page105
CHLORTALIDONE
(Chlorthalidone)
Indications
ascites due to cirrhosis in stable patients
(under close supervision),
oedema due to nephrotic
syndrome,
hypertension (see also notes above),
mild
to moderate chronic heart failure;
diabetes insipidus
(see section 6.5.2)
Cautions
see notes above
Contra-indications
see notes above
Hepatic impairment
see notes above
Renal impairment
see notes above
Pregnancy
see notes above
Breast-feeding
see notes above
Side-effects
see notes above; also
rarely
jaundice and
allergic interstitial nephritis
Dose
. Oedema,
up to 50 mg daily
. Hypertension,
25 mg daily in the morning,
increased
to 50 mg daily if necessary (but see notes above)
. Heart failure,
25–50 mg daily in the morning,
increased if necessary to 100–200 mg daily (reduce to
lowest effective dose for maintenance)
Hygroton
c
(Alliance) A
Tablets
, yellow, scored, chlortalidone 50 mg, net price
28-tab pack = £1.64
CYCLOPENTHIAZIDE
Indications
oedema, hypertension (see also notes
above); heart failure
Cautions
see notes above
Contra-indications
see notes above
Hepatic impairment
see notes above
Renal impairment
see notes above
Pregnancy
see notes above
Breast-feeding
see notes above
Side-effects
see notes above;
also
rarely
depression
Dose
. Heart failure,
250–500 micrograms daily in the
morning increased if necessary to 1 mg daily (reduce
to lowest effective dose for maintenance)
. Hypertension,
initially 250 micrograms daily in the
morning,
increased if necessary to 500 micrograms
daily (but see notes above)
. Oedema,
up to 500 micrograms daily for a short
period
Navidrex
c
(Goldshield) A
Tablets
,
scored,
cyclopenthiazide 500 micrograms,
net price 28-tab pack = £1.27
Excipients
include gluten
Note
May be difficult to obtain
INDAPAMIDE
Indications
essential hypertension
Cautions
see notes above; also acute porphyria (sec-
tion 9.8.2)
Contra-indications
see notes above;
also hypersensi-
tivity to sulfonamides
Hepatic impairment
see notes above
Renal impairment
see notes above
Pregnancy
see notes above
Breast-feeding
present in milk—manufacturer
advises avoid
Side-effects
see notes above; also palpitation, diuresis
with doses above 2.5 mg daily
Dose
. 2.5 mg daily in the morning
Indapamide
(Non-proprietary) A
Tablets
,
s/c,
indapamide 2.5 mg,
net price 28-tab
pack = £1.27,
56-tab pack = £2.01
Natrilix
c
(Servier) A
Tablets
,
f/c,
indapamide 2.5 mg.
Net price 30-tab
pack = £3.40,
60-tab pack = £6.80
Modified release
Ethibide XL
c
(Genus) A
Tablets
,
m/r,
indapamide 1.5 mg,
net price 30-tab
pack = £4.05.
Label:
25
Dose
hypertension,
1 tablet daily,
preferably in the morning
Natrilix SR
c
(Servier) A
Tablets
,
m/r,
indapamide 1.5 mg,
net price 30-tab
pack = £3.40.
Label:
25
Dose
hypertension,
1 tablet daily,
preferably in the morning
METOLAZONE
Indications
oedema, hypertension (see also notes
above)
Cautions
see notes above; also acute porphyria (sec-
tion 9.8.2)
Contra-indications
see notes above
Hepatic impairment
see notes above
Renal impairment
see notes above
Pregnancy
see notes above
Breast-feeding
see notes above
Side-effects
see notes above;
also chills,
chest pain
Dose
. Oedema,
5–10 mg daily in the morning,
increased if
necessary to 20 mg daily in resistant oedema, max.
80 mg daily
. Hypertension,
initially 5 mg daily in the morning;
maintenance 5 mg on alternate days
Metenix 5
c
(Sanofi-Aventis) A
Tablets
,
blue,
metolazone 5 mg,
net price 100-tab
pack = £18.20
XIPAMIDE
Indications
oedema, hypertension (see also notes
above)
Cautions
see notes above; also acute porphyria (sec-
tion 9.8.2)
Contra-indications
see notes above
Hepatic impairment
see notes above
Renal impairment
see notes above
Pregnancy
see notes above
Breast-feeding
no information available
Side-effects
see notes above
Dose
. Oedema,
initially 40 mg daily in the morning,
increased to 80 mg in resistant cases;
maintenance
20 mg in the morning
. Hypertension,
20 mg daily in the morning
Diurexan
c
(Meda) A
Tablets
,
scored,
xipamide 20 mg,
net price 140-tab
pack = £19.46
BNF 61
2.2.1 Thiazides and related diuretics
85
2
Cardiovascular system