Hydrochlorothiazide: profile and news

Point Therapeutics' Diabetes Program Presented at Keystone ... 07 Mar 2006
The study treatment effects of PT-630 were greater than that of metformin, a commonly used drug to treat type 2 diabetes and a cyanopyrrolidine (CP), a DPP-4 ... - Genetic Engineering News,

CROI: Disappointment for glitazones, metformin and testosterone ... Feb 10, 2006
Two different studies from the United States failed to show that metformin - alone or with rosiglitazone - reduces lipodystrophy-associated central fat gain in ... - Aidsmap,

Efforts to curb diabetes reduce incontinence rates Mar 3, 2006
Brown‘s group investigated the effects of diet and exercise, compared to drug treatment with metformin only or inactive "placebo" treatment, on incontinence ... - Pierceland Herald,

Major Canadian Type 2 Diabetes Study Shows Significant Improvement ... Feb 21, 2006
21, 2006 -- Data from a major new Canadian primary-care study show that the combination of rosiglitazone maleate (Avandia®) and low-dose metformin resulted in ... - DG News

Amylin and Eli Lilly seek expanded diabetes approval Mar 3, 2006
...for treatment of people not achieving acceptable blood sugar control despite using the commonly prescribed diabetes medications metformin, a sulfonylurea or a ... - Pharmaceutical Business Review

Sikeston native aids in research of disease Mar 3, 2006
...eight clinical centers of the NASH Clinical Research Network conducting the trials, will also test the effectiveness of vitamin E and metformin, a medication ... - Skieston Standard Democrat,

Latest Diabetes ZOOM Market Report(TM) Released Mar 3, 2006
Takeda has been heavily promoting the results of the PROActive Trial and, in the US and Spain, the new combination of Actos with metformin, ACTOplus met. ... - Yahoo! News (press release)

American Journal of Clinical Nutrition, Vol. 83, No. 2, 466S-469S ... Feb 9, 2006
Furthermore, metformin hydrochloride, a therapy that improves insulin sensitivity by increasing peripheral glucose uptake and utilization and decreasing ... - Am J Clin Nutr (subscription),

Some diabetes drugs may raise risk of cancer death Feb 6, 2006
2 diabetes who take sulfonylureas or insulin appear to be at increased risk of dying from cancer compared with their peers who take metformin, Canadian doctors ... - Reuters

Peroxysome proliferator-activated receptors in reproductive ... Mar 2, 2006
PCOS. Indeed, similar as other 'insulin sensitizer' molecules, such as metformin, glitazones may act directly on ovarian cells. ... - Journal of Endocrinology

American Journal of Clinical Nutrition, Vol. 83, No. 2, 461S-465S ... Feb 9, 2006
68). Metformin also activates AMPK, although metformin does not increase adiponectin concentrations as the TZDs do (69). However ... - Am J Clin Nutr (subscription),

Vinegar Study Offers Hope For Diabetics Feb 4, 2006
...the meal when they consumed the vinegar," said Carol Johnston, Ph.D. "It appears that the vinegar mimics the effects of both Acrabose and Metformin, which are ... - WSOCtv.com,

Behavior med. boon for pharma? Feb 24, 2006
...study that found that an intensive program of physical activity and weight loss was more effective in reducing the incidence of diabetes than the drug metformin ... - Monsters and Critics.com,

Weight loss affects incontinence Feb 21, 2006
...pre-diabetic women who had been randomly assigned to participate in a diet and weight-loss program or to take an oral diabetes drug (metformin) or a placebo. ... - NorthJersey.com,

OSI Pharmaceuticals Announces Initiation of Phase IIa Trial for ... Feb 21, 2006
...with claims covering DPIV as a target foranti-diabetes therapy and the use of combinations of DPIV inhibitorswith other anti-diabetes drugs such as metformin. ... - Finanzen.net,

Women's bladder control seems to improve with weight loss Feb 21, 2006
...overweight, prediabetic women who had been randomly assigned to participate in a diet and weight-loss program or to take an oral diabetes drug (metformin) or a ... - Jackson Hole Star-Tribune,

Obesity Research—Limitations of Methods, Measurements, and ... Feb 14, 2006
The Diabetes Prevention Program evaluated the effects of lifestyle interventions including weight loss compared with metformin and with placebo on diabetes ... - Journal of American Medical Association (subscription),

Weight Loss Improves Bladder Control In Women With Prediabetes Feb 1, 2006
...diabetes by 58 percent. Treatment with metformin lowered the chances of developing diabetes by 31 percent. â€œTo combat the ... - Science Daily (press release)

