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Hemiclor
chlorthalidone
Adult Dosing .
Dosage forms: TAB: 12.5 mg
Special Note
- [equivalency or interchangeability info]
- Info: not interchangeable with Thalitone; do not substitute on a mg to mg basis
HTN
- [12.5-25 mg PO qam]
- Info: give with food
renal dosing
- [see below]
- renal impairment: not defined, caution advised; anuria: contraindicated
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment/progressive hepatic disease: not defined, caution advised
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- anuria
- avoid: sun exposure
- avoid: UV light exposure, artificial
- caution: hypersensitivity to sulfonamides
- caution: renal impairment
- caution: hepatic impairment
- caution: hepatic disease, progressive
- caution: electrolyte abnormalities
- caution: volume depletion
- caution: seizure disorder
- caution: arrhythmia
- caution: post-sympathectomy
- caution: diabetes mellitus
- caution: SLE
- caution: gout history
- caution: pancreatitis history
- caution: HTN, gestational
- caution: elderly patients
Drug Interactions .
Overview
chlorthalidone
thiazide diuretic
- antihypertensive agent
- binds to anion exchange resin/polymer
- decreases renal perfusion/fxn
- diuretic
- hypercalcemia
- hyperglycemic effects
- hyperuricemic effects
- hypokalemia
- hypomagnesemia
- hyponatremia
- photosensitivity
- urine alkalinizer
Contraindicated
- isocarboxazid
- methenamine
Avoid/Use Alternative
- aldesleukin
- amikacin
- aminolevulinic acid topical
- aripiprazole lauroxil
- arsenic trioxide
- chlorothiazide
- clofarabine
- hydrochlorothiazide
- indapamide
- iodixanol
- iomeprol
- iopromide
- ioversol
- lofexidine
- mannitol
- metolazone
- porfimer
- sulfamethoxazole
- tretinoin topical
Monitor/Modify Tx
- abaloparatide
- abiraterone acetate
- acarbose
- acetazolamide
- acyclovir
- adefovir dipivoxil
- albuterol
- albuterol inhaled
- alfentanil
- alfuzosin
- aliskiren
- allopurinol
- almotriptan
- aloe
- alogliptin
- alprostadil intracavernous
- amantadine
- amifostine
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- lutetium Lu 177 dotatate
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- methamphetamine
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- neomycin
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- nicotine
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- nitric oxide
- nitrite
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- omeprazole
- opicapone
- opium
- osilodrostat
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- oxaprozin
- oxazepam
- oxcarbazepine
- oxycodone
- oxymetazoline nasal
- oxymetazoline ophthalmic
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- oxymorphone
- oxytocin
- ozanimod
- paliperidone
- palopegteriparatide
- pamidronate
- panitumumab
- pantoprazole
- paricalcitol
- paromomycin
- paroxetine
- patiromer
- pazopanib
- pegloticase
- pemetrexed
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- pentazocine
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- pentostatin
- pentoxifylline
- perindopril
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- pexidartinib
- phendimetrazine
- phenelzine
- phenobarbital
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- phenylephrine
- phenylephrine injection
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- pioglitazone
- piroxicam
- plazomicin
- polyethylene glycol
- polyethylene glycol/electrolytes
- polymyxin B
- ponatinib
- ponesimod
- posaconazole
- pralsetinib
- pramipexole
- pramlintide
- prazosin
- prednisolone
- prednisone
- primidone
- probenecid
- procarbazine
- prochlorperazine
- promethazine
- propafenone
- propofol
- protriptyline
- pseudoephedrine
- quetiapine
- quinapril
- quinidine (antiarrhythmic)
- quinidine (CYP2D6 inhibitor)
- rabeprazole
- ramipril
- ramucirumab
- rasagiline
- rasburicase
- regorafenib
- remifentanil
- remimazolam
- repaglinide
- Rho(D) immune globulin
