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class="vector-toc-list"> </ul> </li> <li id="toc-Diabetes_insipidus" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Diabetes_insipidus"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.7</span> <span>Diabetes insipidus</span> </div> </a> <ul id="toc-Diabetes_insipidus-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Adverse_effects" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Adverse_effects"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Adverse effects</span> </div> </a> <ul id="toc-Adverse_effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mechanism_of_action" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Mechanism_of_action"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Mechanism of action</span> </div> </a> <ul id="toc-Mechanism_of_action-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Pharmacokinetics" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Pharmacokinetics"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Pharmacokinetics</span> </div> </a> <ul id="toc-Pharmacokinetics-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Chemistry" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Chemistry"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Chemistry</span> </div> </a> <ul id="toc-Chemistry-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Society and culture</span> </div> </a> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of 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Available in 18 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-18" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">18 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%83%D9%84%D9%88%D8%B1%D8%AA%D8%A7%D9%84%D9%8A%D8%AF%D9%88%D9%86" title="كلورتاليدون – Arabic" lang="ar" hreflang="ar" data-title="كلورتاليدون" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%DA%A9%D9%84%D8%B1%D8%AA%D8%A7%D9%84%DB%8C%D8%AF%D9%88%D9%86" title="کلرتالیدون – South Azerbaijani" lang="azb" hreflang="azb" data-title="کلرتالیدون" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target"><span>تۆرکجه</span></a></li><li class="interlanguage-link interwiki-cy mw-list-item"><a href="https://cy.wikipedia.org/wiki/Clortalidon" title="Clortalidon – Welsh" lang="cy" hreflang="cy" data-title="Clortalidon" data-language-autonym="Cymraeg" data-language-local-name="Welsh" class="interlanguage-link-target"><span>Cymraeg</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Chlortalidon" title="Chlortalidon – German" lang="de" hreflang="de" data-title="Chlortalidon" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Clortalidona" title="Clortalidona – Spanish" lang="es" hreflang="es" data-title="Clortalidona" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%DA%A9%D9%84%D8%B1%D8%AA%D8%A7%D9%84%DB%8C%D8%AF%D9%88%D9%86" title="کلرتالیدون – Persian" lang="fa" hreflang="fa" data-title="کلرتالیدون" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Chlortalidone" title="Chlortalidone – French" lang="fr" hreflang="fr" data-title="Chlortalidone" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Klortalidon" title="Klortalidon – Croatian" lang="hr" hreflang="hr" data-title="Klortalidon" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Clortalidone" title="Clortalidone – Italian" lang="it" hreflang="it" data-title="Clortalidone" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%82%AF%E3%83%AD%E3%83%AB%E3%82%BF%E3%83%AA%E3%83%89%E3%83%B3" title="クロルタリドン – Japanese" lang="ja" hreflang="ja" data-title="クロルタリドン" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%95%E0%AD%8D%E0%AC%B2%E0%AD%8B%E0%AC%B0%E0%AC%9F%E0%AC%BE%E0%AC%B2%E0%AC%BF%E0%AC%A1%E0%AC%A8" title="କ୍ଲୋରଟାଲିଡନ – Odia" lang="or" hreflang="or" data-title="କ୍ଲୋରଟାଲିଡନ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Chlorotalidon" title="Chlorotalidon – Polish" lang="pl" hreflang="pl" data-title="Chlorotalidon" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Clortalidona" title="Clortalidona – Portuguese" lang="pt" hreflang="pt" data-title="Clortalidona" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A5%D0%BB%D0%BE%D1%80%D1%82%D0%B0%D0%BB%D0%B8%D0%B4%D0%BE%D0%BD" title="Хлорталидон – Russian" lang="ru" hreflang="ru" data-title="Хлорталидон" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Hlortalidon" title="Hlortalidon – Serbian" lang="sr" hreflang="sr" data-title="Hlortalidon" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Hlortalidon" title="Hlortalidon – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Hlortalidon" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%A5%D0%BB%D0%BE%D1%80%D1%82%D0%B0%D0%BB%D1%96%D0%B4%D0%BE%D0%BD" title="Хлорталідон – Ukrainian" lang="uk" hreflang="uk" data-title="Хлорталідон" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Chlortalidone" title="Chlortalidone – Vietnamese" lang="vi" hreflang="vi" data-title="Chlortalidone" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li> </ul> <div 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<div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Thiazide-like diuretic drug</div> <p class="mw-empty-elt"> </p> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox" style="border-spacing:2px;"><caption class="infobox-title"><span title="International nonproprietary name (INN): Chlortalidone">Chlortalidone</span></caption><tbody><tr><td colspan="2" class="infobox-image notheme" style="background-color: #f8f9fa;"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Chlortalidone.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d3/Chlortalidone.svg/220px-Chlortalidone.svg.png" decoding="async" width="220" height="139" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d3/Chlortalidone.svg/330px-Chlortalidone.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d3/Chlortalidone.svg/440px-Chlortalidone.svg.png 2x" data-file-width="607" data-file-height="384" /></a></span></td></tr><tr><td colspan="2" class="infobox-image notheme" style="background-color: #f8f9fa;"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Chlortalidone_ball-and-stick_3F4X.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c4/Chlortalidone_ball-and-stick_3F4X.png/220px-Chlortalidone_ball-and-stick_3F4X.png" decoding="async" width="220" height="127" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c4/Chlortalidone_ball-and-stick_3F4X.png/330px-Chlortalidone_ball-and-stick_3F4X.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c4/Chlortalidone_ball-and-stick_3F4X.png/440px-Chlortalidone_ball-and-stick_3F4X.png 2x" data-file-width="2000" data-file-height="1151" /></a></span></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd">Clinical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_nomenclature#Trade_names" title="Drug nomenclature">Trade names</a></th><td class="infobox-data">Hygroton, Thalitone, others</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/American_Society_of_Health-System_Pharmacists" title="American Society of Health-System Pharmacists">AHFS</a>/<a href="/wiki/Drugs.com" title="Drugs.com">Drugs.com</a></th><td class="infobox-data"><span title="www.drugs.com"><a rel="nofollow" class="external text" href="https://www.drugs.com/monograph/chlorthalidone.html">Monograph</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span title="medlineplus.gov"><a rel="nofollow" class="external text" href="https://medlineplus.gov/druginfo/meds/a682342.html">a682342</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">License data</a></th><td class="infobox-data"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style><div class="plainlist"> <ul><li><small><abbr class="country-name" title="United States">US</abbr></small> <a href="/wiki/DailyMed" title="DailyMed">DailyMed</a>: <span title="dailymed.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Chlorthalidone">Chlorthalidone</a></span></li></ul></div> </td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Pregnancy_category" title="Pregnancy category">Pregnancy<br />category</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><small><abbr class="country-name" title="Australia">AU</abbr>:</small> C</li> <li class="mw-empty-elt"></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Route_of_administration" title="Route of administration">Routes of<br />administration</a></th><td class="infobox-data"><a href="/wiki/Oral_administration" title="Oral administration">By mouth</a></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_class" title="Drug class">Drug class</a></th><td class="infobox-data"><a href="/wiki/Thiazide-like_diuretic" title="Thiazide-like diuretic">Thiazide-like diuretic</a></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Anatomical_Therapeutic_Chemical_Classification_System" title="Anatomical Therapeutic Chemical Classification System">ATC code</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><a href="/wiki/ATC_code_C03" title="ATC code C03">C03BA04</a> (<span title="www.whocc.no"><a rel="nofollow" class="external text" href="https://www.whocc.no/atc_ddd_index/?code=C03BA04">WHO</a></span>) </li></ul></div></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd">Legal