Chlorothiazide

Chlorothiazide
Systematic (IUPAC) name


6-chloro-1,1-dioxo-2H-1,2,4-benzothiadiazine-7-sulfonamide
Clinical data
Trade names	Diuril
AHFS/Drugs.com	monograph
MedlinePlus	a682341
Pregnancy category	US: C (Risk not ruled out)
Routes of administration	Oral, IV
Legal status
Legal status	US: ℞-only
Pharmacokinetic data
Bioavailability	low
Metabolism	Nil
Biological half-life	45 to 60 hours
Excretion	Renal
Identifiers
CAS Number	58-94-6^Y
ATC code	C03AA04 (WHO)
PubChem	CID 2720
IUPHAR/BPS	4835
DrugBank	DB00880^Y
ChemSpider	2619^Y
UNII	77W477J15H^Y
KEGG	D00519^Y
ChEBI	CHEBI:3640^Y
ChEMBL	CHEMBL842^Y
Chemical data
Formula	C₇H₆ClN₃O₄S₂
Molar mass	295.72 g/mol
SMILES O=S(=O)(c1c(Cl)cc2c(c1)S(=O)(=O)/N=C\N2)N
InChI InChI=1S/C7H6ClN3O4S2/c8-4-1-5-7(2-6(4)16(9,12)13)17(14,15)11-3-10-5/h1-3H,(H,10,11)(H2,9,12,13)^Y Key:JBMKAUGHUNFTOL-UHFFFAOYSA-N^Y
(verify)

Chlorothiazide sodium (Diuril) is an organic compound used as a diuretic and as an antihypertensive.^[1]

It is used both within the hospital setting or for personal use to manage excess fluid associated with congestive heart failure. Most often taken in pill form, it is usually taken orally once or twice a day. In the ICU setting, chlorothiazide is given to diurese a patient in addition to furosemide (Lasix). Working in a separate mechanism than furosemide, and absorbed enterically as a reconstituted suspension administered through a nasogastric tube (NG tube), the two drugs potentiate one another.

Indications

Large amount of excess fluid including:
- Diagnosed congested heart failure
- Peripheral edema
- Rales / Rhonchi
- Hypertension

Contraindications

Renal failure or insufficiency
Allergies to sulfa drugs

Side effects

Nausea / Vomiting
Headache
Dizziness
Excess urine production
Dehydration
Hypoelectrolytemia (esp. hypokalemia / hypomagnesia)

History

The Research team of Merck Sharp and Dohme Research Laboratories of Beyer, Sprague, Baer, and Novello created a new series of medications, the thiazide diuretics, which includes chlorothiazide. They won an Albert Lasker Special Award in 1975 for this work.^[2]

References

↑ Ernst, Michael E.; Grimm, Richard H., Jr. "Thiazide diuretics: 50 years and beyond" Current Hypertension Reviews 2008, volume 4(4), pp. 256-265. doi:10.2174/157340208786241264
↑ http://www.laskerfoundation.org/awards/formaward.htm

Antihypertensives: diuretics (C03)

Sulfonamides
(and etacrynic acid)

CA inhibitors (at PT)	Acetazolamide

Loop (Na-K-Cl at AL)	Furosemide^# Bumetanide Etacrynic acid Etozoline Muzolimine Piretanide Tienilic acid Torasemide

Thiazides (Na-Cl at DCT, Calcium-sparing)	Altizide Bendroflumethiazide Chlorothiazide Cyclopenthiazide Cyclothiazide Epitizide Hydrochlorothiazide^# Hydroflumethiazide Mebutizide Methyclothiazide Polythiazide Trichlormethiazide

Thiazide-likes (primarily DCT)	Quinethazone Clopamide Chlortalidone Mefruside Clofenamide Metolazone Meticrane Xipamide Indapamide Clorexolone Fenquizone

Potassium-sparing (at CD)

ESC blockers	Amiloride^# Triamterene Benzamil

Aldosterone antagonists	Spirolactones: Spironolactone^# Eplerenone Potassium canrenoate Canrenone Non-steroidal: Finerenone

Osmotic diuretics (PT, DL)

Vasopressin receptor inhibitors
(DCT and CD)

Other

Ethanol, Isopropanol, 2M2B
mercurial diuretics (Chlormerodrin, Mersalyl, Meralluride)
Theobromine
Cicletanine

^#WHO-EM
^‡Withdrawn from market
Clinical trials:
- ^†Phase III
- ^§Never to phase III

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