Chlorthalidone: Difference between revisions

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<small>'''''Synonyms / Brand Names:''''' </small>
{{DrugProjectFormSinglePage
|authorTag=


{{CMG}}
{{drugbox
| IUPAC_name = 2-chloro-5-(1-hydroxy-3-oxo-2,3-dihydro-1''H''-isoindol-1-yl)benzene-1-sulfonamide
| image = Chlortalidone.svg
| CAS_number = 77-36-1
|  CASNo_Ref = {{cascite}}
| ChemSpiderID = 2631
| ATC_prefix = C03
| ATC_suffix = BA04
| PubChem = 2732
| DrugBank = APRD00127
| C = 14 |H = 11 |Cl = 1 |N = 2 |O = 4 |S = 1
| molecular_weight = 338.766 [[Gram|g]]/[[Mole (unit)|mol]]
| bioavailability =
| protein_bound = 75%
| metabolism =
| elimination_half-life = 40 hours
| excretion = [[Kidney|Renal]]
| pregnancy_category = C <small>([[Australia|Au]])</small>, B <small>([[United States|U.S.]])</small>
| legal_status = [[Prescription drug|POM]] <small>([[United Kingdom|UK]])</small>
| routes_of_administration = Oral
}}


==Overview==
<!--Overview-->
'''Chlorthalidone''' (spelled chlortalidone in the UK) is a drug used to treat hypertension. It is described as a [[thiazide diuretic]] (or, rather, a [[thiazide-like diuretic]] because it acts similarly to the thiazides but does not contain the [[benzothiadiazine]] molecular structure). Compared with other medications of the thiazide class, chlorthalidone has the longest duration of action, but a similar diuretic effect at maximal therapeutic doses. It is often used in the management of hypertension and edema.
 
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Title
 
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=====Condition1=====
 
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=====Condition1=====
 
* Developed by:
 
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* Condition1
 
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======Cardiovascular======
 
 
 
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|useInRace=
There is no FDA guidance on the use of {{PAGENAME}} with respect to specific racial populations.
 
 
|useInRenalImpair=
There is no FDA guidance on the use of {{PAGENAME}} in patients with renal impairment.
 
 
|useInHepaticImpair=
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|useInReproPotential=
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|useInImmunocomp=
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Oral
 
Intravenous
 
|monitoring=
 
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===Acute Overdose===
 
====Signs and Symptoms====
 
Description
 
====Management====
 
Description
 
===Chronic Overdose===
 
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There is limited information regarding <i>Nonclinical Toxicology</i> of {{PAGENAME}} in the drug label.
 
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|clinicalStudies=
 
There is limited information regarding <i>Clinical Studies</i> of {{PAGENAME}} in the drug label.
 
=====Condition1=====
 
Description


Unlike loop diuretics, chlorthalidone efficacy is diminished in patients with certain renal diseaes (e.g. Chronic Renal Disease). A recent 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, when compared with similar drugs such as [[doxazosin]]. <ref name "ALLHAT"> {{cite journal | title=The ALLHAT Collaborative Research Group. Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). |author=ALLHAT Collaborative Research Group. |journal=JAMA |year=2000 |volume=283 |pages=1967—75 }}</ref> Chlorthalidone was approved by the FDA in 1960.
<!--How Supplied-->


==Mechanism of Action==
|howSupplied=


Chlorthalidone increases the excretion of sodium, chloride, and water into the renal lumen by inhibiting sodium ion transport across the renal tubular epithelium. Its primary site of action is in the cortical diluting segment of the ascending limb of the loop of Henle. Thiazides and related compounds also decrease the glomerular filtration rate, which further reduces the drug's efficacy in patients with renal impairment (e.g. renal insufficiency). By increasing the delivery of sodium to the distal renal tubule, chlorthalidone indirectly increases potassium excretion via the sodium-potassium exchange mechanism (i.e. apical ROMK/Na channels coupled with basolateral NKATPases). This can result in hypokalemia and hypochloremia as well as a mild metabolic alkalosis, however, the diuretic efficacy of chlorthalidone is not affected by the acid-base balance of the patient being treated.
<!--Patient Counseling Information-->


Initially, diuretics lower blood pressure by decreasing cardiac output and reducing plasma and extracellular fluid volume. Eventually, cardiac output returns to normal, and plasma and extracellular fluid volume return to slightly less than normal, but a reduction in peripheral vascular resistance is maintained, thus resulting in an overall lower blood pressure. The reduction in intravascular volume induces an elevation in plasma renin activity and aldosterone secretion, further contributing to the potassium loss associated with thiazide diuretic therapy.
|fdaPatientInfo=


