Chlortalidone 50mg tablets

Angiotensin receptor blockers (ARBs) are with increasing frequency used in arterial hypertension treatment, this class of medications is especially important in treatment of patients with obesity, metabolic syndrome and diabetes mellitus. Although not all the ARBs are the therapy of first choice in these patients. The special requirements are imposed upon antihypertensive mediations for patients with arterial hypertension and metabolic disorders such as high antihypertensive activity, maximum duration of action, possibility of increase of peripheral tissues sensitivity to insulin and, subsequently, metabolic profile. Besides, these patients require the use of combined therapy already at the treatment start. There are very few ARBs combinations with thiazide diuretics that exhibit these properties. The present review discusses possibilities of new ARB azilsartan medoxomil (Edarbi®) and its combination with chlortalidone (Edarbi® Clo) in decrease of cardiovascular risk in patients with obesity, metabolic syndrome and diabetes mellitus.

Abstract licence: CC BY-NC-SA 4.0

Chlortalidone (CLT) is a thiazide-type diuretic with high affinity for the erythrocyte carbonic anhydrase. Therapeutically, it is mostly used to treat edema and hypertension due to liver cirrhosis, heart insufficiency, or renal dysfunction. Although diuretics and masking agents are prohibited by the World Anti-Doping Agency (WADA) at all times in sports, substances belonging to this category are constantly detected in athlete samples, according to WADA's annual testing figures. Within this group of structurally diverse compounds, a threshold of 20 ng/mL has been introduced for six substances solely due to their presence as contaminants in other permitted drugs because of pharmaceutical production processes. In a recent presumptive doping case with a low urinary CLT concentration, the question of unintentional doping, for example, by contaminated non-steroidal anti-inflammatory drug intake, arose. To examine this potential scenario, a co-elimination of low-dose CLT and hydrochlorothiazide (HCTA; 20 × 50 μg, 0.2 mg/day each) was conducted on five consecutive days in two volunteers. Urine samples were subjected to liquid chromatography-tandem mass spectrometry (LC-MS/MS). Moreover, we examined the incorporation of CLT in scalp hair. HCTA is rapidly excreted renally in comparatively high concentrations. In contrast, the elimination of CLT is considerably slower (terminal elimination half-life extended by a factor of 12) and, consequently, much less concentrated in corresponding urine samples (45 and 53 ng/mL, respectively). Conversely, a higher hair incorporation of chlorthalidone was observed with simultaneous dosing of both. The results suggest that an unintentional intake of sub-therapeutic CLT doses due to contamination might result in an adverse analytical finding.

Abstract licence: CC BY-NC-ND 4.0