Clonidine + Chlorthalidone Pharmacology

Clonidine + Chlorthalidone

About Clonidine + Chlorthalidone
Mechanism of Action of Clonidine + Chlorthalidone
Pharmacokinets of Clonidine + Chlorthalidone
Onset of Action for Clonidine + Chlorthalidone
Duration of Action for Clonidine + Chlorthalidone
Half Life of Clonidine + Chlorthalidone
Side Effects of Clonidine + Chlorthalidone
Contra-indications of Clonidine + Chlorthalidone
Special Precautions while taking Clonidine + Chlorthalidone
Pregnancy Related Information
Contraindicated; since Chlorthalidone is contraindicated in pregnancy, the combination generic cannot be used in pregnancy
Old Age Related Information
Breast Feeding Related Information
Contraindicated; since Chlorthalidone is contraindicated in breast feeding, the combination generic cannot be used in breast feeding mother.
Children Related Information
Indications for Clonidine + Chlorthalidone
Interactions for Clonidine + Chlorthalidone
Typical Dosage for Clonidine + Chlorthalidone
1 tablet to be taken once daily
Schedule of Clonidine + Chlorthalidone
Storage Requirements for Clonidine + Chlorthalidone
Effects of Missed Dosage of Clonidine + Chlorthalidone
Effects of Overdose of Clonidine + Chlorthalidone


About Clonidine
Centrally acting Alpha2-Adrenergic Agonist, Sympatholytic Antihypertensive.
Mechanism of Action of Clonidine
Clonidine exerts its action as an antihypertensive agent by stimulating alpha-2A receptors located in regions of brain, such as the nucleus tractus solitarius.Stimulation of these alpha 2 receptors brings about a decrease in sympathetic outflow from the CNS which in turn leads to decrease in peripheral vascular resistance and blood pressure.Bradycardia is also produced by Clonidine as a result of centrally induced facilitation of vagus nerve and stimulation of cardiac prejunctional alpha 2 receptors. Decrease in cardiac out put is due to decrease in stroke volume and bradycardia.
Clonidine has also been used in the prophylactic treatment of migraine or recurrent vascular headaches

Pharmacokinets of Clonidine
Absorption: Well absorbed orally, Distribution: Widely distributed,
Metabolism: Metabolized in liver, Excretion: Excreted mainly through urine.
Onset of Action for Clonidine
24 to 72 hours
Duration of Action for Clonidine
Few days
Half Life of Clonidine
12 hours
Side Effects of Clonidine
2.Mental depression
3.Dryness of mouth, eyes & nose
9.Electrolyte imbalance
11.Withdrawal syndrome
Contra-indications of Clonidine
1.Hypersensitivity to the drug
2.Sick sinus syndrome
3.Disorders of SA node activity and conduction
Special Precautions while taking Clonidine
1.Coronary disorders
2.Myocardial infarction
3.Cerebrovascular diseases
4.Renal impairment
5.Hepatic impairment
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Clonidine
2.Menopausal symptoms
3.Opiate withdrawal
4.Nicotine withdrawal
5.Diabetic diarrhea
6.Growth delay in children
7.Alcohol withdrawal
8.Migraine prophylaxis
9.As a diagnostic agent in pheochromocytoma
Interactions for Clonidine
Typical Dosage for Clonidine
Hypertension: 100 to 200mcg/day orally 12th hourly,Increase if required to600mcg/day,Maximum dose: 2.4 mg/day
Menopausal symptoms:25 to 75 mcg orally 12hourly
Opiate withdrawal: 0.005mg to 0.017mg/kg/day in divided doses for 10 days
Nicotine withdrawal:Starts with 150mcg and increased up to 400mcg orally
Diabetic diarrhea: 150 to 1200mcg/day orally
Migraine prophylaxis:25mcg to 75mcg twice daily
Children: 0.005 to 0.025mg/kg/day
Schedule of Clonidine
Storage Requirements for Clonidine
Store at room temperature.Protect from heat and light.Keep away from children.
Effects of Missed Dosage of Clonidine
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Clonidine
Treatment is supportive and symptomatic. Assure the airway and empty the stomach by gastric lavage. Administer activated charcoal. In case of transdermal patch remove it from the body


