Chlorthalidone

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Chlorthalidone Brand Name– Thalitone

What is Chlorthalidone

Chlorthalidone is a thiazide-like diuretic used in the management of hypertension and edema. Its structure and pharmacological activity are similar to the thiazides.

Compared to other thiazides, chlorthalidone has the longest duration of action, but the diuretic effect is basically equal among the thiazides at maximal therapeutic doses. Unlike loop diuretics, chlorthalidone efficacy is diminished in patients with renal insufficiency.

A recent landmark clinical trial (ALLHAT) compared chlorthalidone to doxazosin in the treatment of high-risk hypertensive patients. In this study, only chlorthalidone significantly reduced the risk of combined cardiovascular disease events, especially heart failure; whereas doxazosin did not.

These results led to discontinuation of the doxazosin treatment arm of the study.

Chlorthalidone was approved by the FDA in 1960.

Indications

  1. edema
  2. heart failure
  3. hepatic cirrhosis
  4. hypertension
  5. nephrotic syndrome

For use as adjunctive therapy in edema associated with heart failure, hepatic cirrhosis, nephrotic syndrome, acute glomerulonephritis, chronic renal failure, and corticosteroid and estrogen therapy

Side Effects

  1. agranulocytosis
  2. anorexia
  3. aplastic anemia
  4. azotemia
  5. constipation
  6. diarrhea
  7. dizziness
  8. exfoliative dermatitis
  9. glycosuria
  10. gout
  11. headache
  12. hemolytic anemia
  13. hyperbilirubinemia
  14. hypercalcemia
  15. hypercholesterolemia
  16. hyperglycemia
  17. hypertriglyceridemia
  18. hyperuricemia
  19. hypochloremia
  20. hypokalemia
  21. hypomagnesemia
  22. hyponatremia
  23. hypotension
  24. hypovolemia
  25. impotence (erectile dysfunction)
  26. jaundice
  27. leukopenia
  28. libido decrease
  29. metabolic alkalosis
  30. muscle cramps
  31. nausea
  32. orthostatic hypotension
  33. pancreatitis
  34. pancytopenia
  35. paresthesias
  36. photosensitivity
  37. polyuria
  38. rash
  39. renal failure (unspecified)
  40. restlessness
  41. Stevens-Johnson syndrome
  42. syncope
  43. thrombocytopenia
  44. toxic epidermal necrolysis
  45. vasculitis
  46. vertigo
  47. vomiting
  48. weakness
  49. xanthopsia

Monitoring Parameters

  • blood glucose
  • blood pressure
  • heart rate
  • serum calcium
  • serum creatinine/BUN
  • serum electrolytes
  • serum magnesium
  • serum uric acid

Contraindications

  • anuria
  • breast-feeding
  • diabetes mellitus
  • electrolyte imbalance
  • geriatric
  • gout
  • hepatic disease
  • hypercalcemia
  • hyperglycemia
  • hyperuricemia
  • hypochloremia
  • hypokalemia
  • hypomagnesemia
  • hyponatremia
  • hypotension
  • hypovolemia
  • metabolic alkalosis
  • neonates
  • orthostatic hypotension
  • pancreatitis
  • preeclampsia
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • sulfonamide hypersensitivity
  • sunlight (UV) exposure
  • sympathectomy
  • syncope
  • systemic lupus erythematosus (SLE)
  • thiazide diuretic hypersensitivity