==Effectiveness==
There is limited information regarding <i>Patient Counseling Information</i> of {{PAGENAME}} in the drug label.
===Hypertension===
Among the [[thiazide]] diuretics, chlorthalidone may be more effective for blood pressure control than [[hydrochlorothiazide]].<ref name="pmid22939358">{{cite journal| author=Bakris GL, Sica D, White WB, Cushman WC, Weber MA, Handley A et al.| title=Antihypertensive Efficacy of Hydrochlorothiazide vs Chlorthalidone Combined with Azilsartan Medoxomil. | journal=Am J Med | year= 2012 | volume= 125 | issue= 12 | pages= 1229.e1-1229.e10 | pmid=22939358 | doi=10.1016/j.amjmed.2012.05.023 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22939358  }} </ref>


==Other Forms==
<!--Precautions with Alcohol-->


It is also available as a combination product with the [[beta blocker]] [[atenolol]], marketed in the UK as [[Co-tenidone]] and in the US as Tenoretic.
|alcohol=
Alcohol-{{PAGENAME}} interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.


==References==
<!--Brand Names-->
{{reflist|2}}


{{Symporter inhibitors}}
|brandNames=
{{Diuretics}}
[[Category:Thiazides]]


[[de:Chlortalidon]]
<!--Look-Alike Drug Names-->
[[hr:Klortalidon]]
[[it:Clortalidone]]
[[ja:クロルタリドン]]
[[pl:Chlortalidon]]


|lookAlike=
* A® — B®<ref name="www.ismp.org">{{Cite web  | last =  | first =  | title = http://www.ismp.org | url = http://www.ismp.org | publisher =  | date =  }}</ref>


==Dosing and Administration==
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==FDA Package Insert Resources==
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[[{{PAGENAME}} indications|Indications]]
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[[{{PAGENAME}} pharmacokinetics and molecular data|Pharmacokinetics and Molecular Data]]
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[FDA label]
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[http://google2.fda.gov/search?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}&x=0&y=0&client=FDA&site=FDA&lr=&proxystylesheet=FDA&output=xml_no_dtd&getfields=* FDA on {{PAGENAME}}]
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==Publication Resources==
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[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&db=pubmed&term={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}} Most Recent Articles on {{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}]
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[[Chlortalidone|WikiDoc State of the Art Review]]
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[http://books.google.com/books?ie=UTF-8&oe=utf-8&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}&qt_s=Search&sa=N&tab=gp Textbook Information on {{PAGENAME}}]
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==Trial Resources==
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[http://clinicaltrials.gov/search/open/condition={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}} Ongoing Trials with {{PAGENAME}} at Clinical Trials.gov]
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==Guidelines & Evidence Based Medicine Resources==
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[http://www.guideline.gov/search/searchresults.aspx?Type=3&txtSearch={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}&num=20 US National Guidelines Clearinghouse on {{PAGENAME}}]
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[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=pubmed&term={{urlencode:({{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}) AND (Cochrane Database Syst Rev[ta])}} Cochrane Collaboration on {{PAGENAME}}]
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[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=pubmed&term={{urlencode:({{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}) AND (Cost effectiveness)}} Cost Effectiveness of {{PAGENAME}}]
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==Media Resources==
[http://www.google.com/search?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}+ppt&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a Powerpoint Slides on {{PAGENAME}}]
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[http://www.google.com/search?hl=en&client=firefox-a&rls=org.mozilla%3Aen-US%3Aofficial&hs=hPo&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}+podcasts+OR+MP3&btnG=Search Podcasts & MP3s on {{PAGENAME}}]
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==Patient Resources==
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[[{{PAGENAME}} (patient information)|Patient Information from National Library of Medicine]]
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[http://www.google.com/search?hl=en&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}+more:for_patients&cx=disease_for_patients&sa=N&oi=cooptsr&resnum=0&ct=col3&cd=1  Patient Resources on {{PAGENAME}}]
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==International Resources==
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[http://www.google.com/search?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|{{PAGENAME}}}}}}+en+espanol&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a {{PAGENAME}} en Español]
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[[Category:Drugs]]
[[Category:Cardiovascular Drugs]]
[[Category:Drug]]

Revision as of 01:30, 30 June 2014

Chlorthalidone
Black Box Warning
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];

Disclaimer

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Black Box Warning

Title
See full prescribing information for complete Boxed Warning.
ConditionName: Content

Overview

Chlorthalidone is a that is FDA approved for the {{{indicationType}}} of . There is a Black Box Warning for this drug as shown here. Common adverse reactions include .

