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
- edema
- heart failure
- hepatic cirrhosis
- hypertension
- 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
- agranulocytosis
- anorexia
- aplastic anemia
- azotemia
- constipation
- diarrhea
- dizziness
- exfoliative dermatitis
- glycosuria
- gout
- headache
- hemolytic anemia
- hyperbilirubinemia
- hypercalcemia
- hypercholesterolemia
- hyperglycemia
- hypertriglyceridemia
- hyperuricemia
- hypochloremia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hypotension
- hypovolemia
- impotence (erectile dysfunction)
- jaundice
- leukopenia
- libido decrease
- metabolic alkalosis
- muscle cramps
- nausea
- orthostatic hypotension
- pancreatitis
- pancytopenia
- paresthesias
- photosensitivity
- polyuria
- rash
- renal failure (unspecified)
- restlessness
- Stevens-Johnson syndrome
- syncope
- thrombocytopenia
- toxic epidermal necrolysis
- vasculitis
- vertigo
- vomiting
- weakness
- 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
- Midodrine
- Miglitol
- Milnacipran
- Milrinone
- Mirtazapine
- Mivacurium
- Moexipril
- Morphine
- Morphine; Naltrexone
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nateglinide
- Nefazodone
- 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
- Rasagiline
- Remifentanil
- Repaglinide
- Risperidone
- Rocuronium
- Rofecoxib
- Rosiglitazone
- Salicylates
- Salmeterol
- Saxagliptin
- Scopolamine
- Selegiline
- Semaglutide
- 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
- Tegaserod
- Terbutaline
- Tetrabenazine
- Tetracaine
- Thiazolidinediones
- Thiothixene
- Tiotropium; Olodaterol
- Tizanidine
- Tolazamide
- Tolbutamide
- Tolmetin
- Tolterodine
- Tolvaptan
- Toremifene
- Tramadol
- Trandolapril
- Trandolapril; Verapamil
- Tranylcypromine
- Trazodone
- Treprostinil
- Tretinoin, ATRA
- Trihexyphenidyl
- Trospium
- Tubocurarine
- Umeclidinium; Vilanterol
- Valdecoxib
- Vecuronium
- Venlafaxine
- Verteporfin
- Vilazodone
- Vitamin D
- Vitamin D analogs
- Vorinostat
- Vortioxetine
- Warfarin
- Yohimbine
- Ziconotide
- Ziprasidone
