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CARDIOVASCULAR SYSTEM › DIURETICS › DIURETICS AND POTASSIUM-SPARING AGENTS IN COMBINATION › Low-ceiling diuretics and potassium-sparing agents
cyclopenthiazide and potassium-sparing agents
C03EA07
Forms & Strengths
- Combination tablet: Cyclopenthiazide 0.25 mg / Potassium-sparing diuretic (e.g., Amiloride 2.5 mg or Spironolactone 25 mg)
- Combination tablet: Cyclopenthiazide 0.5 mg / Potassium-sparing diuretic
Adult Dosing
- Hypertension: 1 tablet daily, administered in the morning
- Edema: 1 to 2 tablets daily in the morning, adjusted according to response
- Maintenance: 1 tablet daily or on alternate days as required
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
- Use in children is generally not recommended
Indications
- Essential hypertension
- Edema associated with congestive heart failure
- Hepatic cirrhosis with ascites (with caution)
- Prevention of thiazide-induced hypokalemia
Mechanism of Action
- Cyclopenthiazide inhibits sodium and chloride reabsorption in the distal convoluted tubules, increasing excretion of sodium, water, and potassium
- Potassium-sparing agent acts on the distal renal tubules to inhibit sodium reabsorption and potassium excretion, mitigating thiazide-induced hypokalemia
Contraindications
- Hypersensitivity to cyclopenthiazide, sulfonamide-derived drugs, or the potassium-sparing component
- Anuria or severe renal failure (CrCl < 30 mL/min)
- Hyperkalemia or conditions predisposing to hyperkalemia
- Addison's disease
- Severe hepatic impairment or hepatic coma
- Refractory hyponatremia
Adverse Reactions
- Hyperkalemia (due to the potassium-sparing component)
- Hypotension and orthostatic hypotension
- Hyponatremia, hypomagnesemia, and hypercalcemia
- Hyperuricemia and gout exacerbation
- Hyperglycemia and dyslipidemia
- Gastrointestinal disturbances (nausea, vomiting, diarrhea)
- Dizziness, headache, and fatigue
Drug Interactions
- ACE inhibitors and ARBs: Increased risk of severe hyperkalemia
- NSAIDs: Reduced antihypertensive efficacy and increased risk of renal impairment
- Lithium: Reduced renal clearance of lithium, leading to potential toxicity
- Potassium supplements or potassium-rich salt substitutes: Severe hyperkalemia risk
- Other antihypertensive drugs: Enhanced hypotensive effect
- Corticosteroids or ACTH: Increased risk of electrolyte depletion, particularly hypokalemia (if loop/thiazide effects dominate)
Curated Content: Needs Vetting Before Put to Clinical Use