status</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">Legal status</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><small><abbr class="country-name" title="United Kingdom">UK</abbr>:</small> <a href="/wiki/Prescription_drug" title="Prescription drug">POM</a> (Prescription only)</li> <li><small><abbr class="country-name" title="United States">US</abbr>:</small> <a href="/wiki/Prescription_drug" title="Prescription drug">℞-only</a></li></ul></div> </td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd"><a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">Pharmacokinetic</a> data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Plasma_protein_binding" title="Plasma protein binding">Protein binding</a></th><td class="infobox-data">75%</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Biological_half-life" title="Biological half-life">Elimination <span class="nowrap">half-life</span></a></th><td class="infobox-data">40 hours</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Excretion" title="Excretion">Excretion</a></th><td class="infobox-data"><a href="/wiki/Kidney" title="Kidney">Kidney</a></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd">Identifiers</th></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/IUPAC_nomenclature_of_chemistry" title="IUPAC nomenclature of chemistry">IUPAC name</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all; text-align:left; padding-left:1.5em; text-indent:-1.5em;"><li style="line-height: inherit; margin: 0"><div style="font-size: 97%;">(<i>RS</i>)-2-Chloro-5-(1-hydroxy-3-oxo-2,3-dihydro-1<i>H</i>-isoindol-1-yl)benzene-1-sulfonamide</div></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/CAS_Registry_Number" title="CAS Registry Number">CAS Number</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="commonchemistry.cas.org"><a rel="nofollow" class="external text" href="https://commonchemistry.cas.org/detail?cas_rn=77-36-1">77-36-1</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/PubChem#CID" title="PubChem">PubChem</a> <span style="font-weight:normal"><abbr title="Compound ID">CID</abbr></span></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="pubchem.ncbi.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://pubchem.ncbi.nlm.nih.gov/compound/2732">2732</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Guide_to_Pharmacology" title="Guide to Pharmacology">IUPHAR/BPS</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.guidetopharmacology.org"><a rel="nofollow" class="external text" href="https://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=7147">7147</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/DrugBank" title="DrugBank">DrugBank</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.drugbank.ca"><a rel="nofollow" class="external text" href="https://www.drugbank.ca/drugs/DB00310">DB00310</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChemSpider" title="ChemSpider">ChemSpider</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.chemspider.com"><a rel="nofollow" class="external text" href="https://www.chemspider.com/Chemical-Structure.2631.html">2631</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Unique_Ingredient_Identifier" title="Unique Ingredient Identifier">UNII</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="precision.fda.gov"><a rel="nofollow" class="external text" href="https://precision.fda.gov/uniisearch/srs/unii/Q0MQD1073Q">Q0MQD1073Q</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/KEGG" title="KEGG">KEGG</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.kegg.jp"><a rel="nofollow" class="external text" href="https://www.kegg.jp/entry/D00272">D00272</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChEBI" title="ChEBI">ChEBI</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.ebi.ac.uk"><a rel="nofollow" class="external text" href="https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:3654">CHEBI:3654</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChEMBL" title="ChEMBL">ChEMBL</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.ebi.ac.uk"><a rel="nofollow" class="external text" href="https://www.ebi.ac.uk/chembl/explore/compound/ChEMBL1055">ChEMBL1055</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/CompTox_Chemicals_Dashboard" title="CompTox Chemicals Dashboard">CompTox Dashboard</a> <span style="font-weight:normal">(<abbr title="U.S. Environmental Protection Agency">EPA</abbr>)</span></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="comptox.epa.gov"><a