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CARDIOVASCULAR SYSTEM › DIURETICS › DIURETICS AND POTASSIUM-SPARING AGENTS IN COMBINATION › Low-ceiling diuretics and potassium-sparing agents
chlortalidone and potassium-sparing agents
C03EA06
Forms & Strengths
- Tablets: 25mg chlortalidone with 25mg spironolactone
- Tablets: 25mg chlortalidone with 50mg amiloride
- Tablets: 50mg chlortalidone with 25mg triamterene
Adult Dosing
- Edema: 50-100mg/day chlortalidone with 25-50mg/day spironolactone
- Hypertension: 25-50mg/day chlortalidone with 25mg/day amiloride
- Dosage adjustment based on patient response and potassium levels
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
- Use with caution in pediatric patients due to potential for hyperkalemia
- Dosing should be individualized based on patient response and potassium levels
Indications
- Treatment of edema associated with congestive heart failure
- Treatment of edema associated with nephrotic syndrome
- Treatment of hypertension
Mechanism of Action
- Chlortalidone inhibits sodium reabsorption in the distal convoluted tubule
- Potassium-sparing agents block aldosterone-mediated sodium reabsorption
- Increased excretion of sodium and water, decreased excretion of potassium
Contraindications
- Anuria or acute kidney injury
- Hyperkalemia
- Severe hepatic impairment
Adverse Reactions
- Hyperkalemia
- Hypokalemia
- Hyponatremia
- Impaired renal function
- Gynecomastia with spironolactone
Drug Interactions
- ACE inhibitors: increased risk of hyperkalemia
- Angiotensin II receptor blockers: increased risk of hyperkalemia
- Potassium supplements: increased risk of hyperkalemia
- Lithium: increased risk of lithium toxicity
Curated Content: Needs Vetting Before Put to Clinical Use