Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Chlorthalidone
Drug ID BADD_D00448
Description Chlorthalidone is a thiazide-like diuretic used for the treatment of hypertension and for management of edema caused by conditions such as heart failure or renal impairment. Chlorthalidone improves blood pressure and swelling by preventing water absorption from the kidneys through inhibition of the Na+/Cl− symporter in the distal convoluted tubule cells in the kidney. The exact mechanism of chlorthalidone's anti-hypertensive effect is under debate, however, it is thought that increased diuresis results in decreased plasma and extracellular fluid volume, decreased cardiac output and therefore overall reduction in blood pressure.[A176324] Chlorthalidone is considered first-line therapy for management of uncomplicated hypertension as there is strong evidence from meta-analyses that thiazide diuretics such as chlorthalidone reduce the risk of stroke, myocardial infarction, heart failure, and cardiovascular all-cause mortality in patients with hypertension.[A173863] In particular, the ALLHAT trial confirmed the role of thiazide diuretics as first-line therapy and demonstrated that chlorthalidone had a statistically significant lower incidence of stroke and heart failure when compared to [DB00722], [DB00381], or [DB00590].[A173884, A173887] Further studies have indicated that low-dose thiazides are as good as, and in some secondary endpoints, better than β-blockers, ACE inhibitors, Calcium Channel Blockers or ARBs. Chlorthalidone has been shown to have a number of pleiotropic effects that differentiate it from other diuretics such as [DB00999]. In addition to its antihypertensive effects, chlorthalidone has also been shown to decrease platelet aggregation and vascular permeability, as well as promote angiogenesis in vitro, which is thought to be partly the result of reductions in carbonic anhydrase–dependent pathways. These pathways may play a role in chlorthalidone's cardiovascular risk reduction effects.[A176330]
Indications and Usage Chlorthalidone is indicated in the management of hypertension either as the sole therapeutic agent or to enhance the effect of other antihypertensive drugs in the more severe forms of hypertension. Chlorthalidone is indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. Chlorthalidone has also been found useful in edema due to various forms of renal dysfunction, such as nephrotic syndrome, acute glomerulonephritis, and chronic renal failure.
Marketing Status approved
ATC Code C03BA04
DrugBank ID DB00310
KEGG ID D00272
MeSH ID D002752
PubChem ID 2732
TTD Drug ID D09NIA
NDC Product Code 44657-0034; 70600-008; 50090-6126; 0378-0222; 71610-029; 51224-118; 53808-1105; 57664-648; 63629-8761; 0378-0213; 65162-247; 68382-970; 71610-682; 72189-356; 44657-0058; 29300-333; 46708-676; 51655-477; 68071-5219; 70756-020; 71335-1829; 71610-472; 55289-067; 70199-017; 70518-3718; 71205-592; 71610-021; 53747-063; 51079-058; 51224-018; 51655-526; 51655-790; 57664-649; 62135-506; 62332-676; 65162-250; 70199-001; 75834-110; 53002-1623; 53002-2623; 62332-677; 63629-8762; 67877-696; 70771-1369; 71335-0624; 0904-6900; 44657-0057; 16714-128; 43598-170; 50090-3190; 62135-505; 68382-971; 68788-8294; 71335-2072; 75834-109; 52562-003; 62512-0026; 27241-216; 27241-217; 43598-167; 50090-5183; 51655-961; 63629-9298; 64980-303; 70756-011; 70771-1370; 43598-719; 43598-720; 46708-677; 51655-992; 59746-761; 63629-2465; 67877-697; 69037-0056; 16714-129; 29300-334; 60687-317; 64980-304; 71335-0906; 50268-167; 59746-760
UNII Q0MQD1073Q
Synonyms Chlorthalidone | Chlorphthalidolone | Phthalamudine | Oxodoline | Chlortalidone | Hygroton | Thalitone
Chemical Information
Molecular Formula C14H11ClN2O4S
CAS Registry Number 77-36-1
SMILES C1=CC=C2C(=C1)C(=O)NC2(C3=CC(=C(C=C3)Cl)S(=O)(=O)N)O
Chemical Structure
ADRs Induced by Drug
*The priority for ADR severity classification is based on FAERS assessment, followed by the most severe level in CTCAE rating. If neither is available, it will be displayed as 'Not available'.
**The 'Not Available' level is hidden by default and can be restored by clicking on the legend twice..
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Abdominal discomfort07.01.06.0010.000221%Not Available
Abdominal pain07.01.05.0020.000251%
Abdominal pain upper07.01.05.003--
Agitation19.06.02.001; 17.02.05.012--
Agranulocytosis01.02.03.001--Not Available
Alkalosis14.01.02.001--
Alkalosis hypochloraemic14.01.02.003--Not Available
Anaphylactic reaction24.06.03.006; 10.01.07.0010.000100%
Angle closure glaucoma06.03.01.0010.000402%Not Available
Aplastic anaemia01.03.03.002--Not Available
Arrhythmia02.03.02.001--Not Available
Arthralgia15.01.02.0010.000301%
Asthenia08.01.01.0010.000522%Not Available
Back pain15.03.04.0050.000201%
Blood uric acid increased13.02.04.001--Not Available
Bradycardia02.03.02.0020.000151%Not Available
Chest pain22.12.02.003; 08.01.08.002; 02.02.02.0110.000221%Not Available
Chills15.05.03.016; 08.01.09.0010.000201%
Cholestasis09.01.01.001--Not Available
Choroidal detachment12.01.04.006; 06.09.01.0030.000151%Not Available
Coagulopathy01.01.02.0010.000151%Not Available
Confusional state19.13.01.001; 17.02.03.0050.000251%
Constipation07.02.02.0010.000201%
Cutaneous vasculitis23.06.02.001; 10.02.02.003; 24.12.04.008--Not Available
Dehydration14.05.05.0010.000251%
Dermatitis23.03.04.002--Not Available
Diabetes mellitus14.06.01.001; 05.06.01.001--Not Available
Diarrhoea07.02.01.001--
Dizziness02.11.04.006; 24.06.02.007; 17.02.05.0030.000572%
Drug interaction08.06.03.0010.000100%Not Available
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