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warnings
WARNINGS Chlorthalidone should be used with caution in severe renal disease. In patients with renal disease, chlorthalidone or related drugs may precipitate azotemia. Cumulative effects of the drug may develop in patients with impaired renal function. Chlorthalidone should be used with caution in patients with impaired hepatic function or progressive liver disease, because minor alterations of fluid and electrolyte balance may precipitate hepatic coma. Sensitivity reactions may occur in patients with a history of allergy or bronchial asthma. The possibility of exacerbation or activation of systemic lupus erythematosus has been reported with thiazide diuretics which are structurally related to chlorthalidone. However, systemic lupus erythematosus has not been reported following chlorthalidone administration.
ADVERSE REACTIONS The following adverse reactions have been observed, but there is not enough systematic collection of data to support an estimate of their frequency. Gastrointestinal System Reactions: anorexia diarrhea gastric irritation constipation nausea jaundice (intrahepatic vomiting cholestatic jaundice) cramping pancreatitis Central Nervous System Reactions: dizziness headache vertigo xanthopsia paresthesias Hematologic Reactions: leukopenia thrombocytopenia agranulocytosis aplastic anemia Dermatologic-Hypersensitivity Reactions: purpura necrotizing angiitis photosensitivity (vasculitis) rash (cutaneous vasculitis) urticaria Lyell’s syndrome (toxic epidermal necrolysis) Cardiovascular Reaction: Orthostatic hypotension may occur and may be aggravated by alcohol, barbiturates or narcotics. Other Adverse Reactions: Hyperglycemia glycosuria weakness Hyperuricemia restlessness muscle spasm impotence Whenever adverse reactions are moderate or severe, chlorthalidone dosage should be reduced or therapy withdrawn.