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.
Thiazide diuretics may increase urinary pH, acting as a urinary alkalinizer, thus reducing urinary excretion and increasing blood concentrations of the amphetamine. Reserve IV chlorothiazide for patients unable to take oral medication or for emergency situations. Moderate Concurrent use of tizanidine with antihypertensive agents can result in significant hypotension.
Akorn – Sodium Diuril® (chlorothiazide sodium)
Although this effect represents a pharmacodynamic interaction and not a pharmacokinetic one, dosage adjustments of probenecid may be necessary if these agents are administered concurrently to patients being treated with probenecid. Anuria, renal disease, renal failure, renal impairment.
Data from long-term studies, however, suggest diuretic-induced cholesterol changes are not clinically significant and do not contribute to coronary heart disease risk.
Moderate Citalopram causes dose-dependent QT interval prolongation. As methadone may also prolong the QT interval, cautious coadministration with diuretics is needed. Hypercalcemia may be exacerbated by coadministration of vitamin D analogs and thiazide diuretics. This is apparently a insdrt of a decrease in gastrointestinal motility and rate of stomach emptying by the antimuscarinic agent.
Do not give by intramuscular administration or subcutaneous administration.
Dilution Chlorothiazide – GlobalRPH
Lower initial doses or slower dose titration of tetrabenazine may be necessary in patients receiving antihypertensive agents concomitantly. Sodium picosulfate; Magnesium oxide; Anhydrous citric acid: Therefore, clinicians should monitor serum magnesium concentrations periodically in patients taking a PPI and diuretics concomitantly.
Moderate Concurrent administration of antihypertensive agents could lead to additive hypotension when administered with milrinone.
If concurrent use of iloperidone and antihypertensive agents is necessary, patients should be counseled on measures to prevent orthostatic hypotension, such as sitting on the edge of the bed for several minutes prior to standing in the morning and rising slowly from a seated position. Increases in cholesterol and triglyceride levels may be associated with thiazide diuretic therapy.
Moderate Concomitant use of a thiazide diuretiic, or the related drug metolazone, with a loop diuretic can cause additive electrolyte and fluid loss. Hyperglycemia or impaired glucose tolerance can occur during therapy with thiazide diuretics. Patients receiving hawthorn concurrently with antihypertensive medications should receive periodic blood pressure monitoring.
If treatment with lithium and a thiazide diuretic cannot be avoided, patients should have their serum lithium concentrations closely monitored, and the lithium dosage adjusted if necessary. Moderate increases in serum calcium have been seen during the treatment with thiazides; if calcium polycarbophil is used concomitantly, monitoring of serum calcium may be prudent. Because chlorothiazide sodium for injection contains no preservative, a fresh solution should be prepared immediately prior to each administration, and the unused portion should be discarded.
Non-steroidal Anti-inflammatory Drugs — In some patients, the administration of a non-steroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics. With an intermittent schedule, excessive diuresis and associated electrolyte imbalances are less likely to occur.
Severe skin reactions include exfoliative dermatitis, toxic epidermal necrolysis and Steven’s Johnson syndrome; some reactions have been fatal. Minor Coadministration of thiazides and prokinetic agents may result in decreased bioavailability of the thiazide diuretic.
Use the smallest dosage necessary to achieve the required response. The exact mechanism responsible for the lowered peripheral resistance is not known; however, excretion of urinary sodium by the kidneys is required to achieve blood pressure reduction.
Generally, the reconstituted solution should be used immediately after reconstitution. Severe The use of hypotensive agents and tranylcypromine is contraindicated by the manufacturer of tranylcypromine because the effects of hypotensive agents may be markedly potentiated.
It is not known whether chlorothiazide can cause fetal harm; however, thiazides cross the placental barrier and appear in cord blood. Major Thiazide diuretics may cause the urine to become alkaline. Careful monitoring of blood pressure and hypotensive symptoms is recommended especially in patients with ischemic heart disease and in patients on antihypertensive agents.
Moderate Thiazide diuretics can decrease insulin sensitivity thereby leading to glucose intolerance and hyperglycemia.
Cumulative effects diuil the drug may develop in patients with impaired renal function. Moderate Thiazide diuretics can decrease the hypoglycemic effects of antidiabetic agents by producing an increase in blood glucose levels. A single or mg dose achieves similar systemic absorption following oral administration. Minor Monitor potassium and magnesium levels when thiazide diuretics are used during ziprasidone therapy.
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