GlaxoSmithKline launches diabetes and cancer drugs Feb 1, 2006
Avandaryl is manufactured by combining the two drugs Avandina and Sulphonylureas and the drug Avandamet is produced by the combination of Avandina and Metformin ... - MedIndia,

How 'Syndrome W' affects middle aged women Feb 1, 2006
That something is the combination of metformin, a common drug used to treat diabetes, with a diet and exercise plan designed to fight. ... - 7Online.com,

Barr Reports Second Quarter Fiscal 2006 GAAP Earnings of $0.88 Per ... Feb 7, 2006
...of its Didanosine product that was launched in December 2004, which offset lower sales of certain other products, including Claravis(TM) and Metformin 750 mg. ... - MSN Money

Merck Gets Ahead in Diabetes Feb 15, 2006
This data will include how the drug fared both on its own and in combination with drugs metformin, sulfonylurea, and TZDs (anti-diabetes drugs called ... - Red Herring,

Complications of Diabetes Feb 3, 2006
...blood sugar levels, but the common food ingredient appears to mimic the effects of two commonly used medications for diabetes - metformin and acrabose. ... - WSOCtv.com,

Gila Monster Saliva Helps Diabetes Patients Feb 15, 2006
Experts said the drug has the potential to make the biggest splash since the introduction of the popular drug Metformin a decade ago. ... - Local6.com,

Jaundice in a Traveler Returning From India Feb 17, 2006
...by his primary care physician for stable type 2 diabetes mellitus, hypertension, and hyperlipidemia for which he has taken metformin, glimepiride, pravastatin ... - Medscape (subscription)

- By Our Correspondent Feb 17, 2006
...“Granulation of bulk drugs like paracetamol, ibuprofen and metformin eliminates the need for formulations manufacturers in the US, our biggest market, to ... - The Asian Age,

Gila monster venom used to make effective diabetes drug Feb 10, 2006
With its weight loss record, experts said this drug has the potential to make the biggest splash since the introduction of the popular drug Metformin a decade ... - San Antonio Express (subscription),

Vinegar For Health Feb 8, 2006
..."It Appears That The Vinegar Mimics The Effects Of Both Acrabose And Metformin Which Are Two Of The Commonly Prescribed Medications For Diabetics.". ... - CBS 5 - Green Bay,

Obese face risk of liver disease Feb 7, 2006
...nonalcoholic fatty liver disease. They will receive vitamin E, metformin (another diabetes drug) or a placebo. Adult participants will ... - Belleville News-Democrat,

2005 - the year of recovery for GSK Feb 9, 2006
...and fluticasone) for asthma, leapt 22% to £3 billion; combined sales of Avandia (rosiglitazone) and Avandamet (rosiglitazone and metformin) for diabetes grew ... - Pharma Times (subscription),

Glaxo wins approvals for drugs Feb 1, 2006
Avandaryl is Glaxo's second combination diabetes medicine, following on the heels of Avandamet -- which is a mixture of Avandia and metformin -- and management ... - Scotsman,

The Market for Metabolic Syndrome Therapies is Forecast to ... Feb 1, 2006
Some of the most widely prescribed drugs for constituents of the metabolic syndrome (eg, metformin, glibenclamide, simvastatin, lovastatin, pravastatin ... - International News Service,

Sarasota clinic conducting diabetes study Feb 2, 2006
...looking for Type 2-diagnosed volunteers ages 18-70 who either currently do not use diabetes medication or use a stable dose and regimen of metformin to treat ... - Bradenton Herald,

Avandaryl - New Diabetes Combination Drug Launched By Glaxo Feb 1, 2006
...is Glaxo's second combination diabetes medicine, following on the heels of Avandamet — which is a mixture of Avandia and metformin — and management hopes ... - DiabeticNews.com,

GlaxoSmithKline Announces the Approval and Availability of ... Feb 1, 2006
The GSK diabetes franchise includes Avandia(R) (rosiglitazone maleate), Avandamet(R) (rosiglitazone maleate and metformin HCl) and the newly approved Avandaryl ... - PharmaLive.com (press release),

GSK debuts Avandaryl for diabetes in the USA Feb 2, 2006
...in the USA. GSK already sells a combination of rosiglitazone and another diabetes drug, metformin, as Avandamet. Combined sales ... - Pharma Times (subscription),

Other information

Indication
Chlorothiazide is indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. It is also indicated in the management of hypertension either as the sole therapeutic agent or to enhance the effectiveness of other antihypertensive drugs in the more severe forms of hypertension.

