Renal Dose Adjustment (Based on CrCl)
- >50 mL/min: Dosage interval should be q24 hrs
- 31-50 mL/min: Dosage interval should be q24-36 hrs
- 10-30 mL/min: Dosage interval should be q24-48 hrs
- <10 mL/min: Dosage interval should be q40-60 hrs
Hepatic Dose Adjustment
- Impaired hepatic function/progressive liver disease: Dose adjustments not defined; use with caution due to the risk of hepatic coma
See Supplemental Patient Information
- Co-administration of lithium is not recommended with diuretics as these agents reduce the renal clearance of lithium and add a high risk of lithium toxicity
- Beta-blockers may inhibit sympathetic stimulation and may precipitate more severe failure in patients with CHF
- Although beta-blockers are contraindicated in overt CHF, if required, they can be used with caution in patients with a history of failure who are well compensated, usually with digitalis and diuretics. Inotropic action of digitalis on heart muscle is not abolished by this drug
- Continuous use of beta blockers may, occasionally, lead to cardiac failure in patients without a history of heart failure. Therefore, digitalize the patient and/or treat them with diuretics at the first sign or symptom of heart failure and closely observe the response or gradually discontinue this drug if possible
- Abrupt discontinuation of this combination drug may lead to exacerbation of angina and, in some cases, development of myocardial infarction [US Black Box Warning]
- Gradually reduce the dose over a period of 1-2 wks and monitor appropriately, especially in patients with ischemic heart disease while discontinuing chronically administered nadolol. If there is significant worsening of angina or development of acute coronary insufficiency, promptly reinstitute administration of this drug, at least temporarily, and undertake other measures appropriate for the management of unstable angina [US Black Box Warning]
- Warn patients against interruption or discontinuation of therapy without the physician's advice [US Black Box Warning]
- Avoid abrupt discontinuation of this drug, because of its nadolol component, even in patients treated only for hypertension since coronary artery disease is common and may be unrecognized [US Black Box Warning]
- Bendroflumethiazide may precipitate azotemia in patients with renal disease. Cumulative effects of this drug may develop in patients with impaired renal function
- Thiazides should be used with caution in patients with impaired hepatic function, as minor alterations of fluid and electrolyte balance may precipitate hepatic coma
- Patients with or without a history of allergy or bronchial asthma are susceptible for developing sensitivity reactions
- Possibility of exacerbation or activation of systemic lupus erythematosus has been associated with this drug
- Periodically determine serum electrolytes at appropriate intervals to detect possible electrolyte imbalance; observe patients for clinical signs of fluid or electrolyte imbalance, namely hyponatremia, hypokalemia, and hypochloremic alkalosis
- Hypokalemia may sensitize or exaggerate the response of the heart to the toxic effects of digitalis; concurrent administration of a potassium-sparing diuretic or potassium supplements may be indicated in these patients
- Hyperuricemia or precipitation of frank gout may be associated in patients receiving thiazide therapy
- Latent diabetes mellitus may become manifest during thiazide administration; also, thiazides may decrease serum PBI levels without signs of thyroid disturbance
- Thiazides increase the urinary excretion of magnesium, which may result in hypomagnesemia
Cautions: Use cautiously in
- Severe renal disease
- Progressive liver disease
- Electrolyte abnormalities
- Volume depletion
- Peripheral vascular disease
- Diabetes mellitus (nadolol may mask signs of hypoglycemia)
- Bronchospastic disease
- History of allergy or bronchial asthma
- Thyrotoxicosis (nadolol may mask some clinical signs of hyperthyroidism)
- Pheochromocytoma
- Post-sympathectomy
- Arrhythmias
- WPW syndrome
- Seizure disorder
- Pregnancy (2nd or 3rd trimester)
- Gestational hypertension
- Breastfeeding
- History of pancreatitis
- Myasthenia gravis
- History of severe anaphylactic reaction
- Major surgery
- Geriatric patients
Supplemental Patient Information
- Advise patients being treated with beta-adrenergic blocking agents to promptly consult their physician at the first sign or symptom of impending cardiac failure
Pregnancy Category:NR
Breastfeeding: If bendroflumethiazide is required by a nursing mother, it is not a reason to discontinue breastfeeding. Intense diuresis with large doses of this drug component may cause decreased milk production, especially during the neonatal period. Other beta-adrenergic blockers are preferred to nadolol, especially while nursing a newborn or preterm infant because of its relatively extensive excretion into breastmilk. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT). Nadolol is compatible and considered safe with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776/T6 last accessed 27 June 2011). As per manufacturer's data, both the component of this combination drug are excreted in human milk. Due to the potential for serious adverse reactions in nursing infants from both these components, a decision should be made whether to discontinue nursing or to discontinue therapy taking into account the importance of the drug to mother.
US Trade Name(s)
US Availability
bendroflumethazide/nadolol (generic)
Corzide (bendroflumethiazide/nadolol)
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Corzide 80-5 MG TABS [Bottle] (KING PHARMA)
30 mg = $119.99
90 mg = $339.95 - Corzide 40-5 MG TABS [Bottle] (KING PHARMA)
30 mg = $109.99
90 mg = $309.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
