Chlorothiazide should be used cautiously in patients with renal disease resulting in severe renal impairment because the drug decreases the glomerular. Easy to read FDA package insert, drug facts, dosage and administration, and adverse effects for Diuril (Chlorothiazide). Chlorothiazide sodium for injection, USP is a diuretic and a vial containing: Chlorothiazide sodium equiva- . toxicity. Refer to the package insert for lithium.
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Patients should be advised to inform their prescriber of their use of CoQ Heart failure guidelines recommend adding a thiazide diuretic to standard therapy for hypertensive patients with reduced ejection fraction heart failure HFrEF and mild fluid retention. Following intravenous use of chlorothiazide sodium, onset of the diuretic action occurs in 15 minutes and the maximal action packafe 30 minutes.
In some cases, thiazide diuretics may be used to counteract lithium-induced polyuria, although close monitoring is necessary if such treatment is initiated. Chlorothiazide is classified by the FDA as pregnancy risk category C. Moderate Concomitant use of medicines with potential to alter renal perfusion or function such onsert diuretics, may increase the risk of acute phosphate nephropathy in patients taking sodium phosphate monobasic monohydrate; sodium phosphate dibasic anhydrous.
Excessive hypotension during thiazide diuretic therapy can result in syncope. It is possible that additive reductions in blood pressure may be seen when fish oils are used in a patient already taking antihypertensive agents.
Akorn – Sodium Diuril® (chlorothiazide sodium)
Discontinuation of citalopram should be considered in patients who develop symptomatic hyponatremia. Titrate milrinone dosage according to hemodynamic response. Minor Because streptozocin is nephrotoxic, concurrent or subsequent administration of other nephrotoxic agents e.
Use with particular caution in hypertensive patients with high or uncontrolled blood pressure. Some references suggest stability intervals up to but not exceeding 24 hours. Major Use of cocaine with antihypertensive agents may increase the antihypertensive effects of the antihypertensive medications or may potentiate cocaine-induced sympathetic stimulation. In addition, thiazide diuretics, like hydrochlorothiazide, can cause hyperuricemia.
Moderate Opiate agonists may potentiate orthostatic hypotension when used concurrently with thiazide diuretics. Thiazides should be avoided in neonates with jaundice.
If needed, monitor for common amphetamine side effects, including decreased appetite, anxiety, dizziness, dry mouth, irritability, insomnia, nausea, increased blood pressure or increased heart rate. Finally, both thiazides and sulfonylureas have been reported to cause photosensitivity reactions; concomitant use may increase the risk of photosensitivity.
An increased risk of falls has been reported for elderly patients receiving thiazide diuretics. Moderate Monitor serum sodium closely if tolvaptan and thiazide diuretics are used together.
Patients should be instructed to rise slowly from a sitting position, and to report syncope or changes in blood pressure or heart rate to their health care provider. Potassium levels should be within the normal range prior to and during therapy with ondansetron. Moderate Patients should be cautioned that ingesting alcohol can increase the chance of low blood pressure and dizziness when taking a thiazide diuretic or the related drug, metolazone.
Although leading drug interaction texts differ in the potential for an interaction between diethylpropion and this group of antihypertensive agents, these effects are likely to be clinically significant and have been described in hypertensive patients on these medications. Moderate Electrolyte disturbances e. Initially, diuretics lower blood pressure by decreasing cardiac output, plasma volume and extracellular fluid volume. Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine: Thiazide diuretics, such as chlorothiazide, distribute into breast milk, and it has been recommended by some manufacturers that women not nurse while receiving selected thiazide diuretics.
Extravasation must be strictly avoided. Thiazide diuretics have been associated with a slight increase in serum cholesterol and triglyceride concentrations. In patients duuril renal disease, thiazides may precipitate azotemia. Concurrent use of citalopram and medications known to cause electrolyte imbalance may increase the packzge of developing QT prolongation. Discontinuation of sertraline should packsge considered in patients who develop symptomatic hyponatremia.
Shake well before administering. Antihypertensives may cause dizziness, postural hypotension, fatigue, and there is an increased risk for falls. Moderate increases in serum calcium have been seen during the treatment with thiazides; if calcium salts are used concomitantly, careful monitoring of serum calcium in recommended.
Reserve IV chlorothiazide for patients unable to take oral medication or for emergency situations. Moderate Concomitant use of antihypertensive agents with levodopa can result in additive hypotensive effects.
Severe skin reactions include exfoliative dermatitis, toxic epidermal necrolysis and Steven’s Johnson syndrome; some reactions have been fatal. Patients should avoid excessive sunlight UV exposure and therapy should be discontinued if phototoxicity occurs. Following IV administration, the onset of the diuretic action occurs in 15 minutes and the peak effect occurs at 30 minutes.
Periodic determination of serum electrolytes to detect possible electrolyte imbalance should be done at appropriate intervals.
Additive reductions in blood pressure may be seen when fish oils are used in a patient already taking antihypertensive agents. Moderate Fentanyl may reduce the efficacy of diuretics due to induction of the release of antidiuretic hormone. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to use whenever solution and container permit.
It is not known whether chlorothiazide can cause fetal harm; however, thiazides cross the placental barrier and appear in cord blood. Moderate Baclofen has been associated with hypotension.
Alcohol, barbiturates, or narcotics — potentiation of orthostatic hypotension may occur. Packagd experts reserve the use of diuretics for pregnant patients with cardiac disease or essential hypertension due to the fact that diuretic use may decrease placental perfusion and the data do not indicate a positive benefit of diuretic use on the outcome of preeclampsia during pregnancy.
Compatible with dextrose or sodium chloride IV solutions. The degree to which chlorothiazide is removed by hemodialysis is unknown. Moderate Patients receiving a diuretic during treatment with vortioxetine may be at greater risk of developing syndrome of inappropriate antidiuretic hormone secretion SIADH. Potassium levels should be within the normal range prior to and during therapy with dolasetron. Antidiabetic drugs — oral agents and insulin — dosage adjustment of the antidiabetic drug may be required.
Electrolyte imbalances may occur while on these diuretics, which may in turn predispose patients to the cardiac effects of halofantrine.