http://www.fpnotebook.com/
Thiazide Diuretic
Aka: Thiazide Diuretic, Thiazide, Hydrochlorothiazide, Chlorthiazide, Chlorthalidone, Indapamide, Metolazone, Zaroxolyn- Indications
- Hypertension (first-line agent)
- Osteoporosis Prevention (investigational)
- Severe Congestive Heart Failure
- Adjunct to Loop Diuretics
- Meniere's Disease
- Precautions: Renal Insufficiency (GFR <30 ml/min)
- Thiazide Diuretics are minimally effective when GFR falls below 30 ml/min
- Switch to Loop Diuretics at this level of renal insufficiency
- Adverse effects
- Hyperuricemia
- Occurs more often with doses over 25mg
- Less of an issue if avoid Hypokalemia
- Avoid Thiazide Diuretics in gout!
- Hyperglycemia
- Hyperlipidemia
- Hypokalemia
- One banana a day is sufficient Potassium Replacement
- Each inch of banana supplies 1 meq of potassium
- Cost benefit is lost when potassium supplement used
- One banana a day is sufficient Potassium Replacement
- Hyponatremia
- Hypomagnesemia
- Hyperuricemia
- Preparations:
- Hydrochlorothiazide (Esidrex, HydroDIURIL)
- Hypertension: 12 to 25 mg orally daily
- Hydrochlorothiazide and Triamterene
- Hctz/Triamterene 25/50 (Dyazide) one daily
- Hctz/Triamterene 50/75 (Maxzide) one daily
- Chlorothiazide (Diuril)
- Hypertension: 125-250 orally daily or divided bid
- Chlorthalidone (Hygroton)
- Hypertension: 12.5 to 25 mg orally daily
- May be preferred over Hydrochlorothiazide
- Longer half life than Hydrochlorothiazide
- Two to three times as potent as Hydrochlorothiazide
- Conversion: Use 12.5 mg of Chlorthalidone in place of 25 mg Hydrochlorothiazide
- Consider monitoring Serum Potassium more often (may be non-issue in combination with ACE Inhibitor or ARB)
- (2012) Presc Lett 19(2): 8
- Indapamide (Lozol)
- Hypertension: 1.25 to 5 mg orally daily
- Metolazone (Zaroxolyn)
- Hypertension: 0.5 mg orally daily (max: 1 mg daily)
- CHF with edema: 2.5 mg daily (max: 20 mg/day)
- Hydrochlorothiazide (Esidrex, HydroDIURIL)
| Medication Costs | ||
|---|---|---|
| HYDROCHLOROTHIAZIDE (on 2/10/2012 at Target.com) | ||
| HYDROCHLOROTHIAZIDE 12.5 MG* Capsule | #30 for $4.00 | ($0.13/unit) |
| HYDROCHLOROTHIAZIDE 25 MG Tablet | #30 for $4.00 | ($0.13/unit) |
| HYDROCHLOROTHIAZIDE 50 MG Tablet | #30 for $4.00 | ($0.13/unit) |
| INDAPAMIDE (on 2/10/2012 at Target.com) | ||
| INDAPAMIDE 1.25 MG Tablet | #30 for $4.00 | ($0.13/unit) |
| INDAPAMIDE 2.5 MG Tablet | #30 for $4.00 | ($0.13/unit) |
| Captopril-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com) | ||
| Captopril-Hydrochlorothiazide 50-15mg Tablets | #60 for $53.99 | ($0.90/unit) |
| Captopril-Hydrochlorothiazide 25-15mg Tablets | #90 for $47.99 | ($0.53/unit) |
| Captopril-Hydrochlorothiazide 25-25mg Tablets | #90 for $44.99 | ($0.50/unit) |
| Captopril-Hydrochlorothiazide 50-25mg Tablets | #60 for $54.99 | ($0.92/unit) |
| Nadolol-Bendroflumethiazide (on 2/9/2012 at DrugStore.com) | ||
| Nadolol-Bendroflumethiazide 40-5mg Tablets | #100 for $219.99 | ($2.20/unit) |
| Hydrochlorothiazide (on 2/9/2012 at DrugStore.com) | ||
| Hydrochlorothiazide 50mg Tablets | #100 for $15.99 | ($0.16/unit) |
| Hydrochlorothiazide 12.5mg Tablets | #100 for $27.99 | ($0.28/unit) |
| Hydrochlorothiazide 12.5mg Capsules | #30 for $14.99 | ($0.50/unit) |
| Hydrochlorothiazide 25mg Tablets | #100 for $12.99 | ($0.13/unit) |
| Benazepril-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com) | ||
| Benazepril-Hydrochlorothiazide 5-6.25mg Tablets | #30 for $25.91 | ($0.86/unit) |
| Benazepril-Hydrochlorothiazide 10-12.5mg Tablets | #30 for $22.99 | ($0.77/unit) |
| Benazepril-Hydrochlorothiazide 20-12.5mg Tablets | #30 for $26.99 | ($0.90/unit) |
| Benazepril-Hydrochlorothiazide 20-25mg Tablets | #30 for $26.99 | ($0.90/unit) |
