Chlorthalidone is a medication primarily used to treat high blood pressure (hypertension). It belongs to a class of drugs known as diuretics, often referred to as "water pills," which help the kidneys remove excess fluid and salt from the body, thereby lowering blood pressure and reducing swelling (edema).
Uses of Chlorthalidone
Chlorthalidone is prescribed for several conditions, including:
- Hypertension: It is a common treatment for high blood pressure.
- Edema: It helps reduce fluid retention caused by congestive heart failure, liver disease (such as cirrhosis with ascites), and kidney disease (including nephrotic syndrome).
A healthcare provider may determine other uses for chlorthalidone based on individual patient needs.
How Chlorthalidone Works
Chlorthalidone increases the amount of urine produced by the body. It facilitates the removal of electrolytes, such as sodium (salt), and water from the body via the kidneys.
Dosage and Administration
Chlorthalidone is available in oral tablet form in the following strengths:
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- 12.5 mg
- 15 mg
- 25 mg
- 50 mg
It should be taken as directed by a healthcare provider.
Storage Instructions
Chlorthalidone should be stored at room temperature, ideally between 68°F to 77°F (20°C to 25°C). Brief exposure to temperatures between 59°F to 86°F (15°C to 30°C) is acceptable, such as during transport. It should be stored in a cool, dry place, kept tightly closed, and out of reach of children.
Common Side Effects
The most common side effects of chlorthalidone include:
- Increased urination
- Low blood pressure
- Electrolyte changes
- Increased blood sugar levels
If these side effects become bothersome, it is important to consult a healthcare provider.
Serious Side Effects
While less common, chlorthalidone can cause serious side effects that require immediate medical attention:
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- Low Blood Pressure with Worsening Kidney Function: Dehydration and reduced blood pressure can result from water loss, potentially leading to kidney problems. Symptoms include dizziness, lightheadedness, fainting, confusion, weakness, fatigue, sudden weight gain, reduced urination, increased thirst, dark urine, dry mouth, sunken eyes, headache, and a fast heartbeat.
- Electrolyte Changes and Increased Blood Sugar: Chlorthalidone can alter electrolyte levels (low potassium, sodium, magnesium, chloride; high calcium) and increase blood sugar levels, leading to symptoms such as weakness, unusual tiredness, muscle cramps or twitching, constipation, nausea, vomiting, loss of appetite, dizziness, restlessness, irritability, difficulty breathing, confusion, abnormal heart rhythm, and seizures.
- Severe Allergic Reactions: Allergic reactions can manifest as breathing problems, wheezing, a racing heart, fever, swollen lymph nodes, swelling of the face, lips, mouth, tongue, or throat, trouble swallowing, itching, skin rash, hives, nausea, vomiting, dizziness, stomach cramps, and joint pain.
- Severe Skin Reactions: Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe skin reactions that require immediate medical attention. Symptoms include painful red or purple skin that looks burned and peels off, flat red rash or blisters on the skin, mouth, nose, and genitals, and red, painful, watery eyes.
- Inflammation of the Pancreas (Pancreatitis): Symptoms include vomiting or severe pain in the upper abdomen that radiates to the back.
- Liver Damage: Symptoms of liver damage include nausea, vomiting, abdominal pain, fever, weakness, fatigue, itching, loss of appetite, light-colored stool, dark-colored urine, and jaundice.
Contraindications
Chlorthalidone is not suitable for everyone. It should be avoided in the following cases:
- Allergies: Individuals allergic to chlorthalidone, any sulfonamide (sulfa drug), or any component of the specific product should not use it.
- Anuria: People who are not producing urine should not take chlorthalidone.
- Electrolyte Imbalance: Individuals with low electrolyte levels (e.g., low sodium or potassium) should avoid chlorthalidone.
Precautions
Before starting chlorthalidone, it is important to inform the healthcare provider about:
- Current and Past Health Conditions: Including heart failure, liver problems, kidney problems, diarrhea, vomiting, low electrolytes, abnormal heart rhythm, diabetes, gout, prostate problems, reduced urination, asthma, and systemic lupus erythematosus.
- Sulfa Allergy: Inform the provider about any allergies to sulfa medications.
- Other Medications and Supplements: Disclose all prescription, over-the-counter medications, vitamins, herbal products, and supplements being taken.
- Pregnancy and Breastfeeding: Discuss any plans to become pregnant or if currently breastfeeding.
Interactions
Chlorthalidone can interact with various substances, including:
- Alcohol: Consumption of alcohol may increase the risk of dizziness.
- Foods and Drinks: Discuss electrolyte intake, including sodium and potassium, with the healthcare provider.
Drug Interactions
Chlorthalidone may interact with other medications, such as:
- Barbiturates
- Opioids
- Diabetes medications
- High blood pressure medications
- Corticosteroids
- Lithium
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Digoxin
- Other diuretics
Special Warnings and Precautions
- Pregnancy: Using chlorthalidone during pregnancy can potentially harm the unborn baby. Effective birth control is crucial.
- Dizziness: Chlorthalidone may cause dizziness, especially when rising from a sitting or lying position.
- Kidney Problems: Monitor for symptoms of kidney problems, such as changes in urine output, swelling, and pain.
- Hypokalemia: Chlorthalidone may cause low potassium levels.
- Photosensitivity: The drug may increase sensitivity to sunlight, necessitating the use of sunscreen and protective clothing.
- Diabetic Patients: Chlorthalidone may affect blood sugar levels.
- Alcohol: Limit alcohol consumption to avoid worsening dizziness.
Effect on Weight Loss
Chlorthalidone can influence weight changes, as demonstrated in the Trial of Antihypertensive Interventions and Management (TAIM). The study showed that chlorthalidone had a more pronounced effect on weight loss compared to atenolol or placebo, especially when combined with a weight loss diet. In this study, the chlorthalidone group lost an average of 6.9 kg, compared to 4.4 kg in the placebo group and 3.0 kg in the atenolol group after six months. This effect attenuated but persisted at 24 months.It is important to note that the weight loss observed with chlorthalidone is primarily due to its diuretic effect, which causes the body to eliminate excess fluid. This type of weight loss is not the same as losing body fat and can lead to dehydration and electrolyte imbalances if not carefully monitored.
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Management of Side Effects
- Dizziness: Rise slowly from sitting or lying down.
- Dehydration: Drink plenty of fluids, especially during episodes of vomiting or diarrhea.
- Electrolyte Imbalance: Follow the healthcare provider's recommendations for diet and electrolyte monitoring.
- Photosensitivity: Use sunscreen and wear protective clothing when exposed to sunlight.
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