Precautions and Warnings With Chlorothiazide

There are a number of precautions and warnings with chlorothiazide to be aware of, including information on who should not take the drug. Before starting treatment, tell your healthcare provider if you have liver disease, asthma, or diabetes. It is also important to know that chlorothiazide may potentially cause extremely low blood pressure, affect electrolytes in the blood, or increase blood sugar levels.

Chlorothiazide: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking chlorothiazide (Diuril®) if you have:
  • Liver disease, including cirrhosis
  • Asthma
  • Kidney disease or kidney failure
  • Diabetes
  • Systemic lupus erythematosus (lupus or SLE)
  • Gout
  • Fluid or electrolyte problems, especially problems with high calcium levels (hypercalcemia)
  • Any allergies, including allergies to sulfa drugs, foods, dyes, or preservatives.
Also, let your healthcare provider know if you:
  • Are pregnant or trying to become pregnant
  • Are breastfeeding.
Tell your healthcare provider about all other medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Some Warnings and Precautions With Chlorothiazide

Some chlorothiazide warnings and precautions to be aware of include:
  • Chlorothiazide should not be started in people with liver problems because changes in fluid or electrolytes can be dangerous in people with liver disease.
  • If kidney problems seem to be getting worse (especially for those with very severe kidney disease), chlorothiazide should be stopped, since the drug can sometimes worsen kidney problems.
  • You may be more likely to be allergic to chlorothiazide if you have asthma. Be sure to talk to your healthcare provider before taking chlorothiazide if you have asthma.
  • There are a number of medicines that chlorothiazide can interact with (see Drug Interactions With Chlorothiazide).
  • Chlorothiazide may cause extreme low blood pressure in some people. Extreme low blood pressure is more likely to occur when the medicine is first started or the dosage is changed. It is also more likely to happen in people who are on dialysis, have congestive heart failure, have diarrhea or vomiting, or sweat a lot. This is why it is important to drink fluids regularly while taking chlorothiazide. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, contact your healthcare provider. If you have fainted, stop taking chlorothiazide until you have talked to your healthcare provider.
Also, make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness until you know how chlorothiazide affects you.
  • Chlorothiazide can increase blood sugar levels, which is important for people with diabetes. Your healthcare provider may need to monitor your blood sugar more closely while you are starting or stopping chlorothiazide.
  • Chlorothiazide may affect electrolytes in the blood (including sodium, calcium, potassium, magnesium, and chloride). Therefore, your healthcare provider will regularly check these levels. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider. These symptoms may include:
o Dry mouth
o Thirst
o Weakness
o Lethargy
o Drowsiness
o Restlessness
o Muscle pain or muscle cramps
o Low blood pressure (hypotension)
o Decreased urination
o Rapid heart rate (tachycardia) or irregular heart rhythm (arrhythmia)
o Nausea or vomiting.
  • Chlorothiazide is also known to worsen gout.
  • Chlorothiazide has been reported to worsen systemic lupus erythematosus or, in some cases, to even to cause the condition.
  • Chlorothiazide can cause high cholesterol and high triglycerides.
  • Chlorothiazide is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Talk to your healthcare provider about the risks and benefits of using chlorothiazide during pregnancy (see Chlorothiazide and Pregnancy for more information).
  • Chlorothiazide passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about using chlorothiazide (see Chlorothiazide and Breastfeeding for more information).
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