| Bisoprolol-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com) | ||
| Bisoprolol-Hydrochlorothiazide 10-6.25mg Tablets | #30 for $22.99 | ($0.77/unit) |
| Bisoprolol-Hydrochlorothiazide 2.5-6.25mg Tablets | #90 for $59.99 | ($0.67/unit) |
| Bisoprolol-Hydrochlorothiazide 5-6.25mg Tablets | #90 for $19.96 | ($0.22/unit) |
| Chlorothiazide (on 2/9/2012 at DrugStore.com) | ||
| Chlorothiazide 250mg Tablets | #30 for $14.99 | ($0.50/unit) |
| Chlorothiazide 500mg Tablets | #30 for $14.99 | ($0.50/unit) |
| Methyclothiazide (on 2/9/2012 at DrugStore.com) | ||
| Methyclothiazide 5mg Tablets | #30 for $54.99 | ($1.83/unit) |
| Metoprolol-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com) | ||
| Metoprolol-Hydrochlorothiazide 50-25mg Tablets | #60 for $63.99 | ($1.07/unit) |
| Metoprolol-Hydrochlorothiazide 100-25mg Tablets | #30 for $50.99 | ($1.70/unit) |
| Metoprolol-Hydrochlorothiazide 100-50mg Tablets | #30 for $55.99 | ($1.87/unit) |
| Quinapril-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com) | ||
| Quinapril-Hydrochlorothiazide 10-12.5mg Tablets | #30 for $35.99 | ($1.20/unit) |
| Quinapril-Hydrochlorothiazide 20-25mg Tablets | #90 for $90.99 | ($1.01/unit) |
| Quinapril-Hydrochlorothiazide 20-12.5mg Tablets | #90 for $86.99 | ($0.97/unit) |
| Amiloride-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com) | ||
| Amiloride-Hydrochlorothiazide 5-50mg Tablets | #90 for $31.99 | ($0.36/unit) |
| Methyldopa-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com) | ||
| Methyldopa-Hydrochlorothiazide 250-25mg Tablets | #60 for $22.99 | ($0.38/unit) |
| Moexipril-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com) | ||
| Moexipril-Hydrochlorothiazide 7.5-12.5mg Tablets | #30 for $37.99 | ($1.27/unit) |
| Moexipril-Hydrochlorothiazide 15-12.5mg Tablets | #100 for $109.98 | ($1.10/unit) |
| Moexipril-Hydrochlorothiazide 15-25mg Tablets | #30 for $36.99 | ($1.23/unit) |
| Enalapril-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com) | ||
| Enalapril-Hydrochlorothiazide 10-25mg Tablets | #30 for $27.99 | ($0.93/unit) |
| Enalapril-Hydrochlorothiazide 5-12.5mg Tablets | #30 for $23.99 | ($0.80/unit) |
| Lisinopril-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com) | ||
| Lisinopril-Hydrochlorothiazide 10-12.5mg Tablets | #30 for $23.99 | ($0.80/unit) |
| Lisinopril-Hydrochlorothiazide 20-12.5mg Tablets | #30 for $21.99 | ($0.73/unit) |
| Lisinopril-Hydrochlorothiazide 20-25mg Tablets | #30 for $21.99 | ($0.73/unit) |
| Chlorthalidone (on 2/9/2012 at DrugStore.com) | ||
| Chlorthalidone 50mg Tablets | #30 for $26.99 | ($0.90/unit) |
| Chlorthalidone 25mg Tablets | #90 for $45.99 | ($0.51/unit) |
| Chlorthalidone 100mg Tablets | #30 for $33.99 | ($1.13/unit) |
| Atenolol-Chlorthalidone (on 2/9/2012 at DrugStore.com) | ||
| Atenolol-Chlorthalidone 50-25mg Tablets | #30 for $13.99 | ($0.47/unit) |
| Atenolol-Chlorthalidone 100-25mg Tablets | #90 for $30.99 | ($0.34/unit) |
| Indapamide (on 2/9/2012 at DrugStore.com) | ||
| Indapamide 1.25mg Tablets | #90 for $15.99 | ($0.18/unit) |
| Indapamide 2.5mg Tablets | #30 for $13.99 | ($0.47/unit) |
| Metolazone (on 2/9/2012 at DrugStore.com) | ||
| Metolazone 5mg Tablets | #30 for $37.99 | ($1.27/unit) |
| Metolazone 2.5mg Tablets | #30 for $42.99 | ($1.43/unit) |
| Zaroxolyn (on 2/9/2012 at DrugStore.com) | ||
| Zaroxolyn 10mg Tablets | #30 for $79.99 | ($2.67/unit) |
| Zaroxolyn 5mg Tablets | #30 for $88.99 | ($2.97/unit) |
| Zaroxolyn 2.5mg Tablets | #30 for $94.99 | ($3.17/unit) |
| FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. | ||
Chlorthalidone (C0008294) |
|
|---|---|