rel="nofollow" class="external text" href="https://comptox.epa.gov/dashboard/chemical/details/DTXSID4022812">DTXSID4022812</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q425289#P3117" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ECHA_InfoCard" class="mw-redirect" title="ECHA InfoCard"><span title="echa.europa.eu">ECHA InfoCard</span></a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="https://echa.europa.eu/substance-information/-/substanceinfo/100.000.930">100.000.930</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q425289#P2566" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd">Chemical and physical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Chemical_formula" title="Chemical formula">Formula</a></th><td class="infobox-data"><span title="Carbon">C</span><sub>14</sub><span title="Hydrogen">H</span><sub>11</sub><span title="Chlorine">Cl</span><span title="Nitrogen">N</span><sub>2</sub><span title="Oxygen">O</span><sub>4</sub><span title="Sulfur">S</span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Molar_mass" title="Molar mass">Molar mass</a></th><td class="infobox-data"><span class="nowrap"><span data-sort-value="7002338760000000000♠"></span>338.76</span> g·mol<sup>−1</sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">3D model (<a href="/wiki/JSmol" class="mw-redirect" title="JSmol">JSmol</a>)</th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="chemapps.stolaf.edu (3D interactive model)"><a rel="nofollow" class="external text" href="https://chemapps.stolaf.edu/jmol/jmol.php?model=O%3DS%28%3DO%29%28N%29c1c%28Cl%29ccc%28c1%29C2%28O%29c3ccccc3C%28%3DO%29N2">Interactive image</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Chirality_(chemistry)" title="Chirality (chemistry)">Chirality</a></th><td class="infobox-data"><a href="/wiki/Racemic_mixture" title="Racemic mixture">Racemic mixture</a></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/Simplified_molecular-input_line-entry_system" class="mw-redirect" title="Simplified molecular-input line-entry system">SMILES</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">O=S(=O)(N)c1c(Cl)ccc(c1)C2(O)c3ccccc3C(=O)N2</div></li></ul> </div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/International_Chemical_Identifier" title="International Chemical Identifier">InChI</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">InChI=1S/C14H11ClN2O4S/c15-11-6-5-8(7-12(11)22(16,20)21)14(19)10-4-2-1-3-9(10)13(18)17-14/h1-7,19H,(H,17,18)(H2,16,20,21)<sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></div></li><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">Key:JIVPVXMEBJLZRO-UHFFFAOYSA-N<sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></div></li></ul> </div></td></tr><tr><td colspan="2" class="infobox-below"><style data-mw-deduplicate="TemplateStyles:r886047488">.mw-parser-output .nobold{font-weight:normal}</style><span class="nobold">  <span class="reflink plainlinks nourlexpansion"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Special:ComparePages&rev1=460034023&page2=Chlortalidone">(verify)</a></span></span></td></tr></tbody></table> <p><b>Chlortalidone</b>, also known as <b>chlorthalidone</b>, is a <a href="/wiki/Thiazide-like_diuretic" title="Thiazide-like diuretic">thiazide-like diuretic</a> drug<sup id="cite_ref-Ace2019_1-0" class="reference"><a href="#cite_note-Ace2019-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> used to treat <a href="/wiki/Hypertension" title="Hypertension">high blood pressure</a>, <a href="/wiki/Edema" title="Edema">swelling</a> (such as occurs in <a href="/wiki/Heart_failure" title="Heart failure">heart failure</a>, <a href="/wiki/Liver_failure" title="Liver failure">liver failure</a>, and <a href="/wiki/Nephrotic_syndrome" title="Nephrotic syndrome">nephrotic syndrome</a>), <a href="/wiki/Diabetes_insipidus" title="Diabetes insipidus">diabetes insipidus</a>, and <a href="/wiki/Renal_tubular_acidosis" title="Renal tubular acidosis">renal tubular acidosis</a>.<sup id="cite_ref-AHFS2019_2-0" class="reference"><a href="#cite_note-AHFS2019-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-BNF76_3-0" class="reference"><a href="#cite_note-BNF76-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Because chlortalidone is effective in most patients with high blood pressure, it is considered a preferred initial treatment.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-AHFS2019_2-1" class="reference"><a href="#cite_note-AHFS2019-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> It is also used to prevent calcium-based <a href="/wiki/Nephrolithiasis" class="mw-redirect" title="Nephrolithiasis">kidney stones</a>.