Chlorothiazide (Intravenous)

Chlorothiazide is also known under US brand names Diuril Sodium and Sodium Diuril. It is a drug that helps reduce fluid retention by reducing the amount of water in the body by increasing the flow of urine.

Overview

Chlorothiazide is a thiazide diuretic drug that is used in the treatment of fluid retention that is caused by kidney disease, severe liver disease (cirrhosis), congestive heart disease, or from treatment with a hormone or steroid medicine. It works by reducing the amount of water in the body by increasing the flow of urine which in turn reduces fluid retention. It is only available via prescription from your doctor or a healthcare professional and is available in the dosage form powder for the solution.

Condition(s) treated?

  • High blood pressure
  • Fluid in the lungs due to chronic heart failure
  • Visible water retention
  • Accumulation of fluid resulting from chronic heart failure

Type of medicine?

  • Powder for solution

Side effects

As with all medications, there can be a variety of side effects associated with chlorothiazide.

Inform your doctor immediately if you experience any of the following side effects when you are taking chlorothiazide:

  • Leg, back or stomach pains
  • Abdominal or stomach pain
  • Bleeding gums
  • Chest pain
  • Blisters on skin
  • Blurred vision
  • Blood in stools or urine
  • Bloody or cloudy urine
  • Blue fingernails or lips
  • Black, tarry stools
  • Chills
  • Crawling, burning, numbness, itching, prickling, "pins and needles", or tingling feelings
  • Cold sweats
  • Confusion
  • Clay-colored stools
  • Constipation
  • Hoarseness or a cough
  • Dark urine
  • Coughing that sometimes produces a pink frothy sputum
  • Decrease in urine output or decrease in urine-concentrating ability
  • Decreased frequency or amount of urine
  • Diarrhea
  • Faintness, dizziness or lightheadedness when getting up from a sitting or lying position suddenly
  • Coughing up blood
  • Difficult, noisy or fast breathing, sometimes with wheezing
  • Difficulty swallowing
  • Fast heartbeat
  • Dry mouth
  • Feeling of constant movement of self or surroundings
  • Fruit-like breath odor
  • Fever
  • Dry, flushed skin
  • General feeling of weakness or tiredness
  • General feeling of illness or discomfort
  • Headache
  • Increased sweating
  • Hives
  • Indigestion
  • Increase in blood pressure
  • Increased sensitivity of skin to sunlight
  • Increased thirst
  • Increase in hunger
  • Increased urination
  • Itching
  • Loss of appetite
  • Stiffness, joint pain or swelling
  • Lower side or back pain
  • Nosebleeds
  • Muscle pain or cramps
  • Tingling, numbness, pain, or weakness in feet or hands
  • Difficult or painful urination
  • Pain in muscles or joints
  • Pains inside stomach, or abdomen, possibly radiating to the back
  • Sensation of spinning
  • Pale skin
  • Pinpoint red spots on skin
  • Severe sunburn
  • Swelling, puffiness of the eyelids or around the face, eyes, lips, or tongue
  • Redness or other discoloration of skin
  • Soreness, redness or itching skin
  • Seizures
  • Shortness of breath
  • Ulcers, sores, or white spots on lips or in mouth
  • Skin rash
  • Welting, sores, or blisters
  • Thickening of bronchial secretions
  • Sugar in the urine
  • Sweating
  • Swelling of ankles and legs
  • Swollen or painful glands
  • Tenderness of salivary glands
  • Troubled breathing
  • Swelling of fingers, face or lower legs
  • Tightness in chest
  • Trembling
  • Unexplained weight loss
  • Unusual bruising or bleeding
  • Unpleasant breath odor
  • Unusual weakness or tiredness
  • Vomiting of blood
  • Unusual weight loss
  • Yellow skin or eyes
  • Weight gain

Some side effects usually do not need urgent medical attention as they will usually improve as your body adjusts to the medicine. If you are suffering from any of the following side effects below, you can contact your doctor for advice to minimize them or ways to avoid them altogether. Remember you can report all side effects to the FDA at 1-800-FDA-1088.

  • Cracks in the skin
  • Peeling, blistering or loosening of skin
  • Decreased interest in sexual intercourse
  • Cramping
  • Difficulty having a bowel movement
  • Inability to have or keep an erection
  • Thinning of hair, hair loss
  • Loss of sexual ability, drive, desire or performance
  • Muscle spasm
  • Loss of heat from the body
  • Red, irritated eyes
  • Pinpoint purple or red spots on skin
  • Restlessness
  • Red, swollen skin
  • Weakness
  • Scaly skin

Dosage

Dosage requirements will differ with each individual depending on a variety of factors, including your age, sex, height and weight, what condition you are being treated for, the severity of your condition and how you reacted to the first dosage. The following dosage amounts are only acting as general guidelines. Stick to the dose that has been established by your doctor and do not change your dosage requirements without the consent of your doctor or a healthcare professional.

Typical adult dose for Edema

500 to 1000 mg once or twice daily

Typical adult dose for Hypertension

500 to 1000 mg once or twice daily

Overdose

In the event of an overdosage, supportive and symptomatic measures should be employed. Gastric lavage should be performed or emesis should be induced. Correct dehydration, hepatic coma, electrolyte imbalance, and hypotension by established procedures. If required, give artificial respiration or oxygen for respiratory impairment.

Interactions

Some medicines cannot be taken together as it can reduce the effectiveness of the medication. In some cases, two different medicines which cause a reaction still need to be taken together. In this type of situation, your doctor or physician may change your dose or take other precautions.

To minimise the risk of interactions, you need to inform your doctor or health care professional of any medications you are currently taking, including vitamins and herbal remedies. Below is a list of medications that are known to react with chlorothiazide. Inform your doctor if you are taking any of these.

