Adult Dosing
Edema
- 500-1000 mg IV q12-24 hrs; may be administered on alternate days or on 3-5 days each wk
Note: Reserve use for patients unable to take oral form
Pediatric Dosing
- Safety and effectiveness in pediatric population have not been established
- For slow direct intravenous injection or intravenous infusion only. Avoid extravasation. Do not give subcutaneously or intramuscularly
- Intravenous chlorothiazide should be reserved for emergency situations or for patients unable to take oral medicines
- Use the smallest dosage to achieve the desired response. IV use in infants is not recommended
- Use with caution in severe renal disease due to risk of azotemia
- Use with caution in hepatic impairment or progressive liver disease as minor alterations in electrolyte and fluid balance can precipitate hepatic coma
- Monitor for signs of fluid or electrolyte imbalance viz hyponatremia, hypochloremic alkalosis, and hypokalemia
- Hypokalemia caused by thaizide diuretics may cause cardiac arrhythmias and may also sensitize/exaggerate the response of the heart to the toxic effects of digitalis. Use potassium sparing diuretics or administer supplemental potassium
- Dilutional hyponatremia may occur in edematous patients in hot weather; water restriction is recommended rather than salt administration, except in rare instances when hyponatremia is considered life-threatening
- Chloride deficit caused by thiazide diuretics is generally mild except in certain circumstances (hepatic or renal disease), which may require treatment including chloride replacement
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Progressive liver disease
- Hx of bronchial asthma
- Diabetes mellitus (monitor blood sugar levels)
- Post sympathectomy (may enhance antihypertensive effects)
- Volume depletion
- Electrolyte imbalances
- Pregnancy near-term
- Systemic Lupus Erythematosus (may aggravate symptoms)
- Hx of gout
- Hx of pancreatitis
- Geriatric Population
- Concomitant use of lithium
Pregnancy Category:C
Breastfeeding: Low dose chlorothiazide is acceptable with breastfeeding. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT)This drug is considered compatible with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776 last accessed 11 Oct. 2010). Manufacturer recommends discontinuation of breastfeeding, or postponing of treatment (taking into account the importance of the drug to the mother).
