Drug reference

chlorothiazide

Thiazide Diuretic · Diuretic

Thiazide DiureticDiuretic

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

Aminolevulinic AcidSevereDatabaseDDInter
AmiodaroneSevereDatabaseDDInter
Arsenic TrioxideSevereDatabaseDDInter
CisaprideSevereDatabaseDDInter

Mechanism

Chlorothiazide inhibits NaCl transport in the distal convoluted tubule by blocking the Na+-Cl− symporter (ENCC1 or TSC) on the luminal membrane of DCT epithelial cells. Some thiazide diuretics also weakly inhibit carbonic anhydrase.

Indications

edema associated with diseases of the heart (CHF)edema associated with diseases of the liver (hepatic cirrhosis)edema associated with diseases of the kidney (nephrotic syndrome, chronic renal failure, acute glomerulonephritis)hypertensionCa2+ nephrolithiasisosteoporosisnephrogenic diabetes insipidusBr− intoxicationedema associated with congestive heart failureliver cirrhosischronic kidney diseasenephrotic syndromekidney stones caused by Ca2+ crystalsEdema associated with heart failureEdema associated with liver cirrhosisEdema associated with chronic kidney diseaseEdema associated with nephrotic syndrome

Pharmacokinetics

Half-life

~1.5

Bioavailability

9%–56% (dose-dependent)

Excretion

renal excretion of intact drug

Contraindications

hypersensitive to sulfonamides
Gout
Pregnancy

Side effects

Common

vertigoheadachephotosensitivityskin rasheserectile dysfunctionhypokalemiahyperuricemiadecreased glucose toleranceincreased plasma LDL cholesterolincreased plasma total cholesterolincreased plasma total triglyceridesHyponatremiaHypercalcemiaChanges in plasma lipidsGlucose intolerance

Serious

systemic lupus erythematosus
sulfa allergic reactions
extracellular volume depletion
hypotension
hyponatremia (severe, potentially fatal)
hypochloremia
metabolic alkalosis
hypomagnesemia
hypercalcemia
unmask latent diabetes mellitus
Ventricular arrhythmias (due to K+ depletion)
Sudden death (dose-dependent increase with >25mg hydrochlorothiazide equivalent)
Skin cancers (squamous skin cell carcinoma, nonmelanoma basal cell carcinoma - specifically for hydrochlorothiazide, unclear for other thiazides)