablet |  | |
| chlorthalidone oral - | 50 mg tablet |  | |
| chlorthalidone oral - | 50 mg tablet |  | |
| chlorthalidone oral - | 25 mg tablet |  | |
| chlorthalidone oral - | 50 mg tablet |  | |
| chlorthalidone oral - | 25 mg tablet |  | |
| chlorthalidone oral - | 25 mg tablet |  | |
| chlorthalidone oral - | 50 mg tablet |  | |
| chlorthalidone oral - | 25 mg tablet |  | |
| chlorthalidone oral - | 25 mg tablet |  | |
| chlorthalidone oral - | 50 mg tablet |  | |
| chlorthalidone oral - | 25 mg tablet |  | |
| chlorthalidone oral - | 25 mg tablet |  | |
| chlorthalidone oral - | 50 mg tablet |  | |
| chlorthalidone oral - | 25 mg tablet |  | |
| chlorthalidone oral - | 50 mg tablet |  | |
| chlorthalidone oral - | 25 mg tablet |  | |
| chlorthalidone oral - | 50 mg tablet |  | |
| chlorthalidone oral - | 50 mg tablet |  | |
| chlorthalidone oral - | 50 mg tablet |  | |
| chlorthalidone oral - | 25 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
chlorthalidone oral
CHLORTHALIDONE - ORAL
(klor-THAL-i-done)
COMMON BRAND NAME(S): Thalitone
USES: Chlorthalidone is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It is also used to reduce extra salt and water in the body caused by conditions such as heart failure, liver disease, and kidney disease. Decreasing extra salt and water in the body helps to decrease swelling (edema) and breathing problems caused by fluid in the lungs. Chlorthalidone is a "water pill" (diuretic). It increases the amount of urine you make, especially when you first start the medication. It also helps to relax the blood vessels so that blood can flow more easily.
HOW TO USE: Take this medication by mouth with food as directed by your doctor, usually once daily in the morning. It is best to avoid taking this medication within 4 hours of your bedtime to avoid having to get up to urinate. Consult your doctor or pharmacist if you have questions about your dosing schedule.The dosage is based on your medical condition and response to treatment.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.If you also take certain drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take this product at least 2 hours before or at least 4 hours after these medications.Tell your doctor if your condition does not improve or if it worsens (such as your blood pressure readings remain high or increase).
SIDE EFFECTS: Dizziness, lightheadedness, or stomach upset may occur. 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 may cause dehydration and electrolyte imbalance. Tell your doctor right away if you have any symptoms of dehydration or electrolyte imbalance, including: extreme thirst, very dry mouth, muscle cramps, weakness, fast/irregular heartbeat, confusion.Tell your doctor right away if you have any serious side effects, including: fainting, toe/joint pain, 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, including: 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, including: 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 chlorthalidone, 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, gout, lupus, untreated mineral imbalance (such as low potassium).This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Too much sweating, diarrhea, or vomiting may cause dehydration and increase your risk of dizziness or lightheadedness. Report prolonged diarrhea or vomiting to your doctor. Be sure to drink enough fluids to prevent dehydration unless your doctor directs you otherwise.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).If you have diabetes, this product 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 medication may reduce the potassium levels in your blood. Ask your doctor about adding potassium to your diet. 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.Older adults may be more sensitive to the side effects of this product, especially dizziness.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication 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 (including 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 include: dofetilide, lithium.Some products have ingredients that could raise your blood pressure or worsen your heart failure. 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 laboratory tests (including parathyroid test, protein-bound iodide test), possibly causing false test results. Make sure laboratory 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, fainting.
NOTES: Do not share this medication with others.Lifestyle changes that may help this medication work better include stress reduction programs, exercise, and dietary changes. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.Lab and/or medical tests (including kidney function, blood mineral levels such as potassium) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.Check your blood pressure 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. 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 December 2022. 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
Adding plans allows you to compare formulary status to other drugs in the same class.
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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.