About Chlorthalidone
Monosulfamyl diuretic, long acting phthalimidine derivative, thiazides like diuretic, Antihypertensive/diuretic
Mechanism of Action of Chlorthalidone
It is long acting phthalimidine derivative exerts thiazides like diuretic action by acting at site-3(central dilating segment of early distal tubule). It binds to Na+-Cl- symporter and inhibits Na+-Cl- symport at the luminal membrane. It has additional carbonic anhydrase inhibitory actions in proximal tubules. It increases natriuresis, kaliuresis and diuresis. It decreases Ca2+ excretion and increases Mg2+ and hence used to correct hypocalcaemia associated with hypoparathyroidism. The antihypertensive actions of the drug may be attributable to depletion of sodium and subsequent reduction in plasma volume and a decrease in peripheral resistance. Decrease in peripheral resistance is due to either the loss of sodium from the arteriolar wall or a direct action on the vascular bed. It is an effective drug in edema associated with congestive heart failure.
Pharmacokinets of Chlorthalidone
Absorption: Slowly absorbed after oral administration. Distribution: It preferentially bound to renal tissues for prolonged periods. Metabolism: It is not significantly metabolized in the body. Excretion: Excreted mainly through urine and a small portion is excreted through bile.
Onset of Action for Chlorthalidone
1 to 3 hours
Duration of Action for Chlorthalidone
48 to 72 hours
Half Life of Chlorthalidone
40 to 50 hours
Side Effects of Chlorthalidone
5.Dry mouth
10.Elevated levels of glucose, calcium, and lipids
11.Altered liver function tests
12.Altered kidney function tests
13.Gastro intestinal disturbances
15.Visual impairment
16.Electrolyte imbalance
Contra-indications of Chlorthalidone
1.Hypersensitivity to the drug
4.Renal impairment
5.Hepatic impairment
9.Addison`s disease
10.Chronic obstructive pulmonary diseases
Special Precautions while taking Chlorthalidone
2.Hepatic diseases
3.Renal impairment
4.Fluid and electrolyte imbalance
6.Severe heart failure
8.Diabetes mellitus
9.Ventricular extra systoles
Pregnancy Related Information
Old Age Related Information
Use with caution
Breast Feeding Related Information
Children Related Information
Use with caution
Indications for Chlorthalidone
2.Oedema associated with heart failure
3.Oedema due to renal and hepatic diseases
4.Ascites due to cirrhosis.
Interactions for Chlorthalidone
Cholestyramine & Colestipol : decrease absorption of chlorthalidone.
Diazoxide : Additive action may cause hyperglycemia, hyperuricaemia and hypotension.
Digitalis : Diuretic induced hypokalaemia may precipitate digitalis toxicity.
Lithium : Chlorthalidone potentiates therapeutic and toxic effects by decreasing its renal excretion.
Frusemide :Synergy leading to profound diuresis and greater than predicted electrolyte loss.
Non-depolarizing muscle relaxants : Diuretic induced hypokalaemia enhances efficacy.
Sulfonylureas : Efficacy decreased due to chlorthalidone induced glucose intolerance.
Chlorpropamide : Hypokalemia.
Propantheline : Bioavailability of chlorthalidone increased.
Metoclopramide : Bioavailability of chlorthalidone decreased.
NSAID?s : Natriuretic effect of chlorthalidone decreased.
Typical Dosage for Chlorthalidone
Hypertension: 25mg daily. Increased to 50mg if required; depending up on the patient`s response.
Oedema: Starts with 50mg. Increased to 100 to 200mg on alternate days; if required.
Maintenance dosage: 25 to 50mg daily or on alternate days.
Children: Hypertension:2mg/kg/day; thrice a week.
Schedule of Chlorthalidone
Storage Requirements for Chlorthalidone
Store at a cool dry place; and at a temperature below 30 degree C. in a well closed container.
Effects of Missed Dosage of Chlorthalidone
Effects of Overdose of Chlorthalidone
Treatment is supportive and symptomatic. Remove drug from the body by induced emesis and gastric lavage. Monitor and support fluid and electrolyte balance.

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