IGROTON ® Clortalidone

IGROTON ® is a chlorthalidone drug

THERAPEUTIC GROUP: Diuretics / Diuretics with minor diuretic action, thiazide-like.

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications IGROTON ® Clortalidone

IGROTON ® is indicated in the treatment of edematous conditions due to heart failure, renal insufficiency, liver failure, premenstrual syndrome and idiopathic forms.

IGROTON ® can be used alone or in combination with other antihypertensive drugs in the treatment of hypertension.

IGROTON ® Clortalidone mechanism of action

IGROTON ® is known to be a long-acting diuretic. This notoriety is justified by the slow pharmacokinetic properties typical of chlorthalidone. The aforementioned active ingredient, in fact, is absorbed for half the dose from the gastro-intestinal tract in about two and a half hours, to reach maximum blood peaks around the twelfth hour and be eliminated, mainly by urine, after about 50 hours of persistence in the body.

The diuretic action is expressed through the inhibition of the sodium / chlorine cotransport at the level of the ascending tract of the Henle loop and of the initial portion of the distal tubule; this effect is accompanied by an increased secretion of potassium ions and water. To the primary effect, it seems subsequently to add an adaptive effect due to the excessive elimination of sodium, which causes the smooth muscle cells of the vascular walls to exchange sodium with calcium, resulting in greater calcium excretion and a reduction in vascular contraction of sodium, partly responsible for high blood pressure levels.

Studies carried out and clinical efficacy

1 CLORTALIDONE, AMONG THE MOST EFFECTIVE TIAZIDICS

Chlorthalidone is today among the most widely used antihypertensive drugs, given the marked therapeutic action expressed even at low doses. An example derives from this study, which compares the hypotensive effect induced by the aforementioned active principle with that of other thiazide diuretics, during 8 weeks of treatment. The results show that on a sample of 30 patients, there was an average drop in systolic blood pressure of about 14mmHg in the chlorthalidone group, and only 7 mmHg in the one treated with other thiazides such as hydrochlorothiazide. In addition to the greater therapeutic effect, the dose of chlorthalidone used was 50% lower than that of hydrochlorothiazide, with a significant decrease in side effects.

2. THE EFFECTIVENESS OF CLORTALIDONE IN HYPERTENSION

The analysis of the literature and all the data taken from the common clinical practice have included chlorthalidone and hydrochlorothiazide, among the most used antihypertensive drugs. More precisely, it was observed that hydrochlorothiazide was the most prescribed active ingredient in the medical class, even in combination therapies. Despite the lower application diffusion, all studies seem to agree on the greater efficacy of chlorthalidone, even at low doses, in the treatment of hypertension, and in a more prolonged biological effect, suggesting its use also in combination therapy.

3. CLORTALIDONE IN COMBINATION: HIGH EFFICIENCY

This study conducted on 300 patients shows that the association of antihypertensive drugs with chlorthalidone at low doses could lead to a greater drop in blood pressure compared to other therapeutic combinations. The greater efficacy of this combination does not derive solely from the greater antihypertensive activity, but also from a significant reduction in collateral effects, given the low but functional doses applied.

Method of use and dosage

IGROTON ® 25 mg chlorthalidone tablets: in the antihypertensive treatment dosages of 25 mg / day (one tablet per day), preferably taken in the morning, are recommended. Given the long half-life of the active ingredient, in the case of prolonged therapies, it is advisable to use a lower maintenance dose than the initial one.

In case of refractoriness to the monotherapy with IGROTON ® it is possible, always under strict medical supervision, to increase the dose, or combine it with other antihypertensive drugs.

In any case, the adjustment of the IGROTON ® dose should be defined by the doctor, following a careful evaluation of the patient's physiopathological characteristics and the severity of his pathology.

IN ANY CASE, BEFORE TAKING IGROTON ® Clortalidone - THE REQUIREMENT AND CHECK OF YOUR DOCTOR IS NECESSARY.

