Even though hydrochlorothiazide hctz and chlorthalidone are frequently considered interchangeable antihypertensive agents, they appear to differ both in their blood pressure lowering efficacy and in their effects on the lipid profile and on. How do hydrochlorothiazide and chlorthalidone compare for. Differences in chlorthalidones mechanism of action vs. Oct 14, 20 a very important difference is the extremely long halflife of 40 to 60 hours for chlorthalidone, in the other hand hydrochlorothiazide has a much shorter but wider variation in halflife, from 3 to hours. In sixty patients with essential hypertension, who were receiving chlorothiazide as well as various antihypertensive agents, hydrochlorothiazide was. Which thiazide to choose as addon therapy for hypertension. A recent study showed an increased risk of adverse events with chlorthalidone, including hyponatremia. To compare the effectiveness and safety of the two drugs in older individuals, investigators conducted a propensitymatched, observational cohort study in ontario residents aged 66 or older who began diuretic treatment with chlorthalidone 10,384 patients or.
Hydrochlorothiazide versus chlorthalidone in the management. Chlorthalidone versus hydrochlorothiazide for hypertension. Get concise advice on drug therapy, plus unlimited access to ce. The shep study, allhat, and recent guidelines from the nice group in england have really made the point that chlorthalidone is a superior thiazidetype diuretic to hydrochlorothiazide. Hydrochlorothiazide, which is better for uses like. Serum potassium was also lower in patients taking chlorthalidone 3. Treatment guidelines and compendia often consider these 2 drugs interchangeable agents within the class of thiazide or thiazidelike diuretics. To compare the effectiveness and safety of the two drugs in older individuals, investigators conducted a propensitymatched, observational cohort study in ontario residents aged 66 or older who began diuretic treatment with chlorthalidone 10,384 patients. T1 longterm effects of chlorthalidone versus hydrochlorothiazide on electrocardiographic left ventricular hypertrophy in the multiple risk factor intervention trial au ernst, michael e. Prescribers need to be made aware of the potential for chlorthalidone for patients with hypertension. Comparison of newonset gout in adults prescribed chlorthalidone vs. P chlorthalidone users more responsive, but less adherent than hctz users. Elliott has received research funding, honoraria, andor travel expenses from essentially every pharmaceutical company that makes, markets, or distributes antihypertensive drugs in the united states. The risk of hypokalemia may be minimized by combining thiazides with blockers of the epithelial sodium channel e.
Compare hydrochlorothiazide vs chlorthalidone skip to. In an observational cohort study, compared with hctz, ctdn was associated with lower left ventricular hypertrophy. The primary outcome was a composite of death or hospitalization for heart failure, stroke, or myocardial infarction. Compare chlorthalidone vs hydrochlorothiazide comprehensive. Other uses include diabetes insipidus, renal tubular acidosis, and to decrease the risk of kidney stones in those with a high calcium level in the urine. Prescribing information chlorthalidone chlortalidone tablets bp 50 mg therapeutic classification diuretic antihypertensive actions and clinical pharmacology chlortalidone inhibits reabsorption of sodium and chloride in the distal renal tubule thus promoting water loss. All generic drug interactions for losartanhydrochlorothiazide oral lists will include brand and. Chlorthalidone versus hydrochlorothiazide for hypertension in. Chlorthalidone versus hydrochlorothiazide in hypertension.
Chlorthalidone and hydrochlorothiazide basic youtube. Both medications reduce theincidence of cardiovascular events in patients with hypertension, but chlorthalidone may confer additional cardiovascular risk reduction strength of recommendation sor. A comparison of hydrochlorothiazide and chlorothiazide in the treatment of hypertension has been attempted in seventytwo patients. There has been a recent trend of using lower doses of these medications and change from chlorthalidone ctl use to hydrochlorothiazide hctz use. Other drugs that have the same active ingredients e. High blood pressure, edema and chronic heart failure. In 9 post hoc analyses comparing patients initially prescribed 12. Hydrochlorothiazide vs chlorthalidone for hypertension. Although there are several thiazide diuretics currently available.
