Chlorthalidone
Mechanism :
It is a long acting diuretic agent related to the thiazide group of drugs. It increases the elimination of water and sodium in urine, thus reducing the fluid volume and body sodium. It is used in the treatment of edema, pulmonary edema associated with heart failure and also used to decrease the blood pressure.
Indication :
Contraindications :
Documented hypersensitivity to chlorthalidone or sulfonamides.
Anuria.
Dosing :
Initially 0.3 mg/kg/day (Oral); may increase to 2 mg/kg/day;
maximum: 50 mg/day.
Adverse Effect :
GI disturbances, hearing loss, hypochloremic alkalosis, vasculitis, spasticity, restlessness, impotency, volume depletion and hypokalemia.
Interaction :
Amisulpride: Risk of hypokalemia.
Cisapride: Risk of prolonged QT interval.
Isocarboxazid: Hypotensive effect nay be seen.
Tretinoin: Increased photoxicity.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 30-50 | Dose as in normal renal function |
| <30 | Avoid. |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Avoid |
| HD | Not dialysed. Avoid |
| HDF/High flux | Unknown dialysability. Avoid |
| CAV/VVHD | Unknown dialysability. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended. Use with caution since minor alterations of fluid and electrolyte balance may precipitate hepatic coma.