chlorothiazide

Contraindicated in:

Hypersensitivity (cross-sensitivity with other thiazides or sulfonamides may exist);
Some products contain tartrazine and should be avoided in patients with known intolerance;
Anuria;
Lactation: Lactation.

Use Cautiously in:

Renal or hepatic impairment;
OB: Use during pregnancy only if clearly needed;
Pedi: May cause jaundice or thrombocytopenia in newborn;
Geri: Appears on Beers list. May worsen or cause hyponatremia in older adults. Use with caution in older adults and monitor sodium concentrations closely when initiating therapy or ↑ the dose..

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypotension

Derm: photosensitivity, rash

EENT: blurred vision

Endo: hyperglycemia

F and E: hypokalemia, dehydration, hypercalcemia, hypochloremic alkalosis, hypomagnesemia, hyponatremia, hypophosphatemia, hypovolemia

GI: anorexia, cramping, hepatitis, nausea, PANCREATITIS, vomiting

Hemat: thrombocytopenia

Metab: hypercholesterolemia, hyperuricemia

MS: muscle cramps

Neuro: drowsiness, dizziness, weakness

Interactions ⬆ ⬇

Drug-drug:

Additive hypotension with other antihypertensives, acute ingestion of alcohol or nitrates.
Additive hypokalemia with corticosteroids, amphotericin B, loop diuretics, or piperacillin.
↓excretion of lithium.
Cholestyramine orcolestipol↓ absorption.
Hypokalemia ↑ risk of digoxin toxicity.
NSAIDs may ↓ effectiveness.

Availability ⬆ ⬇

(Generic available)

Oral suspension: 250 mg/5 mL
Powder for injection: 500 mg/vial

Route/Dosage ⬆ ⬇

When used as a diuretic in adults, generally given daily, but may be given every other day or 2–3 days/wk
PO (Adults ): 125 mg–2 g/day as a single dose or in 2 divided doses.
PO (Children >6 mo): 20 mg/kg/day as a single dose or in 2 divided doses. Maximum dose: 1 g/day.
PO (Neonates up to 6 mo): 20–40 mg/kg/day in 2 divided doses. Maximum dose: 375 mg/day.
IV (Adults ): Diuretic: 100–500 mg/day as a single dose or 2 divided doses.
IV (Children >6 mo): 4 mg/kg/day in 1–2 divided doses. Maximum dose: 20 mg/kg/day.
IV (Neonates up to 6 mo): 2–8 mg/kg/day in 2 divided doses. Maximum dose: 20 mg/kg/day.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Increases excretion of sodium and water by inhibiting sodium reabsorption in the distal tubule.
Promotes excretion of sodium, chloride, potassium, magnesium, phosphate, water, and bicarbonate.
May produce arteriolar dilation.

Therapeutic effects:

Lowering of BP in hypertensive patients and diuresis with mobilization of edema.

Classifications ⬆ ⬇

Therapeutic Classification: antihypertensives, diuretics

Pharmacologic Classification: thiazide diuretics

Pharmacokinetics ⬆ ⬇

Absorption: Poor (10–20%) after oral administration.

Distribution: Distributed into extracellular space; crosses the placenta and enters breast milk.

Metabolism/Excretion: Excreted mainly unchanged by the kidneys.

Half-Life: 1–2 hr.

Time/Action Profile ⬆ ⬇

(diuretic effect)