  • Acemetacin
  • Aceclofenac
  • Acetyldigoxin
  • Amtolmetin Guacil
  • Amphetamine
  • Arsenic Trioxide
  • Bepridil
  • Aspirin
  • Bromfenac
  • Celecoxib
  • Bufexamac
  • Choline Salicylate
  • Deslanoside
  • Clonixin
  • Dexketoprofen
  • Dexibuprofen
  • Diclofenac
  • Digitalis
  • Diflunisal
  • Digitoxin
  • Dipyrone
  • Digoxin
  • Dofetilide
  • Fenoprofen
  • Etodolac
  • Droxicam
  • Etofenamate
  • Etoricoxib
  • Feprazone
  • Felbinac
  • Fepradinol
  • Floctafenine
  • Flecainide
  • Flurbiprofen
  • Flufenamic Acid
  • Ibuprofen
  • Ketanserin
  • Indomethacin
  • Ketorolac
  • Ketoprofen
  • Lithium
  • Loxoprofen
  • Lornoxicam
  • Lumiracoxib
  • Mefenamic Acid
  • Meclofamate
  • Metildigoxin
  • Meloxicam
  • Morniflumate
  • Naproxen
  • Nabumetone
  • Nepafenac
  • Nimesulide
  • Niflumic Acid
  • Oxaprozin
  • Nimesulide Beta Cyclodextrin
  • Parecoxib
  • Oxyphenbutazone
  • Piketoprofen
  • Phenylbutazone
  • Proglumetacin
  • Piroxicam
  • Proquazone
  • Propyphenazone
  • Salsalate
  • Rofecoxib
  • Salicylic Acid
  • Sulindac
  • Sodium Salicylate
  • Tiaprofenic Acid
  • Tenoxicam
  • Tolfenamic Acid
  • Valdecoxib
  • Tolmetin

Some medicines should not be used at or around the time of eating food or eating certain types of food as interactions can occur. This is also the case for using tobacco or alcohol with certain medicines. You should speak with your doctor or health care professional about the use of chlorothiazide with alcohol, food or tobacco.

Disease interactions

The presence of other medical problems can affect the use of chlorothiazide. Inform your doctor or physician if you currently have any medical problems including the ones listed below.

  • Those suffering from Anuria should not use chlorothiazide
  • Diabetes
  • Asthma
  • Gout
  • Hyperuricemia (high uric acid in the blood)
  • Hypochloremia (low chloride in the blood)
  • Hypercalcemia (high calcium in the blood)
  • Hypomagnesemia (low magnesium in the blood)
  • Hypokalemia (low potassium in the blood)
  • Hypophosphatemia (low phosphorus in the blood)
  • Hyponatremia (low sodium in the blood)
  • Use with caution if you have Systemic lupus erythematosus as chlorothiazide can worsen these conditions.
  • Liver disease
  • Use with caution if you have kidney disease as the effects of chlorothiazide may be increased due to the slower removal of the medicine from the body.

Warnings

Below are some of the warnings associated with taking chlorothiazide.

Allergies

Inform your doctor if you have ever had any allergic or unusual reactions to chlorothiazide or any other medicines. You should also inform your doctor or physician if you suffer from any other types of allergic reactions, such as to dyes, foods, animals or even preservatives. Remember that for non-prescription products, you should always read the packaging or labels carefully.

Use during pregnancy

Chlorothiazide is under pregnancy category C which means it should be used only when necessary. It's not recommended in pre-eclampsia and other pregnancy-induced hypertension.

Use during breastfeeding

Studies have suggested that this medication could alter milk composition or production. If an alternative drug is not prescribed, the infant should be closely monitored for adequate milk intake and side effects.

Use in older people

Studies have not indicated anything that would limit the usefulness of chlorothiazide in the elderly. However, older people are more likely to have age-related kidney, liver or heart problems, which may require a dose adjustment for those receiving chlorothiazide.

Use in paediatric population

Appropriate studies have not been conducted on the effects of chlorothiazide and the relationship of age. Therefore, efficacy and safety have not been established.

Other warnings

  • Use with caution if you are suffering from renal disease that is of a severe nature. Thiazides may precipitate azotemia in those who suffer from renal issues.
  • Cumulative effects of the drug may develop in patients with impaired renal function.
  • Caution should be exercised when using thiazides in those who suffer from a progressive liver disease or an impaired hepatic function. This is because even minor alterations of electrolyte balance or fluid may cause a hepatic coma.
  • Thiazides can increase the action of similar antihypertensive medications.
  • Sensitivity reactions may occur in patients with or without a history of bronchial asthma or allergy.
  • There is a reported possibility of activation or exacerbation of systemic lupus erythematosus.
  • Generally, Lithium should not be given with a diuretic.

Storage

A trained health professional or a nurse will give you this medicine. It is administered through a needle which is placed in one of your veins. Since this medication is taken in a hospital setting, you will not need to store it yourself. In general, it should be kept refrigerated when not in use and kept away from damp and moist areas.

Summary

When taken correctly chlorothiazide is successful in reducing water retention in various areas of the body. There are many medicines, drugs and other illnesses that can interact with this drug. It's therefore vital that you inform your doctor or health care professional of all the drugs you are currently taking including those that are herbal remedies or vitamins. You should also inform them of your past medical history and your family history of any illnesses. Your doctor will only give you a few doses of chlorothiazide until your condition begins to improve. They will then switch you to an oral medicine instead that works in the same way. If you raise any questions, queries or concerns about this, you should speak with your doctor. This drug is not recommended in breastfeeding mothers and there may be changes of dose for those who are pregnant. Remember to inform your doctor immediately if you fall pregnant whilst taking this medication.