Although it generally is agreed that as a class, thiazidetype diuretics are effective in reducing blood pressure bp and preventing cardiovascular disease cvd in hypertensive persons. If you have lupus, chlorthalidone can make your lupus. Genome wide analysis approach suggests chromosome 2 locus. Same benefit with equivalent doses of chlorthalidone and hctz. Your doctor will follow you closely to change the dose to match your bodys needs.
Aldactone spironolactone should be used with other medicines to get rid of excess fluid in your body, especially if you have heart failure. Chlorthalidone oral interactions with other medication. The target dose recommenda tions are hydrochlorothiazide 25 to 50 mg or chlorthalidone 12. Lowering of blood pressure with a diureticbased regimen has decreased stroke, heart failure, and cardiovascular disease events in several outcomebased clinical trials. Oct 15, 20 in this retrospective analysis, chlorthalidone and hctz produced the same clinical outcomes in older adults. Compared to hctz, chlorthalidone has a longer half. Hydrochlorothiazide versus chlorthalidone in the management of hypertension.
These data, thus, suggest that combining of data from thiazidelike and thiazide. Longterm effects of chlorthalidone versus hydrochlorothiazide on. In terms of blood pressure lowering, both hctz and chlorthalidone appear to be very effective. Thalitone chlorthalidone is a welltolerated water pill thats increasingly used to treat high blood pressure. Epub ahead of print, gc roush, me ernst, jb kostis, s tandon, da sica from medlinepubmed, a database of the u. In a doubleblind randomized study, we evaluated the effects of 25 mg vs 50 mg of hydrochlorothiazide in 51 elderly patients aged 68.
We used advanced methods, sensitivity analyses, and diagnostics, but given the possibility of residual confounding and the limited length of observation periods, further study is warranted. Dec 12, 20 pharmacologic treatment of hypertension, including the use of thiazidetype diuretics, has had a major impact on reducing the risk of stroke, heart failure, myocardial infarction, and death in the population. If you use doses of chlorthalidone greater than 25 mg the benefit for bp reduction is limited. Each chlorthalidone recipient was matched to up to 2 hydrochlorothiazide recipients on the basis of age, sex, year of treatment initiation, and propensity score. Released at about the same time as hydrochlorothiazide hctz 1959 and 1960, respectively there is great evidence of ctdns non. Possible side effects muscle weakness, dizziness, cramps, thirst, stomach pain, upset stomach, vomiting, diarrhea, loss of appetite, headache, hair loss. Thiazide diuretics are one of the preferred pharmacologic treatments for hypertension.
A very important difference is the extremely long halflife of 40 to 60 hours for chlorthalidone, in the other hand hydrochlorothiazide has a much shorter but wider variation in halflife, from 3 to hours. The diuretics chlorthalidone and hydrochlorothiazide are similarly effective at preventing cardiovascular events among older adults with hypertension, but electrolyte abnormalities are more common with chlorthalidone, according to a study in the annals of internal medicine canadian researchers used healthcare databases to identify nearly 30,000 adults over age. Hydrochlorothiazide versus chlorthalidone hypertension. In general, chlorthalidone was more likely to be associated with hospitalization for.
A comparison of hydrochlorothiazide and chlorothiazide in. Hydrochlorothiazide hctz and chlorthalidone ctd are the most commonly prescribed drugs of these classes. Pdf chlorthalidone versus hydrochlorothiazide researchgate. Chlorthalidone versus hydrochlorothiazide for the treatment of hypertension in older adults. B, conflicting network metaanalysis and cohort studies. Microzide hydrochlorothiazide hctz is a welltolerated water pill thats often the firstchoice treatment for mild high blood pressure. Hydrochlorothiazide and chlorthalidone have been the 2.
