Chlortalidone
Classification: AATC code: C03BA04
Summary
The effect of chlorthalidone regarding reduction of blood pressure, morbidity and mortality has been shown to be similar in men and women.
Additional information
Pharmacokinetics and dosing
No studies with a clinically relevant sex analysis regarding the pharmacokinetics or dosing of chlorthalidone have been found.
Effects
A subgroup analysis of the large ALLHAT study (17 719 men, 15 638 women) showed similar mortality and morbidity rates in men and women taking chlorthalidone [1].
Results from the SHEP Pilot Study (248 men, 303 women) showed that blood pressure response to chlorthalidone 25-50 mg/day was similar in men and women [2].
Adverse effects
In a Canadian study comparing effectiveness and safety of chlorthalidone and hydrochlorothiazide in older hypertensive adults (4 224 men and 6 160 women on chlorthalidone; 7 984 men and 11 505 women on hydrochlorothiazide), no significant sex difference in incidence rate of events per 100 person-years was observed [3].
Reproductive health issues
Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).
Other information
The effects of long-term chlorthalidone use on bone-related biochemical variables in elderly patients who had participated in the SHEP program were studied (36 men, 30 women). In both men and women, chlorthalidone use was associated with a decreased serum iPTH (immunoreactive parathyroid hormone) and serum osteocalcin. Vitamin D (measured as 25OHD) levels were lower in women than in men, but were not affected by actual drug therapy [5].
Updated: 2019-04-17
Date of litterature search: 2019-03-11
References
- Oparil S, Davis BR, Cushman WC, Ford CE, Furberg CD, Habib GB et al. Mortality and morbidity during and after Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial: results by sex. Hypertension. 2013;61:977-86. PubMed
- Furberg CD, Black DM. The systolic hypertension in the elderly pilot program: methodological issues. Eur Heart J. 1988;9:223-7. PubMed
- Dhalla IA, Gomes T, Yao Z, Nagge J, Persaud N, Hellings C et al. Chlorthalidone versus hydrochlorothiazide for the treatment of hypertension in older adults: a population-based cohort study. Ann Intern Med. 2013;158:447-55. PubMed
- Hygropax (klortalidon). Summary of Product Characteristics. Swedish Medical Products Agency [updated 2017-05-16, cited 2019-03-11].
- Perry HM, Jensen J, Kaiser FE, Horowitz M, Perry HM, Morley JE. The effects of thiazide diuretics on calcium metabolism in the aged. J Am Geriatr Soc. 1993;41:818-22. PubMed
- Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2018 [cited 2019-03-08.] länk
Reviewed by: Mia von Euler
Approved by: Karin Schenck-Gustafsson