Clonidine and chlorthalidone

Do not use this medication if you are allergic to clonidine or chlorthalidone, or if you are unable to urinate.

Before using clonidine and chlorthalidone, tell your doctor if you are allergic to any drugs, or if you have:

• kidney disease;

• liver disease;

• asthma or allergies;

• gout;

• lupus;

• diabetes; or

• if you have an allergy to sulfa drugs.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take clonidine and chlorthalidone.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Clonidine and chlorthalidone can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Clonidine and chlorthalidone combinations are used in the treatment of high blood pressure (hypertension).

High blood pressure adds to the work load of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys resulting in a stroke, heart failure, or kidney failure. Hypertension may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Clonidine works by controlling nerve impulses along certain body nerve pathways. As a result, it relaxes blood vessels so that blood passes through them more easily. The chlorthalidone in this combination is a diuretic (water pill) that helps reduce the amount of water in the body by increasing the flow of urine.

Clonidine and chlorthalidone combination is available only with your doctor's prescription.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For clonidine and chlorthalidone, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to clonidine and chlorthalidone or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on clonidine and chlorthalidone have been done only in adult patients, and there is no specific information comparing use of clonidine and chlorthalidone combination in children with use in other age groups. However, children may be more sensitive than adults to clonidine. Clonidine overdose has been reported when children accidentally took clonidine and chlorthalidone.

Geriatric

Dizziness or lightheadedness and signs of too much potassium loss may be more likely to occur in the elderly, who are more sensitive to the effects of clonidine and chlorthalidone.

Pregnancy

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking clonidine and chlorthalidone, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using clonidine and chlorthalidone with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acebutolol
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Amitriptyline
• Amoxapine
• Amtolmetin Guacil
• Arsenic Trioxide
• Aspirin
• Atenolol
• Bepridil
• Betaxolol
• Bevantolol
• Bisoprolol
• Bromfenac
• Bufexamac
• Carteolol
• Celecoxib
• Celiprolol
• Choline Salicylate
• Clomipramine
• Clonixin
• Crizotinib
• Desipramine
• Deslanoside
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Diflunisal
• Digitalis
• Digitoxin
• Digoxin
• Dilevalol
• Diltiazem
• Dipyrone
• Dofetilide
• Dothiepin
• Doxepin
• Droperidol
• Droxicam
• Esmolol
• Etodolac
• Etofenamate
• Etoricoxib
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Flecainide
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Ibuprofen
• Imipramine
• Indomethacin
• Ketanserin
• Ketoprofen
• Ketorolac
• Levobunolol
• Levomethadyl
• Lithium
• Lofepramine
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Metildigoxin
• Metipranolol
• Metoprolol
• Mirtazapine
• Morniflumate
• Nabumetone
• Nadolol
• Naproxen
• Nebivolol
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Nortriptyline
• Oxaprozin
• Oxprenolol
• Oxyphenbutazone
• Parecoxib
• Penbutolol
• Phenylbutazone
• Piketoprofen
• Pindolol
• Piroxicam
• Proglumetacin
• Propranolol
• Propyphenazone
• Proquazone
• Protriptyline
• Rofecoxib
• Salicylic Acid
• Salsalate
• Sodium Salicylate
• Sotalol
• Sulindac
• Tenoxicam
• Tertatolol
• Tiaprofenic Acid
• Timolol
• Tolfenamic Acid
• Tolmetin
• Trimipramine
• Valdecoxib
• Verapamil

Using clonidine and chlorthalidone with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aminolevulinic Acid
• Cyclosporine
• Fluphenazine
• Gossypol
• Licorice
• Mepivacaine
• Naloxone
• Warfarin
• Yohimbine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of clonidine and chlorthalidone. Make sure you tell your doctor if you have any other medical problems, especially:

• Type 2 diabetes mellitus—clonidine and chlorthalidone may change the amount of diabetes medicine needed

• Gout—clonidine and chlorthalidone may increase the amount of uric acid in the blood, which can lead to gout

• Heart or blood vessel disease or
• Lupus erythematosus (history of) or
• Mental depression (history of) or
• Pancreatitis (inflammation of the pancreas) or
• Raynaud's syndrome—clonidine and chlorthalidone may make these conditions worse

• Kidney disease—Effects of clonidine and chlorthalidone may be increased because of slower removal from the body. If kidney disease is severe, the chlorthalidone portion of clonidine and chlorthalidone may not work

• Liver disease—If clonidine and chlorthalidone causes loss of too much water from the body, liver disease can become much worse

• It is used to treat high blood pressure.

Use clonidine and chlorthalidone as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Keep taking this medicine as you have been told by your doctor or other health care provider, even if you feel well.
• To gain the most benefit, do not miss doses.
• Take with or without food.
• This medicine may cause you to pass urine more often. To keep from having sleep problems, try to take before 6 pm.
• Do not stop taking clonidine and chlorthalidone all of a sudden without calling your doctor. You may have a greater risk of side effects. If you need to stop this medicine, you will want to slowly stop it as ordered by your doctor.

What do I do if I miss a dose?

• Take a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.

• Clorpres®

Hypertension: Oral: One tablet (clonidine 0.1-0.3 mg/chlorthalidone 15 mg per tablet) 1-2 times daily; maximum: 0.6 mg clonidine and 30 mg chlorthalidone daily

Store at 20°C to 25°C (68°F to 77°F). Avoid excessive humidity.

Adverse events have been observed in some animal reproduction studies. Refer to individual monographs.

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience constipation, nausea, vomiting, lack of appetite, abdominal cramps, diarrhea, headache, fatigue, or dry mouth. Have patient report immediately to prescriber signs of high blood sugar (confusion, fatigue, increased thirst, increased hunger, polyuria, flushing, fast breathing, or breath that smells like fruit), signs of fluid and electrolyte problems (mood changes, confusion, muscle pain or weakness, abnormal heartbeat, severe dizziness or passing out, tachycardia, increased thirst, seizures, loss of strength and energy, lack of appetite, urinary retention or change in amount of urine passed, dry mouth, dry eyes, or nausea or vomiting), signs of kidney problems (urinary retention, hematuria, change in amount of urine passed, or weight gain), signs of pancreatitis (severe abdominal pain, severe back pain, severe nausea, or vomiting), jaundice, burning or numbness feeling, chills, severe pharyngitis, bruising, bleeding, severe loss of strength and energy, sexual dysfunction, agitation, severe dizziness, passing out, or vision changes (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.