Class: Thiazide Diuretic
Dosage Forms. Tablet: 25 mg, 50 mg
Common FDA Label Indication, Dosing, and Titration.
1. Hypertension: Adults, 25 mg po daily, may titrate to max of 100 mg po daily
2. Edema: 50 mg po daily, may titrate to max of 200 mg po daily
1. Hypertension: Children, 0.3 mg/kg po daily, may titrate to max of 2 mg/kg/d or 50 mg/d, whichever is less
MOA. Chlorthalidone increases sodium and chloride excretion by interfering with their reabsorption in the cortical-diluting segment of the nephron.
Drug Characteristics: Chlorthalidone
Medication Safety Issues: Chlorthalidone
Drug Interactions: Chlorthalidone
Adverse Reactions: Chlorthalidone
Efficacy Monitoring Parameters. Decreased BP, swelling, edema.
Toxicity Monitoring Parameters. Signs/symptoms of CHF, decreased heart rate. Monitor serum electrolytes, uric acid, and renal function at baseline and periodically.
Key Patient Counseling Points. Instruct patient to report signs/symptoms of dyspnea, hypotension, gout, or heart failure. Avoid alcohol and NSAIDs. Avoid abrupt discontinuation. This medicine may cause dizziness. Avoid driving, using machinery, or doing anything else that could be dangerous if not alert. Instruct patient to rise slowly from sitting/supine position, as drug may cause orthostatic hypotension. Instruct patient to eat high-potassium foods during therapy.
Clinical Pearls. Chlorthalidone is not FDA approved for use in children, but it is included in guidelines and can be used off label.