Chlorothiazide (oral route)


    Brand Name

    US Brand Name

    Diuril


    Description

    Chlorothiazide is used to treat fluid retention (edema) that is caused by congestive heart failure, severe liver disease (cirrhosis), kidney disease, or from treatment with a steroid or hormone medicine.

    Chlorothiazide is also used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if the blood pressure is controlled.

    Chlorothiazide is a thiazide diuretic (water pill). It reduces the amount of water in the body by increasing the flow of urine, which helps to lower blood pressure and remove excess fluid (edema).

    This medicine is available only with your doctor's prescription.

    This product is available in the following dosage forms:

    • Suspension
    • Tablet

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies on the relationship of age to the effects of chlorothiazide have not been performed in the pediatric population. However, pediatric-specific problems that would limit the usefulness of this medicine in children are not expected, and no problems have been documented to date.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of chlorothiazide in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment in the dose for patients receiving chlorothiazide.

    Breastfeeding

    Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Acarbose
    • Aceclofenac
    • Acemetacin
    • Acetyldigoxin
    • Albiglutide
    • Albuterol
    • Alogliptin
    • Amphetamine
    • Amtolmetin Guacil
    • Arsenic Trioxide
    • Aspirin
    • Benzhydrocodone
    • Benzphetamine
    • Bepridil
    • Bromfenac
    • Bromocriptine
    • Bufexamac
    • Buprenorphine
    • Canagliflozin
    • Cefepime
    • Celecoxib
    • Chlorpropamide
    • Choline Salicylate
    • Clonixin
    • Codeine
    • Dapagliflozin
    • Deslanoside
    • Desmopressin
    • Dexibuprofen
    • Dexketoprofen
    • Dextroamphetamine
    • Diclofenac
    • Diflunisal
    • Digitalis
    • Digitoxin
    • Digoxin
    • Dihydrocodeine
    • Dipyrone
    • Dofetilide
    • Droxicam

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Aminolevulinic Acid
    • Calcium
    • Ginkgo
    • Gossypol
    • Licorice

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Anuria (not able to form urine)—Should not be used in patients with this condition.
    • Asthma or
    • Diabetes or
    • Gout or
    • Hypercalcemia (high calcium in the blood) or
    • Hypercholesterolemia (high cholesterol in the blood) or
    • Hyperuricemia (high uric acid in the blood) or
    • Hypochloremia (low chloride in the blood) or
    • Hypokalemia (low potassium in the blood) or
    • Hypomagnesemia (low magnesium in the blood) or
    • Hyponatremia (low sodium in the blood) or
    • Liver disease or
    • Systemic lupus erythematosus—Use with caution. This medicine may make these conditions worse.
    • Kidney disease—Use with caution. The effects of the medicine may be increased because of slower removal of the medicine from the body.

    Proper Use

    In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium or potassium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

    Many patients who have high blood pressure will not notice any signs of the problem. In fact, many patients feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

    This medicine will not cure your high blood pressure, but it does help control it. You must continue to receive it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems, such as heart failure, blood vessel disease, stroke, or kidney disease.

    Dosing

    The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

    The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

    • For fluid retention (edema):
      • For oral dosage forms (suspension):
        • Adults—The usual dose is 10 to 20 milliliters (mL) once or twice a day. Your doctor may adjust how often you take your dose.
        • Children—Dose is based on body weight and must be determined by your doctor.
      • For oral dosage forms (tablets):
        • Adults—The usual dose is 500 to 1000 milligrams (mg) once or twice a day. Your doctor may adjust how often you take your dose.
        • Children—Dose is based on body weight and must be determined by your doctor.
    • For high blood pressure:
      • For oral dosage forms (suspension):
        • Adults—The usual dose is 10 to 20 milliliters (mL) once a day as a single dose or in divided doses. Your doctor may adjust your dose if needed.
        • Children—Dose is based on body weight and must be determined by your doctor.
      • For oral dosage forms (tablets):
        • Adults—The usual dose is 500 to 1000 milligrams (mg) once a day as a single dose or in divided doses. Your doctor may adjust your dose if needed.
        • Children—Dose is based on body weight and must be determined by your doctor.

