Thiazide-like diuretic
Chlortalidone
Brand names: Hygroton
Adult dose
Dose: Hypertension: 12.5–25mg OD (max 50mg). Heart failure: 25–50mg OD
Route: PO
Frequency: OD
Clinical pearls
- Longer-acting (40–60h) than bendroflumethiazide; better evidence for cardiovascular outcomes (SHEP, ALLHAT)
- Consider switch from bendroflumethiazide if BP suboptimal
Contraindications
- Severe renal impairment (eGFR <30)
- Anuria
- Refractory hyponatraemia/hypokalaemia
- Severe hepatic impairment
- Symptomatic hyperuricaemia
Side effects
- Hypokalaemia
- Hyponatraemia
- Hyperuricaemia (gout)
- Hyperglycaemia
- Erectile dysfunction
Interactions
- NSAIDs reduce effect
- Lithium toxicity
- ACEi/ARB additive hypotension
- QT-prolonging drugs (with hypokalaemia)
Monitoring
- U&E
- Glucose
Reference: BNF; NICE NG136; https://bnf.nice.org.uk/drugs/chlortalidone/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines