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- Pharmacology For Clonidine + Hydrochlorothiazide
Clonidine + Hydrochlorothiazide Pharmacology
Clonidine + HydrochlorothiazideAbout Clonidine + HydrochlorothiazideN/AMechanism of Action of Clonidine + HydrochlorothiazideN/APharmacokinets of Clonidine + HydrochlorothiazideN/AOnset of Action for Clonidine + HydrochlorothiazideN/ADuration of Action for Clonidine + HydrochlorothiazideN/AHalf Life of Clonidine + HydrochlorothiazideN/ASide Effects of Clonidine + HydrochlorothiazideN/AContra-indications of Clonidine + HydrochlorothiazideN/ASpecial Precautions while taking Clonidine + HydrochlorothiazideN/APregnancy Related InformationContraindicated; since Hydrochlorothiazide is contraindicated in pregnancy, the combination generic cannot be used in pregnancyOld Age Related InformationN/ABreast Feeding Related InformationContraindicated; since Hydrochlorothiazide is contraindicated in breast feeding, the combination generic cannot be used in breast feeding mother.Children Related InformationN/AIndications for Clonidine + Hydrochlorothiazide1.HypertensionInteractions for Clonidine + HydrochlorothiazideN/ATypical Dosage for Clonidine + Hydrochlorothiazide1 tablet to be taken once dailySchedule of Clonidine + HydrochlorothiazideN/AStorage Requirements for Clonidine + HydrochlorothiazideN/AEffects of Missed Dosage of Clonidine + HydrochlorothiazideN/AEffects of Overdose of Clonidine + HydrochlorothiazideN/A
ClonidineAbout ClonidineCentrally acting Alpha2-Adrenergic Agonist, Sympatholytic Antihypertensive. Mechanism of Action of ClonidineClonidine 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 ClonidineAbsorption: Well absorbed orally, Distribution: Widely distributed,
Metabolism: Metabolized in liver, Excretion: Excreted mainly through urine.
Onset of Action for Clonidine24 to 72 hoursDuration of Action for ClonidineFew daysHalf Life of Clonidine12 hoursSide Effects of Clonidine1.Sedation
3.Dryness of mouth, eyes & nose
Contra-indications of Clonidine1.Hypersensitivity to the drug
2.Sick sinus syndrome
3.Disorders of SA node activity and conduction
Special Precautions while taking Clonidine1.Coronary disorders
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with cautionIndications for Clonidine1.Hypertension
6.Growth delay in children
9.As a diagnostic agent in pheochromocytoma
Interactions for ClonidineN/ATypical Dosage for ClonidineAdult
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 ClonidineHStorage Requirements for ClonidineStore at room temperature.Protect from heat and light.Keep away from children.Effects of Missed Dosage of ClonidineTake 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 ClonidineTreatment 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
HydrochlorothiazideAbout HydrochlorothiazideThiazide derivatibve, Diuretic.Mechanism of Action of HydrochlorothiazideIt is thiazide diuretic which exerts its 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+excretion. It also has minor carbonic anhydrase inhibitory action. It also causes direct arteriolar vasodilatation and decreases total peripheral resistance. 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.
Vertigo: Diuretics are used in vertigo in assumption that vertigo is due to endolymphatic hydrops. They reduce labyrinthine fluid pressure
Pharmacokinets of HydrochlorothiazideAbsorption: It is absorbed after oral administration.
Metabolism: It is not metabolized in the body.
Excretion: Excreted unchanged in urine.
Onset of Action for Hydrochlorothiazide1 to 3 hoursDuration of Action for Hydrochlorothiazide12 to 16 hoursHalf Life of Hydrochlorothiazide5 to 15 hoursSide Effects of Hydrochlorothiazide1. Dizziness
2. Blurred vision
4. Tingling fingers
5. Dry mouth
14. Elevated levels of glucose, calcium and lipids
15. Gastro intestinal disturbances
17. Electrolyte imbalance
24. Muscle cramps
26. Blood dyscrasias
Contra-indications of Hydrochlorothiazide1. Hyper uricaemia
2. Hyper calcaemia
3. Renal impairment
4. Hepatic impairment
6. Hypersensitivity to the drug
7. Hyper sensitivity to sulfonamides
8. Fluid and electrolyte imbalance
Special Precautions while taking Hydrochlorothiazide1. Gout
2. Diabetes mellitus
3. Renal impairment
4. Hepatic impairment
5. Monitor and correct Fluid and electrolyte imbalance
6. Hyper parathyroidism
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationMay be usedIndications for Hydrochlorothiazide1. Hypertension
2. Oedema associated with heart failure
3. Oedema due to renal and hepatic diseases
4. Diabetes insipidus
5. Idiopathic hypercalciurea.
Interactions for HydrochlorothiazideCholestyramine & Colestipol: decrease absorption of hydrochlorothiazide.
Diazoxide: Additive action - may cause hyperglycemia, hyperuricaemia and hypotension.
Digitalis: Diuretics induced hypokalaemia may precipitate digitalis toxicity.
Lithium: Hydrochlorothiazide potentiates therapeutic and toxic effects by increasing its renal excretion.
Frusemide: Synergy leading to profound diuresis and greater than predicted electrolyte loss.
Non-depolarizing muscle relaxants: Diuretics induced hypokalaemia enhances efficacy.
Sulfonylureas: Efficacy decreased due to hydrochlorothiazide induced glucose intolerance.
Propantheline: Bioavailability of hydrochlorothiazide increased.
Metoclopramide: Bioavailability of hydrochlorothiazide decreased.
NSAIDs: Natriuretic effect of hydrochlorothiazide decreased.
Typical Dosage for HydrochlorothiazideAdults:
Hypertension: 25mg once daily or in divided doses. Increased to 50mg if required; depending up on the patient`s response.
Children: 1mg/kg single daily dose.
Starts with 25 to 50mg. Increased the dose until desired response is obtained.
Maximum dose: 200mg/day
Maintenance dosage: 25 to 100mg daily or on alternate days.
Children: 1mg/kg single daily dose or 1 to 3mg/kg/day in two divided doses
Schedule of HydrochlorothiazideGStorage Requirements for HydrochlorothiazideStore at room temperature in a well closed container and protected from light.Effects of Missed Dosage of HydrochlorothiazideTake 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 HydrochlorothiazideTreatment is supportive and symptomatic. Remove drug from the body by induced emesis and gastric lavage. Monitor and assist respiratory, cardiovascular, and renal function as indicated. Monitor and support fluid and electrolyte balance.
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