$Unique_ID{BRK03081} $Pretitle{} $Title{chlorothiazide} $Subject{Diachlor Major Diurigen Goldline Diuril Merck Sharp Dohme Diuretic antihypertensive chlorothiazide high blood pressure fluid accumulation heart failure cirrhosis liver kidney disease elimination salt water kidneys} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. chlorothiazide ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) chlorothiazide (various manufacturers) Diachlor (Major) Diurigen (Goldline) Diuril (Merck Sharp & Dohme) TYPE OF DRUG Diuretic and antihypertensive INGREDIENT chlorothiazide DOSAGE FORMS Tablets (250 mg and 500 mg) Oral suspension (250 mg per 5-ml spoonful; 0.5% alcohol) STORAGE Store at room temperature in a tightly closed container. USES Chlorothiazide is prescribed to treat high blood pressure. It is also used to reduce fluid accumulation in the body caused by conditions such as heart failure, cirrhosis of the liver, kidney disease, and the long-term use of some medications. It reduces fluid accumulation by increasing the elimination of salt and water through the kidneys. TREATMENT To decrease stomach irritation, you can take this medication with a glass of milk or with a meal (unless your doctor directs you to do otherwise). Try to take it at the same time every day. Avoid taking a dose after 6:00 p.m.; otherwise, you may have to get up during the night to urinate. If you miss a dose of this medication, take the missed dose as soon as possible, unless it is almost time for the next dose. In that case, do not take the missed dose at all, just wait until the next scheduled dose. Do not double the dose. This medication does not cure high blood pressure, but it will help to control the condition. SIDE EFFECTS Minor. Constipation, cramps, diarrhea, dizziness, drowsiness, headache, heartburn, loss of appetite, restlessness, or upset stomach. As your body adjusts to the medication, these side effects should disappear. This medication can cause increased sensitivity to sunlight. Avoid prolonged exposure to sunlight or sunlamps. Wear protective clothing, and use effective sunscreen. To relieve constipation, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads) and exercise (unless your doctor directs you to do otherwise). To avoid dizziness or light-headedness when you stand, contract and relax the muscles of your legs for a few moments before rising. Do this by pushing one foot against the floor while raising the other foot slightly, alternating feet so that you are "pumping" your legs in a pedaling motion. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about blurred vision, confusion, difficulty in breathing, dry mouth, excessive thirst, excessive weakness, fever, itching, joint pain, mood changes, muscle pains or spasms, nausea, palpitations, skin rash, sore throat, tingling in the fingers or toes, unusual bleeding or bruising, vomiting, or yellowing of the eyes or skin. INTERACTIONS Chlorothiazide diuretic and antihypertensive interacts with several other types of medications: 1. It may decrease the effectiveness of oral anticoagulants, antigout medications, insulin, oral antidiabetic medicines, and methenamine. 2. Fenfluramine can increase the blood-pressure-lowering effects of chlorothiazide, which can be dangerous. 3. Indomethacin can decrease the blood-pressure-lowering effects of chlorothiazide and counteract the desired effects. 4. Cholestyramine and colestipol decrease the absorption of this medication from the gastrointestinal tract. Chlorothiazide should, therefore, be taken one hour before or four hours after a dose of cholestyramine or colestipol (if you have also been prescribed one of these medications). 5. The side effects of amphotericin B, calcium, cortisone-like steroids (such as cortisone, dexamethasone, hydrocortisone, prednisone, and prednisolone), digoxin, digitalis, lithium, quinidine, sulfonamide antibiotics, and vitamin D may be increased by chlorothiazide. BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to diuretics or any other sulfa drugs, including oral antidiabetic medications and sulfonamide antibiotics. * Before you start taking chlorothiazide, tell your doctor if you now have or if you have ever had kidney disease or problems with urination, diabetes mellitus, gout, liver disease, asthma, pancreas disease, or systemic lupus erythematosus. * Chlorothiazide can cause potassium loss. Signs of potassium loss include dry mouth, thirst, weakness, muscle pain or cramps, nausea, and vomiting. If you experience any of these symptoms, call your doctor. To help avoid potassium loss, take this drug with a glass of fresh or frozen orange or cranberry juice, or eat a banana every day. The use of a salt substitute also helps to prevent potassium loss. Do not change your diet or use a salt substitute, however, before discussing it with your doctor. Too much potassium can also be dangerous. Your doctor may want to have blood tests performed periodically to monitor your potassium levels. * Limit your intake of alcoholic beverages while taking this medication, in order to prevent dizziness and light-headedness. * If you have high blood pressure, do not take any over-the-counter (nonprescription) medications for weight control or for cough, cold, allergy, asthma, or sinus problems unless your doctor directs you to do so. * To prevent dehydration (severe water loss) while taking this medication, check with your doctor if you have any illness that causes severe or continuous nausea, vomiting, or diarrhea. * This medication can raise blood sugar levels in diabetic patients. Therefore, blood sugar should be carefully monitored by blood or urine tests when this medication is being taken. * Be sure to tell your doctor if you are pregnant. Although studies in humans have not been conducted, chlorothiazide can cross the placenta and may cause adverse effects in the developing fetus. Also, tell your doctor if you are breastfeeding an infant. Although problems in humans have not been reported, small amounts of this drug can pass into breast milk, so caution is warranted. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.