Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..
PHARMACHOLOGIC EFFECT
A thiazide-like diuretic has a long-lasting effect. It disrupts the reabsorption of sodium, chlorine and equivalent amounts of water in the distal tubules of the kidneys. In addition, it increases the excretion of the ions of potassium, magnesium, bicarbonate, delays the excretion of uric acid, calcium ions. Refers to diuretics of average efficiency. Diuretic effect begins after 2 hours, reaches a maximum after 12 hours and lasts up to 72 hours. It causes a decrease in elevated blood pressure. The hypotensive effect develops gradually, reaching a maximum in 2-4 weeks. after the beginning of treatment. In addition, chlortalidone causes a decrease in polyuria in patients with diabetes insipidus, although the mechanism of its action is not clear.
PHARMACOKINETICS
After ingestion chlortalidone is absorbed from the digestive tract. Absorption is unstable. It binds to a high degree with erythrocytes, much less is associated with plasma proteins.
T 1/2 long, is 40-60 hours.
It is excreted mainly unchanged in the urine.
In elderly patients excretion slows down, in comparison with patients of young and middle age, absorption does not change.
INDICATIONS
Arterial hypertension. Edema syndrome of various etiologies (chronic heart failure, nephrotic syndrome, liver cirrhosis).
DOSING MODE
Install individually. With arterial hypertension - 25 mg 1 time / day. If necessary, the dose can be increased to 50-100 mg / day. When the effect is achieved, they switch to maintenance therapy in the minimum effective dose. When edematous syndrome is used in a dose of 50-100 mg 1 time / day, if necessary - up to 200 mg, after reaching the effect pass to maintenance therapy.
SIDE EFFECT
On the part of the digestive system: nausea, vomiting, diarrhea, constipation, loss of appetite are possible.
From the side of the central nervous system and peripheral nervous system: headache, weakness, paresthesia, dizziness are possible.
From the water-electrolyte balance: hypokalemia, hypomagnesemia, hyponatremia, hypochloraemic alkalosis, hypercalcemia are possible.
From the side of metabolism: hyperuricemia, hyperglycemia are possible.
From the hemopoietic system: rarely - thrombocytopenia, leukopenia.
Dermatological reactions: skin rashes are possible.
CONTRAINDICATIONS
Anuria, severe renal and hepatic insufficiency, hypokalemia, hyponatremia, hypercalcemia, hyperuricemia, hypochloraemic alkalosis, arterial hypertension in pregnancy, hypersensitivity to chlorthalidone and sulfonamides.
PREGNANCY AND LACTATION
Penetrates through the placental barrier. When pregnancy is contraindicated in hypertension. In other cases, the application is only possible on strict indications at the lowest effective dose and when the expected benefit of therapy for the mother exceeds the potential risk to the fetus.
Chlortalidone is excreted in breast milk. If it is necessary to use lactation, breastfeeding should be discontinued.
APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindicated in severe renal failure. With caution apply for violations of the excretory function of the kidneys.
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
Contraindicated in severe hepatic insufficiency.
APPLICATION IN ELDERLY PATIENTS
Use with caution in the elderly.
SPECIAL INSTRUCTIONS
With caution apply in patients with diabetes mellitus, with gout, severe atherosclerosis of coronary and cerebral vessels, violations of excretory function of the kidneys, in the elderly.
In the process of treatment, it is necessary to monitor the blood picture, electrolyte blood composition, uric acid level, glucose in the blood.
Impact on the ability to drive vehicles and manage mechanisms
Chlortalidone, especially at the beginning of treatment, can disrupt the ability to drive vehicles and control mechanisms.
DRUG INTERACTION
When used simultaneously with SCS, amphotericin B, carbenoxolone, the risk of developing severe hypokalemia increases.
When used simultaneously with NSAIDs, a decrease in the diuretic and antihypertensive effect of chlorthalidone is possible.
With simultaneous use with digitalis preparations, an increase in the risk of toxic effects of digitalis preparations due to hypokalemia due to the action of chlorthalidone is possible.
With the simultaneous use of lithium carbonate, the concentration of lithium in the blood plasma increases and the risk of lithium intoxication.