Warnings IGROTON ® Clortalidone

The administration of IGROTON ® as well as other diuretics should be preceded and accompanied by a careful evaluation of the plasma levels of the electrolytes. In the event of an electrolyte imbalance and a correlated symptomatology, it would be necessary to suspend the therapy and provide to balance the deficiencies. This control should be more stringent in patients at risk of electrolyte deficiency, such as elderly subjects, patients suffering from vomiting and persistent diarrhea, in digital therapy and in other similar conditions. Moreover, for diabetic or hyperuricemic patients, it would also be necessary to constantly monitor blood glucose and uricemia levels, given the ability of chlorthalidone to reduce glucose tolerance and facilitate haemoconcentration processes, potentially dangerous even for patients with liver diseases and nephropathies.

It is also important to remember that the drug is excreted intact in the urine, as it may cause side effects of accumulation in anuric patients and suffering from severe renal insufficiency.

There is no known experimental evidence showing a direct effect of chlorthalidone in altering normal driving skills, but it is necessary to take into account that in the event of overdose and electrolytic decompensation, the patient's perceptive and reactive performance may decrease, exposing him to potential risks.

PREGNANCY AND BREASTFEEDING

IGROTON ® more precisely the chlorthalidone, can easily pass the placental barrier and at the same time modify the normal blood flow of organs essential for the correct development of the embryo, first, and of the fetus subsequently. Therefore, it is not recommended to take it during the first trimester of pregnancy, postponing its use later in case of real and inevitable necessity, and naturally under strict medical supervision.

Furthermore, the chlorthalidone is secreted intact in the mother's milk, thus suggesting to suspend breast-feeding while taking the drug.

Interactions

The hypotensive action of IGROTON ® can be increased by the concomitant administration of:

1. Other antipertenisivi drugs;
2. Alcohol;
3. barbiturates and narcotics.

and decreased by non-steroidal anti-inflammatory drugs.

IGROTON ® can instead increase the biological and potentially toxic effect of:

1. Lithium;
2. Curare derivatives;
3. Antihypertensive.

while the excretion of potassium, with consequent risk of hypokalaemia and associated symptoms, can be increased by corticosteroids, ACTH, amphotericin and carbenoxolone.

Contraindications IGROTON ® Clortalidone

Given the particular pharmacokinetic and pharmacodynamic properties of IGROTON ®, its use in the case of anuria, renal and hepatic insufficiency, severe cerebral and coronary vascular diseases, hypersensitivity to one of its components, alterations of the electrolyte (hyponatriemine, hypokalemia, hypercalcemia ) and metabolic (hyperuricemia).

Undesirable effects - Side effects

The recommended dose of IGROTON ® seems to be quite safe and well tolerated, while the incidence of side effects tends to increase with increasing dosage.

Given the biological action of chlorthalidone, its side effects are shared with all other drugs belonging to the same pharmaceutical category and determined by:

• excessive action of the drug: due to incorrect dosages or prolonged treatments, and characterized by the induction of an electrolyte imbalance with the consequent appearance of nausea, vomiting, gastro-enteric diseases, muscle cramps, hypotension, vertigo and, in the most serious cases, arrhythmias.
• haemoconcentration: with increased serum levels of glucose, lipids, nitrogen, uric acid and greater frequency of gouty attacks in hyperuremic patients;
• hypersensitivity to one of its components, with predominantly dermatological reactions.

Note

IGROTON ® is salable only under medical prescription.

The use of IGROTON ® should always take place after consulting your doctor.

The indiscriminate use of IGROTON, between athletes and non-athletes, for the search for the loss of a few pounds, exposes the organism to serious side effects. Furthermore, it is always advisable to reiterate that weight loss is dictated by the elimination of liquids and salts and not by a real weight loss effect, understood as a loss of fat mass.

Therefore IGROTON ® is classified among the DOPANTI substances.