| Definition (MSH) | A benzenesulfonamide-phthalimidine that tautomerizes to a BENZOPHENONES form. It is considered a thiazide-like diuretic. |
| Definition (NCI) | A thiazide diuretic of the sulfamoylbenzamide class. Chlorthalidone directly inhibits sodium and chloride reabsorption on the luminal membrane of the early segment in the distal convoluted tubule in the kidney. This leads to an increase in water, sodium, chloride, bicarbonate, and potassium secretion and a decrease in calcium and uric acid secretion. Chlorthalidone is used in the treatment of high blood pressure, edema and congestive heart failure. |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D002752 |
| SnomedCT | 387324004, 57893000 |
| English | Chlorphthalidolone, Chlorthalidone, Oxodoline, Phthalamudine, chlorthalidone, Benzenesulfonamide, 2-chloro-5-(2,3-dihydro-1-hydroxy-3-oxo-1H-isoindol-1-yl)-, Chlortalidone, Benzenesulfonamide, 2-Chloro-5-(2,3-dihydro-1-hydroxy-3-oxo-1H-isoindol-1-yl)-, Benzenesulfonamide, 2-chloro-5-(1-hydroxy-3-oxo-1-isoindolinyl)-, chlorthalidone (medication), CHLORTHALIDONE, Chlorthalidone [Chemical/Ingredient], chlortalidone, Chlorthalidone (product), Chlorthalidone (substance) |
| Swedish | Klortalidon |
| Czech | chlorthalidon |
| Finnish | Klooritalidoni |
| French | Phthalamudine, Chlorphthalidolone, Chlortalidone |
| Russian | KHLORTALIDON, FTALAMUDIN, KHLORFTALIDOLON, ФТАЛАМУДИН, ХЛОРТАЛИДОН, ХЛОРФТАЛИДОЛОН |
| Japanese | クロルサリドン, クロルフタリドロン, フタルアムジン, クロルタリドン |
| Croatian | KLORTALIDON |
| Polish | Chlortalidon |
| Spanish | clortalidona (producto), clortalidona (sustancia), clortalidona, Clorftalidolona, Clortalidona, Ftalamudina |
| German | Chlorphthalidolon, Chlortalidon, Chlorthalidon, Phthalamudin |
| Italian | Clortalidone |
| Portuguese | Clorftalidolona, Clortalidona, Ftalamudina |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Thiazide Diuretics (C0012802) |
|
|---|---|
| Definition (MSH) | Diuretics characterized as analogs of 1,2,4-benzothiadiazine-1,1-dioxide. All have a common mechanism of action and differ primarily in the dose required to produce a given effect. They act directly on the kidney to increase the excretion of sodium chloride and water and also increase excretion of potassium ions. |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D049993 |
| SnomedCT | 372747003, 45518007, 371342005, 350616005, 371343000 |
| English | THIAZIDE DIURETICS, Thiazide diuretic, NOS, THIAZIDES/RELATED DIURETICS, thiazides, thiazide diuretics, 722 THIAZIDE DIURETICS, thiazide diuretics (medication), THIAZIDE DIURETIC, [CV701] THIAZIDES/RELATED DIURETICS, Thiazide Diuretic, Thiazide Diuretic [EPC], Thiazide-class Diuretic, thiazide diuretic, diuretic thiazide, diuretics thiazide, diuretic thiazides, Thiazide diuretic, Thiazide diuretic (substance), Thiazide diuretic (product), Thiazide diuretic product, Thiazide Diuretics, Thiazide diuretic product (product), Thiazide-related diuretic (substance), Thiazide-related diuretic product (product), Thiazide-related diuretic product, Thiazide-related diuretic (product), Thiazide-related diuretic, Thizaide-related diuretic, Benzothiadiazine Diuretics, Diuretics, Benzothiadiazine, Diuretics, Thiazide |
| French | Diurétiques thiazides, Diurétiques thiazidiques, Benzothiadiazides, Diurétiques thiaziques |
| Spanish | diurético relacionado con las tiazidas (producto), diurético relacionado con las tiazidas, diurético tipo tiazida, diurético tiazídico (sustancia), diurético tiazídico, producto (producto), diurético tiazídico, producto, diurético tiazídico, diurético tipo tiazida (producto), diurético tipo tiazida (sustancia), producto con diurético tiazídico (producto), producto con diurético tiazídico, diurético tiazídico (producto), tiazida |
