Uses of Clortha 25: - Hypertension (high blood pressure) Hypertension, Oedema, Diabetes insipidus, Congestive heart failure Severe renal impairment or anuria. Severe hepatic impairment, addison's disease, preexisting hypercalcaemia, asthma; hypersensitivity; severe allergy. Pregnancy and lactation.

Thiazide diuretics & related drugs

Chlortalidone prevents reabsorption of sodium and chloride by inhibiting the Na+/Cl− symporter in the distal convoluted tubule. Thiazides and related compounds also decrease the glomerular filtration rate, which further reduces the drug's efficacy in patients with kidney impairment (e.g. kidney insufficiency). By increasing the delivery of sodium to the distal renal tubule, chlortalidone 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 chlortalidone is not affected by the acid-base balance of the patient being treated.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.

How to use Chlorthalidone: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Chlorthalidone is to be taken with food. Administration: Should be taken with food. Take during meals. Adult Dose: Hypertension 25-100 mg/day PO; usual range, 12.5-25 mg/day Edema 50-100 mg/day PO or 100 mg PO every other day; not to exceed 200 mg/day Heart Failure 12.5-25 mg/day PO; not to exceed 100 mg/day Renal Dose: Renal impairment CrCl <10 mL/min: Ineffective; do not use CrCl >10 mL/min: Dose adjustment not necessary

NSAIDs antagonise hypotensive action. Suppresses action of oral anticoagulants due to reduced prothrombin activity. Increased risk of hypokalaemia when corticosteroids are given concurrently. Potentially Fatal: Potentiates bone marrow suppression caused by anticancer drugs. Diuretic-induced vol depletion can potentiate aminoglycoside nephrotoxicity. Impairs action of oral hypoglycaemic agents. Enhances digitalis toxicity due to hypokalaemia. vol depletion enhances lithium toxicity, conversely, sudden withdrawal of diuretics may result in subtherapeutic levels of circulating lithium. Prolonged paralysis with tubocurarine due to hypokalaemia.

Severe renal impairment or anuria. Severe hepatic impairment, addison's disease, preexisting hypercalcaemia, asthma; hypersensitivity; severe allergy. Pregnancy and lactation.

Common - Headache - Nausea - Increased blood uric acid - Decreased potassium level in blood - Glucose intolerance - Altered blood lipid level Common Cardiovascular: Hypotension, vasculitis Dermatologic: Photosensitivity, phototoxicity Endocrine/metabolic: Electrolyte abnormalities, hyperglycemia, hyperuricemia Gastrointestinal: Constipation, diarrhea, loss of appetite, nausea, vomiting Musculoskeletal: Spasticity Neurologic: Dizziness, headache, paresthesia Ophthalmologic: Blurred vision, xanthopsia Psychiatric: Restlessness Reproductive: Impotence Potentially Fatal: Rare. Severe hyponatraemia and idiosyncratic hypersensitivity.

Pregnancy category B. Thiazides are excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from chlorthalidone, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Precaution: Existing fluid and electrolyte disturbances, hepatic cirrhosis, severe heart failure, hyperuricaemia, mild to moderate renal impairment. Elderly. Monitor fluid and electrolyte balance. Kidney or liver disease; diabetes; gout; hyperlipidaemia and ventricular extra systoles. Lactation: Drug enters breast milk; not recommended (American Academy of Pediatrics states that it is "compatible with nursing")

Symptoms of acute overdosage include nausea, weakness, dizziness, and disturbances of electrolyte balance. The oral LD 50 of the drug in the mouse and the rat is more than 25,000 mg/kg body weight. The minimum lethal dose (MLD) in humans has not been established. There is no specific antidote, but gastric lavage is recommended, followed by supportive treatment. Where necessary, this may include intravenous dextrose-saline with potassium, administered with caution.

Store in a cool and dry place, protected from light.

Thiazide diuretics & related drugs

Chlortalidone is an oral, long acting antihypertensive/diuretic. It is a monosulfamyl diuretic that acts by enhancing the excretion of sodium and chloride ions, and water by interfering with the transport of sodium ions across the renal tubular epithelium. Their primary site of action appears to be at the cortical diluting segment in the nephron of the loop of Henle.

Pregnancy Available data over decades from observational studies and reports with chlorthalidone use in pregnant women have not identified a drug-associated risk of major birth defects or miscarriage; however, adverse fetal outcomes, including fetal or neonatal jaundice, thrombocytopenia, hypoglycemia, and electrolyte abnormalities reported following maternal use of thiazide diuretics Drug not for use as first-line therapy to treat hypertension in pregnancy; advise pregnant women of potential risk to fetus Hypertension in pregnancy increases maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (eg, need for cesarean section, and post-partum hemorrhage); hypertension increases fetal risk for intrauterine growth restriction and stillbirth Thiazides can cross placenta, and concentrations reached in umbilical vein approach those in maternal plasma; thiazides, like other diuretics, can cause placental hypoperfusion Use of thiazides during pregnancy associated with risk of fetal or neonatal jaundice, thrombocytopenia, hypoglycemia, and electrolyte abnormalities; thiazides do not prevent or alter course of EPH (Edema, Proteinuria, Hypertension) gestosis (pre-eclampsia) and should not be used as first-line therapy to treat hypertension in pregnant women Lactation Drug is present in human milk; there is no information regarding effects of on breastfed infant or on milk production; because of potential for drug accumulation which may lead to serious adverse reactions in breastfed infant (such as jaundice, thrombocytopenia, hyperglycemia, electrolyte abnormalities), advise patients that breastfeeding is not recommended during therapy Pregnancy Categories