They have similar mechanism of action and side effect profile. Chlorthalidone, not hydrochlorothiazide, is the right. In high blood pressure it is a preferred initial treatment. Headtohead trials have shown ctdns superiority in antihypertensive potency, particularly during the critical nighttime period sbp difference 7. Efficacy of lowdose chlorthalidone and hydrochlorothiazide.
The authors aim to compare the efficacy of amlodipine or hydrochlorothiazide hctz with an arb. Thiazide diuretics are a mainstay for the treatment of hypertension. Azilsartanchlorthalidone combo bests olmesartanhctz medscape. Chlorthalidone ctd is the best diuretic for the treatment of hypertension, both in blood pressurelowering efficacy and, most importantly, in prevention of hypertensionrelated morbidity and mortality.
As a result, some experts have argued that clinicians should favor it over hydrochlorothiazide 8, whereas others have argued that the drugs are largely interchangeable 14. Thalitone chlorthalidone can increase the kidneys retention of uric acid, which can increase your risk of gouty attacks. Glucose and insulin levels during diuretic therapy in. All generic drug interactions for lisinoprilhydrochlorothiazide oral lists will include brand and. Is chlorthalidone better than hydrochlorothiazide in. How do hydrochlorothiazide and chlorthalidone compare for treating hypertension. Nov, 2019 this medicine is a strong fluidlowering drug diuretic. Prevention of recurrent calcium stone disease includes treatment with thiazide and thiazidetype diuretics to reduce urinary calcium uca levels, with the reduction in uca correlating with risk of stone recurrence. Sumiye l, vivian as, frisof kb, podany ec potassium loss associated with hydrochlorothiazide versus chlorthalidone. Pdf on jun 18, 20, alberto donzelli and others published chlorthalidone versus hydrochlorothiazide find, read and cite all the research you need on. However, we wish to highlight that chlorthalidone ctd is the evidencebased and recommended antihypertensive diuretic, and should replace hctz in the trial to effectively compare efficacy against the ccb amlodipine. Hydrochlorothiazide vs chlorthalidone detailed answer.
In this retrospective analysis, chlorthalidone and hctz produced the same clinical outcomes in older adults. Generic chlorthalidone is covered by most medicare and insurance plans, but some pharmacy coupons or cash prices may be lower. The study is based on chlorthalidone and hydrochlorothiazide the active ingredients of chlorthalidone and hydrochlorothiazide, respectively, and chlorthalidone and hydrochlorothiazide the brand names. Chlorthalidone as the optimal diuretic for the management of hypertension. Relationship of resistant hypertension and treatment outcomes with total arterial compliance in a predominantly african american hypertensive cohort. For people with a history of kidney problems, this can put more pressure on your kidneys and make it harder for them to work. Studies have found that chlorthalidone provides greater blood pressure lowering effects over a 24hour period than hctz. Mar 12, 2015 headtohead comparisons of hydrochlorothiazide with indapamide and chlorthalidone. This is despite several clinical trials that have used and documented the benefits of chlorthalidone for hypertension management. Chlorthalidone and hydrochlorothiazide are often considered as interchangeable. Effects of thiazidetype and thiazidelike diuretics. Although there are several thiazide diuretics currently available, hydrochlorothiazide hctz continues to be the most popular thiazide used for treating high blood pressure.
Chlorthalidone and hydrochlorothiazide drug interactions. Hydrochlorothiazide in hypertension disclosure information. Does chlorthalidone interact with other medications. Comparison of cardiovascular and safety outcomes of. Hello, thank you for trusting healthcaremagic both hydrochlorothiazide and chlorthalidone belong to similar class of medication. Chlorthalidone vs chlorothiazide hypertension drugs. Chlorthalidone versus hydrochlorothiazide for the treatment.