<sup id="cite_ref-AHFS2019_2-2" class="reference"><a href="#cite_note-AHFS2019-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> It is taken by mouth.<sup id="cite_ref-AHFS2019_2-3" class="reference"><a href="#cite_note-AHFS2019-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Effects generally begin within three hours and last for up to three days.<sup id="cite_ref-AHFS2019_2-4" class="reference"><a href="#cite_note-AHFS2019-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Long-term treatment with chlortalidone is more effective than <a href="/wiki/Hydrochlorothiazide" title="Hydrochlorothiazide">hydrochlorothiazide</a> for prevention of <a href="/wiki/Heart_attack" class="mw-redirect" title="Heart attack">heart attack</a> or <a href="/wiki/Stroke" title="Stroke">stroke</a>.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>Common adverse effects include <a href="/wiki/Hypokalemia" title="Hypokalemia">low blood potassium</a>, <a href="/wiki/Hyponatremia" title="Hyponatremia">low blood sodium</a>, <a href="/wiki/High_blood_sugar" class="mw-redirect" title="High blood sugar">high blood sugar</a>, dizziness, and <a href="/wiki/Erectile_dysfunction" title="Erectile dysfunction">erectile dysfunction</a>.<sup id="cite_ref-AHFS2019_2-5" class="reference"><a href="#cite_note-AHFS2019-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-BNF76_3-1" class="reference"><a href="#cite_note-BNF76-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Other adverse effects may include <a href="/wiki/Gout" title="Gout">gout</a>, <a href="/wiki/Hypomagnesemia" class="mw-redirect" title="Hypomagnesemia">low blood magnesium</a>, <a href="/wiki/Hypercalcemia" class="mw-redirect" title="Hypercalcemia">high blood calcium</a>, allergic reactions, and <a href="/wiki/Low_blood_pressure" class="mw-redirect" title="Low blood pressure">low blood pressure</a>.<sup id="cite_ref-AHFS2019_2-6" class="reference"><a href="#cite_note-AHFS2019-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-BNF76_3-2" class="reference"><a href="#cite_note-BNF76-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> Some reviews have found chlortalidone and hydrochlorothiazide to have a similar risk of adverse effects,<sup id="cite_ref-Din2019_8-0" class="reference"><a href="#cite_note-Din2019-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Rou2018_9-0" class="reference"><a href="#cite_note-Rou2018-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> while other reviews have found chlortalidone to have a higher risk.<sup id="cite_ref-Ace2019_1-1" class="reference"><a href="#cite_note-Ace2019-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Spr2015_10-0" class="reference"><a href="#cite_note-Spr2015-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> While it may be used in <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a> it is a less preferred option.<sup id="cite_ref-AHFS2019_2-7" class="reference"><a href="#cite_note-AHFS2019-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> How it works is not completely clear but is believed to involve increasing the amount of <a href="/wiki/Sodium" title="Sodium">sodium</a> and water lost by the kidneys.<sup id="cite_ref-AHFS2019_2-8" class="reference"><a href="#cite_note-AHFS2019-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>Chlortalidone was patented in 1957 and came into medical use in 1960.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> It is on the <a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">World Health Organization's List of Essential Medicines</a>.<sup id="cite_ref-WHO23rd_12-0" class="reference"><a href="#cite_note-WHO23rd-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> It is available as a <a href="/wiki/Generic_medication" class="mw-redirect" title="Generic medication">generic medication</a>.<sup id="cite_ref-BNF76_3-3" class="reference"><a href="#cite_note-BNF76-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> In 2022, it was the 108th most commonly prescribed medication in the United States, with more than 5<span class="nowrap"> </span>million prescriptions.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Medical_use">Medical use</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=1" title="Edit section: Medical use"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="High_blood_pressure">High blood pressure</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=2" title="Edit section: High blood pressure"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chlortalidone is considered a first-line medication for treatment of <a href="/wiki/High_blood_pressure" class="mw-redirect" title="High blood pressure">high blood pressure</a>.