Methyclothiazide

Indications

Methyclothiazide is used for: Hypertension, Oedema

Adult Dose

Oral Oedema Adult: 2.5-5 mg once daily in the morning. Max: 10 mg once daily. Hypertension Adult: 2.5-5 mg once daily, either alone or w/ other antihypertensives.

Child Dose

Renal Dose

Renal Impairment Contraindicated in anuria Use with renal impairment may cause azotemia

Administration

Contra Indications

Hypersensitivity to sulfonamide-derived drugs, anuria.

Precautions

Patient w/ fluid and electrolyte disturbances, gout, DM, hypercholesterolaemia, parathyroid disease, history of allergy and bronchial asthma. May exacerbate SLE. Hepatic and renal impairment. Pregnancy and lactation. Monitoring Parameters Assess wt, input and output reports daily to determine fluid loss, BP, serum electrolytes, BUN, creatinine.

Pregnancy-Lactation

Pregnancy Category: B; diuretics not recommended during pregnancy Lactation: Distributed in breast milk; diuresis may affect breast milk production; not recommended

Interactions

Increased risk of lithium toxicity. Hypokalaemia may develop during concomitant use of steroids or ACTH. Insulin requirement in DM patients may be altered. Decreased arterial responsiveness to norepinephrine. Increased responsiveness to tubocurarine. Potentiation of orthostatic hypotension by barbiturates or narcotics.

Adverse Effects

Side effects of Methyclothiazide : Frequency Not Defined Body as a whole: Headache, cramping, weakness Cardiovascular: Orthostatic hypotension Gastrointestinal: Pancreatitis, jaundice (intrahepatic cholestatic), sialadenitis, vomiting, diarrhea, nausea, gastric irritation, constipation, anorexia Hematologic: Aplastic anemia, hemolytic anemia, agranulocytosis, leukopenia, thrombocytopenia Hypersensitivity Reactions: Anaphylactic reactions, necrotizing angiitis (vasculitis, cutaneous vasculitis), Stevens-Johnson syndrome, respiratory distress including pneumonitis and pulmonary edema, fever, purpura, urticaria, rash, photosensitivity Metabolic and Nutritional Disorders: Hyperglycemia, hyperuricemia, electrolyte imbalance Neurologic: Vertigo, dizziness, paresthesias, muscle spasm, restlessness Special senses: Transient blurred vision, xanthopsia Urogenital: Glycosuria

Mechanism of Action

Methyclothiazide inhibits Na reabsorption in the distal tubules causing increased excretion of Na and water, as well as K and hydrogen ions.