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Condition1
  • Dosing Information
  • Dosage
Condition2
  • Dosing Information
  • Dosage
Condition3
  • Dosing Information
  • Dosage
Condition4
  • Dosing Information
  • Dosage

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

Condition1
  • Developed by:
  • Class of Recommendation:
  • Strength of Evidence:
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Guideline-Supported Use of Chlorthalidone in adult patients.

Non–Guideline-Supported Use

Condition1
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Non–Guideline-Supported Use of Chlorthalidone in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

Condition1
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding FDA-Labeled Use of Chlorthalidone in pediatric patients.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

Condition1
  • Developed by:
  • Class of Recommendation:
  • Strength of Evidence:
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Guideline-Supported Use of Chlorthalidone in pediatric patients.

Non–Guideline-Supported Use

Condition1
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Non–Guideline-Supported Use of Chlorthalidone in pediatric patients.

Contraindications

  • Condition1

Warnings

Title
See full prescribing information for complete Boxed Warning.
ConditionName: Content

Description

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Clinical Trial Experience of Chlorthalidone in the drug label.

Central Nervous System
Cardiovascular
Respiratory
Gastrointestinal
Hypersensitivity
Miscellaneous

Postmarketing Experience

There is limited information regarding Postmarketing Experience of Chlorthalidone in the drug label.

Central Nervous System
Cardiovascular
Respiratory
Gastrointestinal
Hypersensitivity
Miscellaneous

Drug Interactions

  • Drug
  • Description

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA):

  • Pregnancy Category


Pregnancy Category (AUS):

  • Australian Drug Evaluation Committee (ADEC) Pregnancy Category

There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Chlorthalidone in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Chlorthalidone during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Chlorthalidone with respect to nursing mothers.

Pediatric Use

There is no FDA guidance on the use of Chlorthalidone with respect to pediatric patients.

Geriatic Use

There is no FDA guidance on the use of Chlorthalidone with respect to geriatric patients.

Gender

There is no FDA guidance on the use of Chlorthalidone with respect to specific gender populations.

Race

There is no FDA guidance on the use of Chlorthalidone with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Chlorthalidone in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Chlorthalidone in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Chlorthalidone in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Chlorthalidone in patients who are immunocompromised.

Administration and Monitoring

Administration

Oral

Intravenous

Monitoring

There is limited information regarding Monitoring of Chlorthalidone in the drug label.

Condition1

Description

IV Compatibility

There is limited information regarding IV Compatibility of Chlorthalidone in the drug label.

Overdosage

Acute Overdose

Signs and Symptoms

Description

Management

Description

Chronic Overdose

There is limited information regarding Chronic Overdose of Chlorthalidone in the drug label.

Pharmacology

There is limited information regarding Chlorthalidone Pharmacology in the drug label.

Mechanism of Action

There is limited information regarding Chlorthalidone Mechanism of Action in the drug label.

Structure

There is limited information regarding Structure of Chlorthalidone in the drug label.

Pharmacodynamics

There is limited information regarding Pharmacodynamics of Chlorthalidone in the drug label.

Pharmacokinetics

There is limited information regarding Pharmacokinetics of Chlorthalidone in the drug label.

Nonclinical Toxicology

There is limited information regarding Nonclinical Toxicology of Chlorthalidone in the drug label.

Clinical Studies

There is limited information regarding Clinical Studies of Chlorthalidone in the drug label.

Condition1

Description

How Supplied

There is limited information regarding Chlorthalidone How Supplied in the drug label.

Storage

There is limited information regarding Chlorthalidone Storage in the drug label.

Images

Drug Images

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Package and Label Display Panel

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Patient Counseling Information

There is limited information regarding Patient Counseling Information of Chlorthalidone in the drug label.

Precautions with Alcohol

Alcohol-Chlorthalidone interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

There is limited information regarding Chlorthalidone Brand Names in the drug label.

Look-Alike Drug Names

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

  1. ↑ "http://www.ismp.org". External link in |title= (help)


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