    Missed Dose

    If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

    Storage

    Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

    Keep out of the reach of children.

    Do not keep outdated medicine or medicine no longer needed.

    Ask your healthcare professional how you should dispose of any medicine you do not use.


    Precautions

    It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

    Check with your doctor right away if you have any of the following symptoms while taking this medicine: convulsions or seizures; decreased urine; drowsiness; dry mouth; excessive thirst; muscle pains or cramps; nausea or vomiting; increased heart rate or pulse; or unusual tiredness or weakness. These may be symptoms of a condition called hypokalemia or low potassium.

    This medicine may cause some people to become dizzy. Do not drive, use machines, or do anything else that could be dangerous if you are dizzy.

    Drinking alcoholic beverages may also make the dizziness worse. While you are taking this medicine, be careful to limit the amount of alcohol you drink.

    Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests (e.g., tests for parathyroid function) may be affected by this medicine.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    Incidence not known

    • Abdominal or stomach pain
    • back, leg, or stomach pains
    • black, tarry stools
    • bleeding gums
    • blistering, peeling, or loosening of skin
    • bloating
    • blood in urine or stools
    • bloody urine
    • blue lips and fingernails
    • blurred vision
    • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
    • chest pain
    • chills
    • clay-colored stools
    • cloudy urine
    • cold sweats
    • confusion
    • constipation
    • cough or hoarseness
    • coughing that sometimes produces a pink frothy sputum
    • coughing up blood
    • cracks in the skin
    • darkened urine
    • decrease in urine output or decrease in urine-concentrating ability
    • decreased frequency or amount of urine
    • diarrhea
    • difficult, fast, or noisy breathing, sometimes with wheezing
    • difficulty swallowing
    • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
    • dry mouth
    • fast or irregular heartbeat
    • fever
    • flushed, dry skin
    • fruit-like breath odor
    • general body swelling
    • general feeling of discomfort or illness
    • general feeling of tiredness or weakness
    • greatly decreased frequency of urination or amount of urine
    • headache
    • hives
    • increased blood pressure
    • increased hunger
    • increased sweating
    • increased thirst
    • increased urination
    • indigestion
    • itching
    • joint pain, stiffness, or swelling
    • loss of appetite
    • loss of heat from the body
    • lower back or side pain
    • muscle cramps or pain
    • nausea or vomiting
    • nosebleeds
    • numbness, tingling, pain, or weakness in hands or feet
    • pain in joints or muscles
    • painful or difficult urination
    • pains in stomach, side, or abdomen, possibly radiating to the back
    • pale skin
    • pinpoint red spots on skin
    • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
    • rash
    • red, irritated eyes
    • red skin lesions, often with a purple center
    • red, swollen skin
    • redness, soreness, or itching skin
    • scaly skin
    • seizures
    • shortness of breath
    • sore throat
    • sores, ulcers, or white spots on lips or in mouth
    • sores, welting, or blisters
    • sugar in the urine
    • swelling of face, fingers, legs, ankles, feet, or lower legs
    • swollen or painful glands
    • tenderness of salivary glands
    • thickening of bronchial secretions
    • tightness in chest
    • trembling
    • troubled breathing
    • unpleasant breath odor
    • unusual bleeding or bruising
    • unusual tiredness or weakness
    • unusual weight loss
    • vomiting of blood
    • weakness and heaviness of legs
    • weight gain
    • wheezing
    • yellow eyes or skin

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Incidence not known

    • Cramping
    • decreased interest in sexual intercourse
    • difficulty having a bowel movement (stool)
    • feeling of constant movement of self or surroundings
    • hair loss, thinning of hair
    • inability to have or keep an erection
    • increased sensitivity of skin to sunlight
    • loss in sexual ability, desire, drive, or performance
    • muscle spasm
    • pinpoint red or purple spots on skin
    • redness or other discoloration of skin
    • restlessness
    • sensation of spinning
    • severe sunburn
    • weakness

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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