ROUTE	ONSET	PEAK	DURATION
PO, IV	2 hr	4 hr	6–12 hr
IV	2 hr	4 hr	2 hr

Patient/Family Teaching ⬆ ⬇

Instruct patient to take this medication at the same time each day. Take missed doses as soon as remembered but not just before next dose is due. Do not double doses.
- Instruct patient to monitor weight biweekly and notify health care professional of significant changes.
- Caution patient to change positions slowly to minimize orthostatic hypotension. This may be potentiated by alcohol.
- Advise patient to use sunscreen and protective clothing to prevent photosensitivity reactions.
- Instruct patient to discuss dietary potassium requirements with health care professional (see Food Sources for Specific Nutrients).
- Instruct patient to notify health care professional of medication regimen before treatment or surgery.
- Advise patient to report muscle weakness, cramps, nausea, vomiting, diarrhea, or dizziness to health care professional.
- May cause fetal harm. Advise females of reproductive potential to avoid use of chlorothiazide during pregnancy and breastfeeding and to notify health care professional if pregnancy is planned or suspected.
- Emphasize the importance of routine follow-up exams.
Hypertension: Advise patients to continue taking the medication even if feeling better. Medication controls but does not cure hypertension.
- Encourage patient to comply with additional interventions for hypertension (weight reduction, low-sodium diet, regular exercise, smoking cessation, moderation of alcohol consumption, and stress management).
- Instruct patient and family in correct technique for monitoring weekly BP.
- Advise patient to consult health care professional before taking other Rx, OTC, or herbal products, especially cough or cold preparations, concurrently with this therapy.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

0378- Mylan Pharmaceuticals Inc.
- 0378-0150- Chlorothiazide
  - 0378-0150-01- 100 TABLET in 1 BOTTLE, PLASTIC (0378-0150-01)

0378- Mylan Pharmaceuticals Inc.
- 0378-0162- Chlorothiazide
  - 0378-0162-01- 100 TABLET in 1 BOTTLE, PLASTIC (0378-0162-01)

0517- American Regent, Inc.
- 0517-1820- Chlorothiazide Sodium
  - 0517-1820-01- 1 VIAL in 1 CARTON (0517-1820-01) > 18 mL in 1 VIAL

17478- Akorn, Inc.
- 17478-419- Chlorothiazide Sodium
  - 17478-419-40- 1 VIAL in 1 CARTON (17478-419-40) > 1 INJECTION in 1 VIAL

25021- Sagent Pharmaceuticals
- 25021-305- chlorothiazide sodium
  - 25021-305-20- 1 VIAL in 1 CARTON (25021-305-20) > 18 mL in 1 VIAL

25021- Sagent Pharmaceuticals
- 25021-305- chlorothiazide sodium
  - 25021-305-66- 1 VIAL in 1 CARTON (25021-305-66) > 18 mL in 1 VIAL

47335- Sun Pharmaceutical Industries, Inc.
- 47335-330- CHLOROTHIAZIDE SODIUM
  - 47335-330-40- 1 VIAL, SINGLE-DOSE in 1 CARTON (47335-330-40) > 18 mL in 1 VIAL, SINGLE-DOSE

63323- Fresenius Kabi USA, LLC
- 63323-658- Chlorothiazide
  - 63323-658-20- 1 VIAL in 1 BOX (63323-658-20) > 18 mL in 1 VIAL

63323- Fresenius Kabi USA, LLC
- 63323-658- Chlorothiazide
  - 63323-658-27- 1 VIAL in 1 BOX (63323-658-27) > 18 mL in 1 VIAL

63323- Fresenius Kabi USA, LLC
- 63323-658- Chlorothiazide
  - 63323-658-94- 1 VIAL in 1 BOX (63323-658-94) > 18 mL in 1 VIAL

65649- Salix Pharmaceuticals, Inc
- 65649-311- DIURIL
  - 65649-311-12- 237 mL in 1 BOTTLE (65649-311-12)

67457- Mylan Institutional LLC
- 67457-263- chlorothiazide sodium
  - 67457-263-30- 1 VIAL in 1 CARTON (67457-263-30) > 18 mL in 1 VIAL

76478- Oak Pharmaceuticals, Inc. (Subsidiary of Akorn, Inc.)
- 76478-711- Sodium Diuril
  - 76478-711-40- 1 VIAL in 1 CARTON (76478-711-40) > 18 mL in 1 VIAL

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Indications ⬇

Contraind./Precautions ⬆ ⬇