P rxlist drug interaction checker to check drug combinations. Even though hydrochlorothiazide hctz and chlorthalidone are frequently considered interchangeable antihypertensive agents, they appear to differ both in their blood pressure lowering efficacy and in their effects on the lipid profile and on serum potassium, uric acid and glucose levels. Hydrochlorothiazide is the more commonly prescribed thiazide diuretic, but chlorthalidone may have greater benefits. Effects on systolic blood pressure a oxford academic journals. Chlorthalidone vs chlorothiazide hypertension drugs comparison. In time, pending more data, chlorthalidone and indapamide may need to be. Learn about drug interactions between chlorthalidone oral and losartanhydrochlorothiazide oral and use the rxlist drug interaction checker to check drug combinations. The benefits of switching from hydrochlorothiazide to. Chlortalidone, also known as chlorthalidone, is a diuretic medication used to treat high blood pressure, swelling including that due to heart failure, liver failure, and nephrotic syndrome, diabetes insipidus, and renal tubular acidosis. Headtohead studies have shown trends favoring chlorthalidone as a more effective blood pressure lowering agent compared with hctz, but statistical significance in this regard has not been consistently. Sometimes too much water and major elements potassium in the blood may be lost. Headtohead comparisons of hydrochlorothiazide with indapamide and chlorthalidone.
Longterm effects of chlorthalidone versus hydrochlorothiazide on electrocardiographic left ventricular hypertrophy in the multiple risk factor intervention trial. Chlorthalidone is only available as a generic drug. Comparison between baseline and wilcoxon signed rank test results. The benefits of switching from hydrochlorothiazide to chlorthalidone.
Chlorthalidone is more potent and exhibits both a longer duration of action and elimination halflife compared to hydrochlorothiazide. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Although different antihypertensive drugs can be combined, not all. Learn about drug interactions between chlorthalidone oral and lisinoprilhydrochlorothiazide oral and use the rxlist drug interaction checker to check drug combinations. The use of thiazide diuretics for the treatment of hypertension is strongly encouraged by current guidelines.
Mean 24h sbp was significantly lower for the chlorthalidone group than for the hydrochlorothiazide group at week 4 125. Apr 24, 20 some study findings suggest that chlorthalidone is more effective than hydrochlorothiazide for hypertension treatment. Efficacy of chlorthalidone and hydrochlorothiazide in combination. Hydrochlorothiazide hctz or hct is a diuretic medication often used to treat high blood pressure and swelling due to fluid build up. Although hctz, chlorthalidone, and indapamide as addon therapy. Comparisons of hydrochlorothiazide with indapamide and. There are important differences between hydrochlorothiazide and chlorthalidone in pharmacology, potency, and frequency of met abolic side effects. However, greater nighttime blood pressure reduction, and alleged pleiotropic effects have renewed the interest in chlorthalidone.
Hydrochlorothiazide and chlorthalidone have been the 2 most commonly used diuretics in major clinical trials. Chlorthalidone versus hydrochlorothiazide hypertension. High blood pressure, chronic heart failure and heart failure. Combined therapy is required in the majority of patients with hypertension to achieve blood pressure bp targets. Some study findings suggest that chlorthalidone is more effective than hydrochlorothiazide for hypertension treatment. Chlorthalidone associated with more electrolyte problems. Henry black discusses the decadeslong question about the best diuretic.
The comparative effectiveness of hydrochlorothiazide and. Hydrochlorothiazide for treatment of hypertension karyn springer, md, utah valley family medicine residency, provo, utah help desk answers provides answers to questions. A new kind of veterans affairs cooperative study article in annals of internal medicine 1659 august 2016 with 83 reads how we measure reads. Background thiazide and thiazidelike diuretic agents are being increasingly used at lower doses. Compare chlorthalidone vs lisinopril comprehensive.
Antihypertensive and metabolic effects hypertension 2015 mar 02. Let your doctor know if you have a history of gout. This medicine is a strong fluidlowering drug diuretic. Ctd is structurally and pharmacokinetically distinct from hctz with a much longer halflife 4060 h vs. Pharmacologic treatment of hypertension, including the use of thiazidetype diuretics, has had a major impact on reducing the risk of stroke, heart failure, myocardial infarction, and death in the population. Compare chlorthalidone vs metoprolol comprehensive analysis.
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