Clortha 25 mg (Tablet)

Indications

• Management of hypertension
• Adjunctive therapy in edema associated with congestive heart failure
• Adjunctive therapy in edema associated with hepatic cirrhosis
• Adjunctive therapy in edema associated with corticosteroid and estrogen therapy

Pharmacology

• Thiazide-type diuretic-antihypertensive
• Treatment of hypertension
• Inhibition of sodium and chloride reabsorption in the distal renal tubule
• Promotion of water loss
• Long elimination half-life
• Volume reduction effects on blood pressure
• Excretion by kidneys
• Metabolism and hepatic excretion into bile

Dosage & Administration

• Initiation with lowest possible dose
• Titration for maximum therapeutic benefit and minimum side effects
• Single daily or every other day dose with food
• Usual adult dose of 25 to 50 mg daily for hypertension
• Clinically useful dosage range of 12.5 to 50 mg daily
• Lowest effective dose identification for edema of specific origin
• Individual adaptation of dosage for long-term therapy
• Suitability for treating hypertension in the elderly

Interactions

• Caution in impaired hepatic function or progressive liver disease
• Enhanced antihypertensive effects in postsympathectomy patients
• Potential interactions with antihypertensive agents, digitalis, corticosteroids, NSAIDs, curare derivatives, cholestyramine, vitamin D, cyclosporine, calcium salts, antineoplastic agents, anticholinergics, amantadine
• Increased risk of adverse effects from amantadine
• Decreased absorption by cholestyramine

Contraindications

• Anuria
• Severe renal failure
• Severe hepatic failure
• Refractory hypokalemia
• Enhanced potassium loss conditions
• Hyponatremia
• Hypercalcemia
• Symptomatic hyperuricemia
• Hypersensitivity to Chlorthalidone and other sulfonamide derivatives

Side Effects

• Hypokalemia
• Hyperuricemia
• Rise in blood lipids
• Hyponatremia
• Hypomagnesemia
• Postural hypotension
• Dizziness
• Intrahepatic cholestasis or jaundice

Pregnancy & Lactation

• Avoidance in treating hypertension in pregnant women
• Avoidance in other indications in pregnancy, particularly in first trimester
• Avoidance in nursing mothers due to presence in breast milk

Precautions & Warnings

• Reduction of dosage in moderate renal failure
• Risk of precipitating hepatic encephalopathy in patients with liver cirrhosis
• Better to avoid use in pregnancy and lactation due to crossing the placenta and presence in breast milk

Overdose Effects

• Symptoms of acute overdosage
• No specific antidote
• Recommended gastric lavage followed by supportive treatment

Therapeutic Class

Thiazide diuretics & related drugs

Storage Conditions

Keep below 30°C temperature, away from light & moisture, and out of reach of children