Interactions

  • Acarbose
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Acetazolamide
  • Acetohexamide
  • Aclidinium; Formoterol
  • Acrivastine; Pseudoephedrine
  • Albiglutide
  • Albuterol
  • Albuterol; Ipratropium
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Alendronate; Cholecalciferol
  • Alfentanil
  • Allopurinol
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alpha-glucosidase Inhibitors
  • Alprostadil
  • Amifostine
  • Aminolevulinic Acid
  • Amiodarone
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphetamine; Dextroamphetamine Salts
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Amyl Nitrite
  • Angiotensin-converting enzyme inhibitors
  • Anticholinergics
  • Apomorphine
  • Apraclonidine
  • Arformoterol
  • Aripiprazole
  • Arsenic Trioxide
  • Articaine; Epinephrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Atracurium
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Baclofen
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Benzhydrocodone; Acetaminophen
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzphetamine
  • Benztropine
  • Beta-agonists
  • Bortezomib
  • Bosentan
  • Brexpiprazole
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Budesonide; Formoterol
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Cabergoline
  • Calcium
  • Calcium Phosphate, Supersaturated
  • Calcium; Vitamin D
  • Canagliflozin
  • Canagliflozin; Metformin
  • Captopril
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cardiac glycosides
  • Cariprazine
  • Celecoxib
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chlordiazepoxide; Clidinium
  • Chloroprocaine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpropamide
  • Cholestyramine
  • Cidofovir
  • Cisapride
  • Cisatracurium
  • Citalopram
  • Clindamycin; Tretinoin
  • Clozapine
  • Co-Enzyme Q10, Ubiquinone
  • Cocaine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colchicine; Probenecid
  • Colestipol
  • Conivaptan
  • Corticosteroids
  • Cosyntropin
  • Cyclophosphamide
  • Dapagliflozin
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Desloratadine; Pseudoephedrine
  • Desvenlafaxine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexlansoprazole
  • Dexmethylphenidate
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Quinidine
  • Diazoxide
  • Dichlorphenamide
  • Diclofenac
  • Diclofenac; Misoprostol
  • Dicyclomine
  • Diethylpropion
  • Diflunisal
  • Digitoxin
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Dobutamine
  • Dofetilide
  • Dolasetron
  • Dopamine
  • Doxacurium
  • Droperidol
  • Dulaglutide
  • Duloxetine
  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Enflurane
  • Ephedrine
  • Epinephrine
  • Ergocalciferol, Vitamin D2
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Escitalopram
  • Esomeprazole
  • Esomeprazole; Naproxen
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Ethanol
  • Etodolac
  • Etomidate
  • Exenatide
  • Famotidine; Ibuprofen
  • Fenoprofen
  • Fentanyl
  • Fexofenadine; Pseudoephedrine
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Flavoxate
  • Fluocinolone; Hydroquinone; Tretinoin
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Flurbiprofen
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Fluvoxamine
  • Formoterol
  • Formoterol; Mometasone
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fospropofol
  • Gallium Ga 68 Dotatate
  • General anesthetics
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Granisetron
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Halobetasol; Tazarotene
  • Halofantrine
  • Haloperidol
  • Halothane
  • Homatropine; Hydrocodone
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hyoscyamine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen
  • Ibuprofen lysine
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Icosapent ethyl
  • Iloperidone
  • Inamrinone
  • Incretin Mimetics
  • Indacaterol
  • Indacaterol; Glycopyrrolate
  • Indomethacin
  • Inotersen
  • Insulin Degludec; Liraglutide
  • Insulin Glargine; Lixisenatide
  • Insulins
  • Intravenous Lipid Emulsions
  • Isocarboxazid
  • Isoflurane
  • Isoproterenol
  • Isosorbide Dinitrate, ISDN
  • Isosorbide Mononitrate
  • Ketamine
  • Ketoprofen
  • Ketorolac
  • Lansoprazole
  • Lansoprazole; Naproxen
  • Lesinurad; Allopurinol
  • Levalbuterol
  • Levodopa
  • Levomethadyl
  • Levomilnacipran
  • Levorphanol
  • Linagliptin
  • Linagliptin; Metformin
  • Liraglutide
  • Lisdexamfetamine
  • Lisinopril
  • Lithium
  • Lixisenatide
  • Loop diuretics
  • Loratadine; Pseudoephedrine
  • Lovastatin; Niacin
  • Lurasidone
  • Magnesium Salts
  • Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
  • Mannitol
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meglitinides
  • Meloxicam
  • Mepenzolate
  • Meperidine
  • Meperidine; Promethazine
  • Mequinol; Tretinoin
  • Mestranol; Norethindrone
  • Metaproterenol
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methadone
  • Methamphetamine
  • Methazolamide
  • Methenamine
  • Methenamine; Sodium Acid Phosphate
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methotrexate
  • Methoxsalen
  • Methscopolamine
  • Methylphenidate
  • Metoclopramide
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  • Milrinone
  • Mirtazapine
  • Mivacurium
  • Moexipril
  • Morphine
  • Morphine; Naltrexone
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nateglinide
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  • Nesiritide, BNP
  • Neuromuscular blockers
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Nitrates
  • Nitroglycerin
  • Nitroprusside
  • Nonsteroidal antiinflammatory drugs
  • Norepinephrine
  • Octreotide
  • Olanzapine
  • Olodaterol
  • Omeprazole
  • Omeprazole; Amoxicillin; Rifabutin
  • Omeprazole; Sodium Bicarbonate
  • Ondansetron
  • Oprelvekin, rh-IL-11
  • Oxaprozin
  • Oxybutynin
  • Oxycodone
  • Oxymetazoline
  • Oxymorphone
  • Paliperidone
  • Pancuronium
  • Pantoprazole
  • Paroxetine
  • Pasireotide
  • Pentamidine
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentoxifylline
  • Perindopril
  • Perindopril; Amlodipine
  • Phendimetrazine
  • Phenelzine
  • Phenothiazines
  • Phentermine
  • Phentermine; Topiramate
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Photosensitizing agents (topical)
  • Pimozide
  • Pioglitazone
  • Pirbuterol
  • Piroxicam
  • Polycarbophil
  • Polyethylene Glycol; Electrolytes
  • Polyethylene Glycol; Electrolytes; Ascorbic Acid
  • Porfimer
  • Pramlintide
  • Prazosin
  • Prilocaine; Epinephrine
  • Probenecid
  • Procainamide
  • Procaine
  • Propantheline
  • Propofol
  • Pseudoephedrine
  • Quetiapine
  • Quinapril
  • Quinidine
  • Rabeprazole
  • Ramipril
  • Rapacuronium
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  • Remifentanil
  • Repaglinide
  • Risperidone
  • Rocuronium
  • Rofecoxib
  • Rosiglitazone
  • Salicylates
  • Salmeterol
  • Saxagliptin
  • Scopolamine
  • Selegiline
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  • Serotonin norepinephrine reuptake inhibitors
  • Sertraline
  • Sevoflurane
  • Silodosin
  • Simvastatin; Sitagliptin
  • Sitagliptin
  • Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Solifenacin
  • Streptozocin
  • Succinylcholine
  • Sufentanil
  • Sulfacetamide
  • Sulfacetamide; Sulfur
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfinpyrazone
  • Sulfonylureas
  • Sulindac
  • Tapentadol
  • Tazarotene
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  • Tetrabenazine
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  • Vilazodone
  • Vitamin D
  • Vitamin D analogs
  • Vorinostat
  • Vortioxetine
  • Warfarin
  • Yohimbine
  • Ziconotide
  • Ziprasidone

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