Chlorthalidone

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
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• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
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• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
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