IntravenousOedemaAdult: 0.5-1 g once daily or bid, may also be taken on alternate days or on 3-5 days wkly.
OralHypertensionAdult: 0.5-1 g daily as a single dose or in 2 divided doses. Max: 2 g daily in divided doses.
Child: <6 mth 10-30 mg/kg/day in 2 divided doses. Max: 375 mg daily; 6 mth to 12 yr 10-20 mg/kg/day in 1-2 divided doses. Max: 375 mg/day (<2 yr), 1000 mg/day (2-12 yr).
OralOedemaAdult: 0.5-1 g once daily or bid, may also be taken on alternate days or on 3-5 days wkly. Max: 2 g daily.
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Should be taken with food.
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Add 18 mL of sterile water for inj to a 500 mg vial to provide a soln of 27.8 mg/mL. May be further diluted w/ NaCl, dextrose, or other compatible infusion fluids before admin.
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Chlorpromazine HCl, codeine phosphate, hydralazine HCl, insulin, norepinephrine bitartrate, levorphanol tartrate, methadone HCl, morphine sulfate, polymyxin B sulfate, procaine HCl, rochlorperazine mesylate, promazine HCl, promethazine HCl, streptomycin sulfate, tetracycline HCl, vancomycin HCl. Chlorothiazide Na inj should not be administered simultaneously w/ whole blood or its derivatives.
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Hypersensitivity to sulfonamide-derived drugs, anuria.
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Patient w/ gout, DM, hypercholesterolemia, hypercalcaemia, hypokalaemia, history of allergy or bronchial asthma. May exacerbate SLE. Renal and hepatic impairment. Pregnancy and lactation.
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Hypotension, necrotising angiitis, dizziness, fever, headache, restlessness, vertigo, alopecia, erythema multiforme, exfoliative dermatitis, photosensitivity, purpura, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria, increase in cholesterol and triglycerides, electrolyte disturbances , (e.g. hypercalcaemia, hypokalaemia), hyperglycaemia, hyperuricaemia, abdominal cramping, anorexia, constipation, diarrhoea, gastric irritation, nausea, pancreatitis, sialadenitis, vomiting, impotence, agranulocytosis, aplastic anaemia, hemolytic anaemia, leukopenia, thrombocytopenia, jaundice, muscle spasm, paraesthesia, weakness, blurred vision, xanthopsia, glycosuria, haematuria, interstitial nephritis, renal failure, pneumonitis, pulmonary oedema, resp distress, anaphylactic reactions.
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Monitor serum electrolytes, renal function and BP. Assess wt, input and output reports daily to determine fluid loss.
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Symptoms: Hypokalaemia, hypochloremia, hyponatraemia and dehydration resulting from excessive diuresis. Management: Symptomatic and supportive treatment. Correct dehydration, electrolyte imbalance, hepatic coma and hypotension. If required, give oxygen or artificial respiration for resp impairment.
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May increase risk of lithium toxicity. Potentiation of orthostatic hypotension w/ barbiturates and narcotics. Reduced therapeutic effect of antidiabetics. Additive effect w/ other antihypertensives. Reduced diuretic absorption from the GI tract w/ cholestyramine and colestipol. Intensified electrolyte depletion w/ corticosteroids. Reduced diuretic effect w/ NSAID.
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Increased absorption if taken w/ food. Avoid alcohol as it may increase the risk of orthostatic hypotension.
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Thiazides should be discontinued before carrying out tests for parathyroid function.
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Description:
Mechanism of Action: Chlorothiazide reduces the reabsorption of electrolytes from the renal tubules, hence increasing the excretion of Na and Cl ions and consequently of water. It also reduces the GFR.
Onset: W/in 2 hr (oral); 15 min (IV).
Duration: Approx 6-12 hr.
Pharmacokinetics:
Absorption: Incompletely and variably absorbed from the GI tract. Food may increase the extent of absorption. Time to peak plasma concentration: Approx 4 hr (oral); 30 min (IV).
Distribution: Crosses placenta and excreted in breast milk (small amounts).
Metabolism: Not metabolised.
Excretion: Via urine (as unchanged drug). Plasma half-life: Approx 45-120 min.
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Anon. Chlorothiazide: Drug Information. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 30/05/2014. Buckingham R (ed). Chlorothiazide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 30/05/2014. Chlorothiazide Sodium Injection (Akorn, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 30/05/2014. Chlorothiazide tablet (West-ward Pharmaceutical Corp.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 30/05/2014. McEvoy GK, Snow EK, Miller J et al (eds). Chlorothiazide, Chlorothiazide Sodium. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 30/05/2014.
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