Chlortalidone

Chlortalidone
Clinical data
Trade namesHygroton, Thalitone, others
AHFS/Drugs.comMonograph
MedlinePlusa682342
License data
Pregnancy
category
  • AU: C
Routes of
administration		By mouth
Drug classThiazide-like diuretic
ATC code
Legal status
Legal status
Pharmacokinetic data
Protein binding75%
Elimination half-life40 hours
ExcretionKidney
Identifiers
  • (RS)-2-Chloro-5-(1-hydroxy-3-oxo-2,3-dihydro-1H-isoindol-1-yl)benzene-1-sulfonamide
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.000.930 Edit this at Wikidata
Chemical and physical data
FormulaC14H11ClN2O4S
Molar mass338.76 g·mol−1
3D model (JSmol)
ChiralityRacemic mixture
  • O=S(=O)(N)c1c(Cl)ccc(c1)C2(O)c3ccccc3C(=O)N2
  • InChI=1S/C14H11ClN2O4S/c15-11-6-5-8(7-12(11)22(16,20)21)14(19)10-4-2-1-3-9(10)13(18)17-14/h1-7,19H,(H,17,18)(H2,16,20,21) checkY
  • Key:JIVPVXMEBJLZRO-UHFFFAOYSA-N checkY
  (verify)

Chlortalidone, also known as chlorthalidone, is a thiazide-like diuretic drug[1] used to treat high blood pressure, swelling (such as occurs in heart failure, liver failure, and nephrotic syndrome), diabetes insipidus, and renal tubular acidosis.[2][3] Because chlortalidone is effective in most patients with high blood pressure, it is considered a preferred initial treatment.[4][2] It is also used to prevent calcium-based kidney stones.[2] It is taken by mouth.[2] Effects generally begin within three hours and last for up to three days.[2] Long-term treatment with chlortalidone is more effective than hydrochlorothiazide for prevention of heart attack or stroke.[5]

Common adverse effects include low blood potassium, low blood sodium, high blood sugar, dizziness, and erectile dysfunction.[2][3][6] Other adverse effects may include gout, low blood magnesium, high blood calcium, allergic reactions, and low blood pressure.[2][3][7] Some reviews have found chlortalidone and hydrochlorothiazide to have a similar risk of adverse effects,[8][9] while other reviews have found chlortalidone to have a higher risk.[1][10] While it may be used in pregnancy it is a less preferred option.[2] How it works is not completely clear but is believed to involve increasing the amount of sodium and water lost by the kidneys.[2]

Chlortalidone was patented in 1957 and came into medical use in 1960.[11] It is on the World Health Organization's List of Essential Medicines.[12] It is available as a generic medication.[3] In 2022, it was the 108th most commonly prescribed medication in the United States, with more than 5 million prescriptions.[13][14]

  1. ^ a b Cite error: The named reference Ace2019 was invoked but never defined (see the help page).
  2. ^ a b c d e f g h i "Chlorthalidone Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Retrieved 18 April 2019.
  3. ^ a b c d British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. pp. 229–230. ISBN 978-0-85711-338-2.
  4. ^ Ernst ME, Fravel MA (July 2022). "Thiazide and the Thiazide-Like Diuretics: Review of Hydrochlorothiazide, Chlorthalidone, and Indapamide". American Journal of Hypertension. 35 (7): 573–586. doi:10.1093/ajh/hpac048. PMID 35404993.
  5. ^ Roush GC, Messerli FH (June 2021). "Chlorthalidone versus hydrochlorothiazide: major cardiovascular events, blood pressure, left ventricular mass, and adverse effects". Journal of Hypertension. 39 (6): 1254–1260. doi:10.1097/HJH.0000000000002771. PMID 33470735. S2CID 231649367.
  6. ^ Liamis G, Filippatos TD, Elisaf MS (February 2016). "Thiazide-associated hyponatremia in the elderly: what the clinician needs to know". Journal of Geriatric Cardiology. 13 (2): 175–82. doi:10.11909/j.issn.1671-5411.2016.02.001 (inactive 2 November 2024). PMC 4854958. PMID 27168745.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  7. ^ "Chlorthalidone" (PDF). FDA. Retrieved 27 March 2020.
  8. ^ Dineva S, Uzunova K, Pavlova V, Filipova E, Kalinov K, Vekov T (November 2019). "Comparative efficacy and safety of chlorthalidone and hydrochlorothiazide-meta-analysis". Journal of Human Hypertension. 33 (11): 766–774. doi:10.1038/s41371-019-0255-2. PMC 6892412. PMID 31595024.
  9. ^ Roush GC, Abdelfattah R, Song S, Ernst ME, Sica DA, Kostis JB (October 2018). "Hydrochlorothiazide vs chlorthalidone, indapamide, and potassium-sparing/hydrochlorothiazide diuretics for reducing left ventricular hypertrophy: A systematic review and meta-analysis". Journal of Clinical Hypertension. 20 (10): 1507–1515. doi:10.1111/jch.13386. PMC 8030834. PMID 30251403.
  10. ^ Springer K (December 2015). "Chlorthalidone vs. Hydrochlorothiazide for Treatment of Hypertension". American Family Physician. 92 (11): 1015–6. PMID 26760416.
  11. ^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 457. ISBN 978-3-527-60749-5.
  12. ^ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
  13. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  14. ^ "Chlorthalidone Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.