| Czech | diuretika thiazidová |
| German | Diuretika, Thiazid-, Benzothiadiazindiuretika, Thiaziddiuretika |
| Italian | Diuretici tiazidici |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Hydrochlorothiazide (C0020261) |
|
|---|---|
| Definition (MSH) | A thiazide diuretic often considered the prototypical member of this class. It reduces the reabsorption of electrolytes from the renal tubules. This results in increased excretion of water and electrolytes, including sodium, potassium, chloride, and magnesium. It is used in the treatment of several disorders including edema, hypertension, diabetes insipidus, and hypoparathyroidism. |
| Definition (CHV) | drug that increases voiding |
| Definition (CHV) | drug that increases voiding |
| Definition (NCI) | The hydrogenated derivative of chlorothiazide, a thiazide diuretic with antihypertensive and anti-urolithic effects. This agent binds to the electroneutral Na-K-Cl cotransporter (NKCC) and thereby impairs Na+, K+ and Cl- reabsorption on the luminal membrane of the early segment in the distal convoluted tubule in the kidney. This leads to an increase in urinary excretion of sodium, chloride, potassium, bicarbonate and water subsequently reducing plasma and extracellular fluid volume leading to a reduction in blood pressure. Hydrochlorothiazide also decreases urinary calcium and uric acid excretion by direct action on the distal tubule. |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D006852 |
| SnomedCT | 387525002, 91667005 |
| English | Dichlothiazide, Dihydrochlorothiazide, HCTZ, Hydrochlorothiazide, 2H-1,2,4-Benzothiadiazine-7-sulfonamide, 6-chloro-3,4-dihydro-, 1,1-dioxide, 6-Chloro-3,4-dihydro-2H-1,2,4-benzothiadiazine-7-sulfonamide 1,1-dioxide, hydrochlorothiazide, hydrochlorothiazide (medication), HYDROCHLOROTHIAZIDE, Hydrochlorothiazide [Chemical/Ingredient], hctz, Hydrochlorothiazide (product), Hydrochlorothiazide (substance) |
| Spanish | Hidroclorotiazida, hidroclorotiazida (producto), hidroclorotiazida (sustancia), hidroclorotiazida |
| Swedish | Hydroklortiazid |
| Czech | hydrochlorthiazid |
| Finnish | Hydroklooritiatsidi |
| Russian | NEFRIKS, GIPOTIAZID, EZIDREKS, GIDROKHLOROTIAZID, DIKHLOTIAZID, GIDROKHLORTIAZID, ГИДРОХЛОРОТИАЗИД, ГИДРОХЛОРТИАЗИД, ГИПОТИАЗИД, НЕФРИКС, ЭЗИДРЕКС, ДИХЛОТИАЗИД |
| Japanese | ヒドロクロロチアジド |
| Italian | HCTZ, Diidroclorotiazide, Idroclorotiazide |
| Croatian | HIDROKLOROTIAZID |
| Polish | Hydrochlorotiazyd |
| French | Hydrochlorothiazide |
| German | Hydrochlorothiazid |
| Portuguese | Hidroclorotiazida |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Indapamide (C0021186) |
|
|---|---|
| Definition (MSH) | A benzamide-sulfonamide-indole. It is called a thiazide-like diuretic but structure is different enough (lacking the thiazo-ring) so it is not clear that the mechanism is comparable. |
| Definition (NCI) | An indole derivative of chlorosulphonamide and a sulfamyl diuretic with antihypertensive activity. Indapamide may interact directly with the subunits of delayed rectifier potassium channels, thereby blocking both slow and rapid K+ (IKs and IKr) currents through the channels. Through the homeostasis mechanism in balancing total ion concentration (Ca++, Na+), it reduces vascular hyperreactivity and peripheral and arterial vascular resistance, possibly by inhibiting transmembrane ionic influx, probably calcium ions, and stimulating prostaglandin E2 synthesis, thereby causing vasodilatation. Indapamide exerts its diuretic effect by inhibiting reabsorption of sodium and chloride, primarily as a result of action on the cortical diluting segment of the renal distal tubule, thereby promoting urinary excretion of water and electrolytes. |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D007190 |
