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 For 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.
Marketing Status Prescription; Discontinued
ATC Code C03BA04
DrugBank ID DB00310
KEGG ID D00272
MeSH ID D002752
PubChem ID 2732
TTD Drug ID D09NIA
NDC Product Code 50090-3910; 50090-5860; 70934-470; 57664-649; 68071-4018; 70199-017; 55700-586; 53808-1105; 66689-345; 51079-058; 50090-4223; 71610-472; 44657-0058; 70600-008; 65162-247; 29300-334; 50090-3190; 62135-505; 71205-592; 68382-971; 70934-938; 50090-5085; 63629-6347; 16714-801; 62512-0026; 44657-0057; 63629-8762; 70518-1376; 0378-0222; 59746-761; 43598-720; 53747-063; 63629-8761; 63629-2465; 71335-0906; 71335-1829; 29300-333; 59746-760; 50090-3161; 75834-110; 70199-001; 50268-167; 69037-0056; 71610-029; 0378-0213; 70934-562; 27241-217; 16714-128; 67877-697; 57664-648; 70518-2552; 64980-304; 66689-346; 67877-696; 64980-303; 71610-021; 68382-970; 70518-2690; 63629-8480; 75834-109; 65162-250; 50090-5643; 50090-5183; 55289-067; 16714-129; 53002-1623; 71335-1708; 71335-0624; 27241-216; 0904-6900; 50090-5044; 68071-5219; 16714-800; 68071-4636; 43598-719; 63629-5259; 50090-5541; 62135-506; 60687-317; 70771-1369; 70771-1370; 44657-0034; 52562-003
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
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Not AvailableNot AvailableNot AvailableNot AvailableNot Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Pyrexia08.05.02.0030.001537%
Rash23.03.13.001--Not Available
Respiratory failure22.02.06.002; 14.01.04.0030.000769%
Restlessness19.11.02.002; 17.02.05.021--
Rhabdomyolysis15.05.05.0020.000512%
Septic shock24.06.02.011; 11.01.11.0040.001025%Not Available
Syncope24.06.02.012; 17.02.04.008; 02.01.02.0080.001537%
Thrombocytopenia01.08.01.002--Not Available
Toxic epidermal necrolysis23.03.01.008; 11.07.01.006; 12.03.01.015; 10.01.01.006--
Transient ischaemic attack24.04.06.005; 17.08.04.0010.000512%
Tremor17.01.06.0020.000769%
Type I hypersensitivity10.01.03.0060.001025%Not Available
Urticaria23.04.02.001; 10.01.06.001--
Vascular purpura24.07.06.011; 23.06.01.008; 01.01.04.007--Not Available
Vasculitis24.05.02.001; 10.02.02.006--
Vasculitis necrotising24.05.02.002; 10.02.02.008--Not Available
Vertigo17.02.12.002; 04.04.01.003--
Vomiting07.01.07.0030.002562%
Xanthopsia06.02.05.002--Not Available
Mental status changes19.07.01.0010.000512%Not Available
Tubulointerstitial nephritis20.05.02.002--Not Available
Epigastric discomfort07.01.02.004--Not Available
Inappropriate antidiuretic hormone secretion14.05.07.001; 05.03.03.0010.000769%Not Available
Metabolic disorder14.11.01.001--Not Available
Cardiac disorder02.01.01.0030.000769%Not Available
Temperature regulation disorder08.05.01.0040.000769%Not Available
Decreased appetite14.03.01.005; 08.01.09.0280.000512%
Erectile dysfunction21.03.01.007; 19.08.04.001--
Renal impairment20.01.03.0100.000769%Not Available
Hypophagia19.09.01.004; 14.03.01.006; 07.01.06.0100.000512%Not Available
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