Precautions and Warnings With Chlorthalidone

Understanding precautions and warnings with chlorthalidone can help ensure a safe treatment process. For example, the medication can make kidney disease, gout, or lupus worse, and may also cause extreme low blood pressure. Precautions and warnings with chlorthalidone also apply to women who are pregnant or breastfeeding, as well as people with certain allergies, such as to "sulfa" drugs.

Chlorthalidone: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking chlorthalidone (Thalitone®) 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
  • Breastfeeding.
You should also make sure to tell your healthcare provider about all of the medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Chlorthalidone

Some warnings and precautions to be aware of prior to taking chlorthalidone include:
  • The medication should be started cautiously to treat cirrhosis or ascites (fluid retention in the abdominal cavity), since 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 severe kidney disease), chlorthalidone should be stopped, since the medication can make kidney problems worse.
  • You may be more likely to be allergic to chlorthalidone if you have asthma. Be sure to talk with your healthcare provider before taking the medication if you have asthma.
  • There are a number of medicines that chlorthalidone can potentially interact with (see Drug Interactions With Chlorthalidone).
  • People who are allergic to sulfonamides ("sulfa" drugs) may also be allergic to chlorthalidone.
  • The medication may cause extreme low blood pressure in some people. This is more likely to happen when the medicine is first started or the dosage is changed. It is also more likely to happen in people who are on dialysis; people who sweat a lot; and people who have congestive heart failure, diarrhea, or vomiting. This is why it is important to drink fluids regularly while taking the drug. If you have any symptoms of low blood pressure -- such as dizziness, lightheadedness, or fainting -- contact your healthcare provider. If you have fainted, stop taking the drug until you talk with your healthcare provider.
  • Do not to drive, operate any heavy machinery, or perform any other tasks that require alertness until you know how chlorthalidone affects you.
  • Chlorthalidone 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:
    • Dry mouth
    • Thirst
    • Weakness
    • Lethargy
    • Drowsiness
    • Restlessness
    • Muscle pain or muscle cramps
    • Low blood pressure (hypotension)
    • Decreased urination
    • A rapid heart rate (tachycardia) or irregular heart rhythm (arrhythmia)
    • Nausea or vomiting.
  • Chlorthalidone is also known to make gout worse in some people.
  • The medication has been reported to make systemic lupus erythematosus worse or, in some cases, even to cause the condition.
  • Chlorthalidone is considered a pregnancy Category B medication. This means that it is likely safe to take during pregnancy. However, you should talk with your healthcare provider about the risks and benefits of using the drug while pregnant (see Chlorthalidone and Pregnancy).
  • Chlorthalidone passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider before taking the drug (see Chlorthalidone and Breastfeeding).
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