Clonidine and Chlorthalidone

Pronunciation

(KLON i deen & klor THAL i done)

U.S. Brand Names

Clorpres®; Combipres® [DSC]

Synonyms

Chlorthalidone and Clonidine

Generic Available

No

Use

Management of mild to moderate hypertension

Pregnancy Risk Factor

C

Pregnancy Implications

Refer to Clonidine monograph.

Lactation

Clonidine: Enters breast milk/not recommended

Chlorthalidone: Enters breast milk/compatible

Adverse Reactions

See individual agents.

Drug Interactions

See individual agents.

Pharmacodynamics/Kinetics

See individual agents.

Dosage

Oral: 1 tablet 1-2 times/day; maximum: 0.6 mg clonidine and 30 mg chlorthalidone

Patient Education

See individual agents. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to become pregnant. Breast-feeding is not recommended.

Cardiovascular Considerations

Combination therapy for the treatment of hypertension should be individualized for each patient. Potential advantages for clonidine and chlorthalidone combination therapy may include improved compliance and synergistic reductions in blood pressure with an accomplished reduction in side effects. Thiazide therapy improves cardiovascular outcomes in patients with hypertension. See Special Cardiovascular Considerations for individual agents.

Dental Health: Effects on Dental Treatment

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions

No information available to require special precautions

Mental Health: Effects on Mental Status

Drowsiness is common

Mental Health: Effects on Psychiatric Treatment

Dry mouth, orthostatic hypotension, and sedation may be increased with concurrent psychotropic use; TCAs may antagonize clonidine's hypotensive effect; rare reports of blood dyscrasias; use caution with clozapine and carbamazepine; thiazides decrease lithium clearance resulting in elevated serum lithium levels and potential toxicity; monitor serum lithium levels

Dosage Forms

Tablet:

0.1: Clonidine hydrochloride 0.1 mg and chlorthalidone 15 mg

0.2: Clonidine hydrochloride 0.2 mg and chlorthalidone 15 mg

0.3: Clonidine hydrochloride 0.3 mg and chlorthalidone 15 mg

References

Chobanian AV, Bakris GL, Black HR, et al, "The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report,"JAMA, 2003, 289(19):2560-71.

Kaplan NM and Sever PS, "Combination Therapy: A Key to Comprehensive Patient Care,"Am J Hypertens, 1997, 10(7 Pt 2):127S.

Moser M and Black HR, "The Role of Combination Therapy in the Treatment of Hypertension,"Am J Hypertens, 1998, 11(6 Pt 2):73S-8S, 95S-100S.