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CARDIOVASCULAR SYSTEM › ANTIHYPERTENSIVES › ANTIHYPERTENSIVES AND DIURETICS IN COMBINATION › Alkaloids, excl. rauwolfia, in combination with diuretics
veratrum and diuretics
C02LK01
Forms & Strengths
- Veratrum viride 2.5mg, Deslanoside 0.25mg tablets
- Veratrum viride 5mg, Chlorothiazide 250mg tablets
- Veratrum viride 2.5mg, Hydrochlorothiazide 25mg tablets
- Injectable solutions of Veratrum alkaloids with diuretics
Adult Dosing
- Veratrum viride 2.5mg, Deslanoside 0.25mg: 1-2 tablets orally twice daily
- Veratrum viride 5mg, Chlorothiazide 250mg: 1 tablet orally twice daily
- Initial dose: 2.5mg Veratrum viride with 25mg Hydrochlorothiazide orally once daily
Pediatric Dosing
- Children under 12 years: not recommended
- 12-18 years: dose reduction and close monitoring of electrolytes, ECG
Indications
- Treatment of hypertension with fluid retention
- Edema associated with CHF, cirrhosis, nephrotic syndrome
- Diuretic-resistant edema
Mechanism of Action
- Veratrum alkaloids decrease sympathetic tone, reducing vasoconstriction
- Diuretics increase sodium and water excretion, decreasing fluid retention
Contraindications
- Hypersensitivity to Veratrum or diuretics
- Severe hypotension, bronchial asthma, hyperkalemia
- Digitalis toxicity, AV block, Adams-Stokes syndrome
Adverse Reactions
- Gastrointestinal disturbances, hypokalemia, dehydration
- Dizziness, headache, bradycardia, AV block
- Hyperglycemia, gout, impotence, menstrual irregularity
Drug Interactions
- Digitalis: increased risk of digitalis toxicity
- Quinidine: potential for additive cardiotoxic effects
- Lithium: decreased lithium clearance, increased toxicity risk
- Other antihypertensive agents: potential for excessive hypotension
Curated Content: Needs Vetting Before Put to Clinical Use