- rimegepant
- riociguat
- ripretinib
- risperidone
- rituximab
- rizatriptan
- romidepsin
- ropeginterferon alfa-2b
- ropinirole
- ropivacaine
- rosiglitazone
- rotigotine transdermal
- sacituzumab govitecan
- sacubitril
- safinamide
- salmeterol inhaled
- salsalate
- saxagliptin
- selegiline
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- selinexor
- selpercatinib
- semaglutide
- sertraline
- sevoflurane
- sildenafil
- silodosin
- siponimod
- sirolimus
- sirolimus albumin-bound
- sitagliptin
- sodium benzoate
- sodium ferric gluconate complex
- sodium phenylacetate
- sodium phenylbutyrate
- sodium picosulfate
- sodium polystyrene sulfonate
- sodium thiosulfate
- sorafenib
- sotagliflozin
- sotalol
- sparsentan
- spironolactone
- streptomycin
- streptozocin
- sufentanil
- sulfate bowel prep
- sulindac
- sumatriptan
- sunitinib
- tacrolimus
- tadalafil
- tafasitamab
- tagraxofusp
- tamsulosin
- tapentadol
- taurine
- telavancin
- telmisartan
- temsirolimus
- tenofovir alafenamide
- tenofovir disoproxil
- terazosin
- terbutaline
- teriflunomide
- teriparatide
- testosterone
- tetrahydrozoline ophthalmic
- thalidomide
- thioridazine
- thiothixene
- thyroid
- timolol ophthalmic
- tiopronin
- tirzepatide
- tivozanib
- tizanidine
- tobramycin
- tobramycin inhaled
- tolcapone
- tolmetin
- topiramate
- toremifene
- torsemide
- tramadol
- trametinib
- trandolapril
- tranylcypromine
- trazodone
- treprostinil
- triamcinolone
- triamterene
- trifluoperazine
- trimipramine
- ubrogepant
- vaccinia immune globulin
- vadadustat
- valacyclovir
- valganciclovir
- valsartan
- vamorolone
- vancomycin
- vandetanib
- vardenafil
- vasopressin
- venlafaxine
- vilanterol inhaled
- vilazodone
- viloxazine
- vitamin A (retinol)
- voclosporin
- vonoprazan
- vortioxetine
- vosoritide
- willow bark
- yohimbe
- zavegepant
- ziprasidone
- ziv-aflibercept
- zoledronic acid
- zolmitriptan
- zonisamide
Caution Advised
- acitretin
- icosapent ethyl
- methoxsalen
- verteporfin
Adverse Reactions .
Serious Reactions
- hypokalemia, severe
- electrolyte imbalance
- arrhythmia
- pancreatitis
- cholestatic jaundice
- anaphylaxis
- necrotizing angiitis
- erythema multiforme
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- exfoliative dermatitis
- photosensitivity
- renal failure
- interstitial nephritis
- aplastic anemia
- agranulocytosis
- leukopenia
- hemolytic anemia
- thrombocytopenia
Common Reactions
- hypokalemia
- hypochloremia
- hyponatremia
- hypomagnesemia
- hypercalcemia
- hyperuricemia
- hyperglycemia
- hyperlipidemia
- hypotension, orthostatic
- anorexia
- nausea
- vertigo
- constipation
- dizziness
- photosensitivity
- rash
- urticaria
- paresthesia
- headache
- muscle spasm
- weakness
- impotence
Safety/Monitoring .
Monitoring Parameters
BUN/Cr; electrolytes at baseline, then periodically
Look/Sound-Alike Drug Names
chlorthalidone confused with: chlorothiazide; chlorproMAZINE; clomiPRAMINE
Pregnancy/Lactation .
Pregnancy
Clinical Summary
may use during pregnancy if on chronic tx before conception, otherwise weigh risk/benefit; no known risk of teratogenicity based on human data; possible risk of decr. placental perfusion and neonatal adverse effects, including hypoglycemia, thrombocytopenia, and electrolyte abnormalities, based on limited or conflicting human data; risks not observed if chronic use before conception
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; possible risk of infant harm based on limited human data and drug properties; possible decr. milk production based on conflicting human data
Pharmacology .
Metabolism: for chlorthalidone: liver; CYP450: unknown
Excretion: for chlorthalidone: urine 50-75% (primarily unchanged); Half-life: 40-60h
Subclass: Diuretics, Thiazides
Mechanism of Action
for chlorthalidone: inhibits distal convoluted tubule sodium and chloride reabsorption
Formulary .
No Formulary Selected
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