Cyclopenthiazide

CLINICAL USE

Hypertension Heart failure Oedema

DOSE IN NORMAL RENAL FUNCTION

Oedema: up to 500 mcg once dailyHeart failure: 250 mcg – 1 mg once dailyHypertension: 250–500 mcg once daily

PHARMACOKINETICS

Molecular weight :379.9

%Protein binding :No data

%Excreted unchanged in urine : 100

Volume of distribution (L/kg) :No data

half-life – normal/ESRD (hrs) :12/Increased

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Unlikely to work

<10 : Unlikely to work

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Unlikely to work

HD :Unknown dialysability. Unlikely to work

HDF/high flux :Unknown dialysability. Unlikely to work

CAV/VVHD :Unknown dialysability. Unlikely to work

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAnalgesics: increased risk of nephrotoxicity with NSAIDs; antagonism of diuretic effectAnti-arrhythmics: hypokalaemia leads to increased cardiac toxicity; effects of lidocaine and mexiletine antagonisedAntibacterials: avoid administration with lymecyclineAntidepressants: increased risk of hypokalaemia with reboxetine; enhanced hypotensive effect with MAOIs; increased risk of postural hypotension with tricyclicsAnti-epileptics: increased risk of hyponatraemia with carbamazepineAntifungals: increased risk of hypokalaemia with amphotericinAntihypertensives: enhanced hypotensive effect; increased risk of first dose hypotension with post-synaptic alpha-blockers like prazosin; hypokalaemia increases risk of ventricular arrhythmias with sotalolAntipsychotics: hypokalaemia increases risk of ventricular arrhythmias with amisulpride or sertindole; enhanced hypotensive effect with phenothiazines; hypokalaemia increases risk of ventricular arrhythmias with pimozide – avoid concomitant useAtomoxetine: hypokalaemia increases risk of ventricular arrhythmiasCardiac glycosides: increased toxicity if hypokalaemia occursCiclosporin: increased risk of nephrotoxicity and possibly hypomagnesaemiaLithium: excretion reduced, increased toxicity

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

Monitor for hypokalaemia Acts within 1–3 hours, peaks in 4–8 hours and lasts up to 12 hours

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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