| SnomedCT | 387419003, 74213004 |
| English | Indapamide, Metindamide, Benzamide, 3-(aminosulfonyl)-4-chloro-N-(2,3-dihydro-2-methyl-1H-indol-1-yl)-, indapamide, indapamide (medication), INDAPAMIDE, Indapamide [Chemical/Ingredient], Indapamide (product), Indapamide (substance) |
| Swedish | Indapamid |
| Czech | indapamid |
| Finnish | Indapamidi |
| Russian | INDAPAMID, METINDAMID, ИНДАПАМИД, МЕТИНДАМИД |
| Japanese | インダパミド, メチンダミド |
| Polish | Indapamid |
| Spanish | indapamida (producto), indapamida (sustancia), indapamida, Indapamida, Metindamida |
| French | Indapamide |
| German | Indapamid, Metindamid |
| Italian | Indapamide |
| Portuguese | Indapamida, Metindamida |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Metolazone (C0025854) |
|
|---|---|
| Definition (MSH) | A quinazoline-sulfonamide that is considered a thiazide-like diuretic which is long-acting so useful in chronic RENAL FAILURE. It also tends to lower BLOOD PRESSURE and increase POTASSIUM loss. |
| Definition (NCI) | A sulfonamide derivative and a member of the quinazoline family, chemically related to thiazides, with diuretic, antihypertensive and antiurolithic properties. By blocking Na/Cl transporter, metolazone inhibits electrolyte reabsorption in the distal convoluted tubule and proximal tubule in the kidney. This prevents salt and fluid retention, leading to decreased plasma volume and reduce peripheral resistance of blood vessels, thereby reversal of hypertension. |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D008788 |
| SnomedCT | 22198003, 387123003 |
| English | Metolazone, 6-Quinazolinesulfonamide, 7-chloro-1,2,3,4-tetrahydro-2-methyl-3-(2-methylphenyl)-4-oxo-, 2-Methyl-3-o-tolyl-6-sulfamyl-7-chloro-1,2,3,4-tetrahydro-4-quinazolinone, 7-Chloro-1,2,3,4-tetrahydro-2-methyl-3-(2-methylphenyl)-4-oxo-6-quinazolinesulfonamide, 7-Chloro-1,2,3,4-tetrahydro-2-methyl-4-oxo-3-o-tolyl-6-quinazolinesulfonamide, metolazone, Metolazene, metolazone (medication), METOLAZONE, Metolazone [Chemical/Ingredient], Metolazone (product), Metolazone (substance) |
| Swedish | Metolazon |
| Czech | metolazon |
| Finnish | Metolatsoni |
| Russian | METOLAZON, МЕТОЛАЗОН |
| Japanese | メトラゾン |
| Polish | Metolazon |
| Spanish | metolazona (producto), metolazona (sustancia), metolazona, Metolazona |
| French | Métolazone |
| German | Metolazon |
| Italian | Metolazone |
| Portuguese | Metolazona |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Thiazides (C0541746) |
|
|---|---|
| Definition (CSP) | family of bicyclic compounds in which one ring has a sulfony l and 2 nitrogen heteroatoms; they inhibit renal sodium resorption, and so are used as diuretics and antihypertensives. |
| Definition (MSH) | Heterocyclic compounds with SULFUR and NITROGEN in the ring. This term commonly refers to the BENZOTHIADIAZINES that inhibit SODIUM-POTASSIUM-CHLORIDE SYMPORTERS and are used as DIURETICS. |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D049971 |
| Italian | Tiazidi |
| Swedish | Tiazider |
| English | thiazide, Thiazides, Thiazides [Chemical/Ingredient], thiazides |
| Czech | thiazidy |
| Finnish | Tiatsididiureetit |
| Russian | TIAZIDY, ТИАЗИДЫ |
| Croatian | Not Translated[Thiazides] |
| Polish | Tiazydu pochodne |
| Portuguese | Tiazidas |
| German | Thiazide |
| French | Thiazides |
| Spanish | Tiacidas, Tiazidas |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Zaroxolyn (C0701383) |
|
|---|---|
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D008788 |
| English | zaroxolyn, Zaroxolyn |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |