Bendroflumethiazide

Oral
Oedema

Oral
Suppression of lactation

Oral
Hypertension

Oral
Idiopathic hypercalciuria

Severe: Contraindicated.

Severe: Contraindicated.

May be taken with or without food. May be taken w/ food or milk.

Anuria, severe renal and hepatic impairment, symptomatic hyperuricaemia, Addison's disease. Refractory hypokalaemia, hyponatraemia, and hypercalcaemia.

Patients w/ electrolyte imbalance, DM, gout, mild to moderate hepatic and renal impairment. May exacerbate SLE. Pregnancy and lactation.

Electrolyte imbalance, gout, postural hypotension, GI effects, hyperglycaemia, altered plasma lipid concentration, rashes, photosensitivity, blood disorders, pancreatitis, intrahepatic cholestasis.

PO: C (FDA Pregnancy Category C applies to bendroflumethiazide in combination w/ nadolol.)

Symptoms: Anorexia, nausea, vomiting, diarrhoea, diuresis, dehydration, hypotension, dizziness, weakness, muscle cramps, paraesthesia, tetany, GI bleeding, hyponatraemia, hypo- or hyperglycaemia, hypokalaemia and metabolic alkalosis. Management: Initiate emesis or gastric lavage, if appropriate. Symptomatic and supportive treatment including correction of fluid and electrolyte imbalance. Monitor BP.

Increased serum levels of lithium. Increased nephrotoxicity of NSAID. Increased hypokalaemic effect w/ xanthines, beta-agonists, ACTH, corticosteroids, acetazolamide, carbenoxolone and reboxetine. Enhanced neuromuscular blocking effect of non-depolarising muscle relaxants (e.g. tubocurarine). Postural hypotension may be enhanced by barbiturates, opioids and TCA. Increased risk of hyponatraemia w/ carbamazepine, amphotericin and aminoglutethimide. Increased risk of nephrotoxicity and ototoxicity w/ cisplatin. Reduced absorption by colestipol and colestyramine. Increased risk of ventricular arrhythmias w/ pimozide, thioridazine and terfenadine.

May interfere w/ PBI (protein-bound iodine) and parathyroid function tests.

Description:
Mechanism of Action: Bendroflumethiazide reduces the reabsorption of electrolytes from the renal tubules, thus increasing the excretion of Na and Cl ions and consequently of water. It also reduces the GFR.
Onset: Approx 2 hr.
Duration: 12-18 hr or longer.
Pharmacokinetics:
Absorption: Completely absorbed from the GI tract. Time to peak plasma concentration: Approx 3-6 hr.
Distribution: Highly bound to plasma proteins.
Metabolism: Undergoes fairly extensive metabolism.
Excretion: Via urine (as unchanged drug). Plasma half-life: Approx 3-4 hr.

Store between 20-25°C. Protect from excessive heat.

Diuretics

Anon. Thiazides General Statement. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com.

Buckingham R (ed). Bendroflumethiazide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/06/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Bendroflumethiazide. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 04/06/2014.