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Indications

Hypertension Heart Failure Edema

Thalin is used to treat high blood pressure. It's also used alongside other treatments to relieve fluid retention (edema) linked to congestive heart failure, liver cirrhosis, or the use of corticosteroid or estrogen medicines.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Chlorthalidone is a thiazide-type diuretic and antihypertensive used to treat high blood pressure. It may be used alone or together with other antihypertensive agents. Chlorthalidone is also used as an add-on treatment for fluid retention (edema) associated with kidney disease; mild to moderate congestive heart failure (functional class II or III), when the glomerular filtration rate is greater than 30 ml/min; ascites due to liver cirrhosis in stable patients; estrogen therapy; and corticosteroid therapy.

Chlorthalidone works by inhibiting the reabsorption of sodium and chloride in the distal renal tubule, which promotes water loss. The higher urine volume also increases potassium loss. Little information is available on the drug's absorption. Its long elimination half-life and clinical experience place it among the long-acting thiazide derivatives, and longer-acting agents of this kind tend to cause greater potassium loss.

Although it is a mild diuretic on its own, combining it with loop diuretics produces a particularly potent effect, since loop diuretics deliver much more sodium chloride to the distal tubule. The blood-pressure-lowering effect is initially due to a reduction in fluid volume, but the effect that persists afterward involves other, not fully understood, mechanisms that reduce peripheral resistance. A high salt intake reverses the antihypertensive effect.

Most of an absorbed dose of chlorthalidone is excreted by the kidneys, with an elimination half-life averaging 50 hours. Metabolism and excretion into the bile by the liver account for only a minor part of its elimination. Within 120 hours, about 70% of the dose is excreted, mainly unchanged, in the urine and feces.

Pregnancy & Breastfeeding

Pregnancy: Like other diuretics, Chlorthalidone can reduce blood flow to the placenta. Because it does not prevent or change the course of EPH (edema, proteinuria, hypertension) preeclampsia, it must not be used to treat high blood pressure in pregnant women. For other indications (e.g. heart disease), Chlorthalidone should be avoided during pregnancy, especially in the first trimester, unless the potential benefits outweigh the possible risks, such as when no safer alternative is available.

Lactation: Chlorthalidone passes into breast milk, reaching levels of about 4% of those in the mother's blood. Because of this, it should be avoided in mothers who are breastfeeding.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Therapy should begin with the lowest possible dose, then be adjusted gradually to gain the greatest therapeutic benefit while keeping side effects to a minimum (for example, finding the minimum effective maintenance dose for each patient). A single dose taken once daily or every other day, in the morning with food, is recommended. Hypertension: The usual adult dose is 25 to 50 mg daily, with a clinically useful range of 12.5 to 50 mg daily. Doses above 50 mg per day increase the risk of metabolic complications and rarely offer added therapeutic benefit. For any given dose, the full effect is reached after 3 to 4 weeks. If the blood pressure reduction achieved with 25 or 50 mg per day proves inadequate, combining treatment with other antihypertensive drugs, such as beta blockers and ACE inhibitors, is recommended. When an ACE inhibitor is added, the Chlorthalidone dose should be reduced or stopped. Edema of Specific Origin: The lowest effective dose should be found by gradual adjustment. Maintenance doses should not exceed 50 mg per day and should be given only for limited periods. The dose should be tailored to each patient's clinical picture and response to treatment. For long-term therapy, the lowest dose that maintains an optimal effect should be used, and this is especially important for elderly patients. The therapeutic effect of Chlorthalidone occurs even without restricting salt intake and is well maintained with continued use. The elderly: This drug is suitable for treating hypertension in older adults, particularly systolic hypertension. A dose of 50 mg daily or less should be used to avoid hypovolemia and hypokalemia.

Side Effects & Interactions

Side Effects

No side-effect data recorded yet.