Pharmacology
Like other thiazides, chlorothiazide promotes water loss from the body (diuretics). It inhibits Na⁺/Cl^- reabsorption from the distal convoluted tubules in the kidneys. Thiazides also cause loss of potassium and an increase in serum uric acid. Thiazides are often used to treat hypertension, but their hypotensive effects are not necessarily due to their diuretic activity. Thiazides have been shown to prevent hypertension-related morbidity and mortality although the mechanism is not fully understood. Thiazides cause vasodilation by activating calcium-activated potassium channels (large conductance) in vascular smooth muscles and inhibiting various carbonic anhydrases in vascular tissue. Chlorothiazide affects the distal renal tubular mechanism of electrolyte reabsorption. At maximal therapeutic dosages, all thiazides are approximately equal in their diuretic efficacy. Chlorothiazide increases excretion of sodium and chloride in approximately equivalent amounts. Natriuresis may be accompanied by some loss of potassium and bicarbonate.

Mechanism Of Action
As a diuretic, chlorothiazide inhibits active chloride reabsorption at the early distal tubule via the Na-Cl cotransporter, resulting in an increase in the excretion of sodium, chloride, and water. Thiazides like chlorothiazide also inhibit sodium ion transport across the renal tubular epithelium through binding to the thiazide sensitive sodium-chloride transporter. This results in an increase in potassium excretion via the sodium-potassium exchange mechanism. The antihypertensive mechanism of chlorothiazide is less well understood although it may be mediated through its action on carbonic anhydrases in the smooth muscle or through its action on the large-conductance calcium-activated potassium (KCa) channel, also found in the smooth muscle.

Drug Category
Diuretics, Thiazide; Antihypertensive Agents; ATC:C03AA03; ATC:C03AA04

Brand Names/Synonyms
Aldoclor; Alurene; CT; Chloriazid; Chlorosal; Chlorothiazid; Chlorothiazide; Chlorthiazide; Chlortiazid; Chlorurit; Chlotride; Chlrosal; Clotride; Diupres; Diuresal; Diuril; Diuril Boluses; Diuril Lyovac [As Sodium Salt]; Diurilix; Diurite; Diutrid; Esidrix; Flumen; Hydro-D; Hydrochlorothiazide; Hydrochlorothiazide Intensol; Hydrodiuril; Lyovac Diuril [As Sodium Salt]; Microzide; Minzil; Neo-Dema; Oretic; Salisan; Salunil; Saluretil; Saluric; Sk-Chlorothiazide; Thiazide; Urinex; Warduzide; Yadalan; Zide

Dosage Forms
TABLET (250, 500 mg)

Absorption
Not Available

Interactions
Interactions for Chlorothiazide: When given concurrently the following drugs may interact with thiazide diuretics. - Alcohol, barbiturates, or narcotics: Potentiation of otthostatic hypotension may occur. - Antidiabetic drugs: (Oral agents and insulin) Dosage adjustment of the antidiabetic drug may be required. - Other antihypertensive drugs: Additive effect or potentiation. - Cholestyramine and colestipol resins: Cholestytamine and colestipol resins have the potential of binding thiazide diuretics and reducing diuretic absorption from the gastrointestinal tract. - Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia. - Pressor amines (e.g., norepinephrine): Possible decreased response to pressor amines but not sufficient to preclude their use. - Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine): Possible increased responsiveness to the muscle relaxant. - Lithium: Generally should not be given with diuretics. Diuretic agents reduce the renal clearance of lithium and add a high risk of lithium toxicity. Refer to the package insert for lithium preparations before use of such preparations with chlorothiazide. - Non-steroidal Anti-inflammatory Drugs: In some patients, the administration of a non-steroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics. Therefore, when chlorothiazide and non-steroidal anti-inflammatory agents are used concomitantly, the patient should be observed closely to determine if the desired effect of the diuretic is obtained. - Drug/Laboratory Test Interactions: Thiazides should be discontinued before carrying out tests for parathyroid function.

Chemical IUPAC Name
9-chloro-5,5-dioxo-5$l^{6}-thia-2,4-diazabicyclo[4.4.0]deca-3,6,8,10-tetraene-8-sulfonamide

Chemical Formula
C7H6ClN3O4S2

Half Life
45-120 minutes

Drug Type
Approved Drug

# Accession No
APRD00721

CAS Registry Number
58-94-6