<sup id="cite_ref-AHFS2019_2-9" class="reference"><a href="#cite_note-AHFS2019-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Some recommend chlortalidone over <a href="/wiki/Hydrochlorothiazide" title="Hydrochlorothiazide">hydrochlorothiazide</a>.<sup id="cite_ref-Ace2019_1-2" class="reference"><a href="#cite_note-Ace2019-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> A meta-analysis of randomized controlled trials found that chlortalidone is more effective than hydrochlorothiazide for lowering blood pressure, while the two drugs have similar toxicity.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Ace2019_1-3" class="reference"><a href="#cite_note-Ace2019-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Spr2015_10-1" class="reference"><a href="#cite_note-Spr2015-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>Trials of chlortalidone for high blood pressure found that lower doses of chlortalidone (e.g., 12.5 mg daily in ALLHAT study) had maximal blood pressure lowering effect and that higher doses did not lower it more. Chlortalidone and other thiazide diuretics are effective for lowering high blood pressure in persons with <a href="/wiki/Chronic_kidney_disease" title="Chronic kidney disease">chronic kidney disease</a>, although the risk of adverse effects is higher.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> <sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Left_ventricular_hypertrophy">Left ventricular hypertrophy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=3" title="Edit section: Left ventricular hypertrophy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chlortalidone is used to treat <a href="/wiki/Left_ventricular_hypertrophy" title="Left ventricular hypertrophy">enlargement of the left ventricle of the heart</a>; it works chiefly by lowering blood pressure, and thereby reducing systemic vascular resistance. There is evidence that chlortalidone is superior to hydrochlorothiazide for reducing the mass of the left ventricle of the heart in persons with <a href="/wiki/Left_ventricular_hypertrophy" title="Left ventricular hypertrophy">enlargement of the left ventricle of the heart</a>.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> Chlortalidone is superior to <a href="/wiki/Angiotensin_converting_enzyme" class="mw-redirect" title="Angiotensin converting enzyme">angiotensin converting enzyme</a> Inhibitors or <a href="/wiki/Angiotensin_II_receptor_blocker" title="Angiotensin II receptor blocker">angiotensin II receptor blockers</a> for inducing regression of enlargement of the left ventricle, which is the main pumping chamber of the heart.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Swelling">Swelling</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=4" title="Edit section: Swelling"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chlortalidone reduces <a href="/wiki/Edema" title="Edema">edema</a> (swelling) by increasing urinary salt and water excretion, lowering intravascular hydrostatic pressure and thereby lowering transcapillary pressure (see <a href="/wiki/Starling_Equation" class="mw-redirect" title="Starling Equation">Starling Equation</a>). Edema may be caused by either increased <a href="/wiki/Hydrostatic_pressure" class="mw-redirect" title="Hydrostatic pressure">hydrostatic pressure</a> or reduced <a href="/wiki/Oncotic_pressure" title="Oncotic pressure">oncotic pressure</a> in the blood vessels. Edema due to increased hydrostatic pressure may be a result of serious cardiopulmonary disease (which reduces glomerular perfusion in the kidney) or to kidney injury or disease (which may reduce glomerular excretion of salt and water by the kidney) or due to relatively benign conditions such as menstrual-related fluid retention, or as an adverse effect of <a href="/wiki/Dihydropyridine" class="mw-redirect" title="Dihydropyridine">dihydropyridine</a> <a href="/wiki/Calcium_channel_blocker" title="Calcium channel blocker">calcium channel blockers</a>, which commonly cause swelling of the feet and lower legs. Edema due to decreased oncotic pressure may be a result of leaking of blood proteins through the glomeruli of an injured kidney<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> or a result of diminished synthesis of blood proteins by a damaged liver. Regardless of cause, chlortalidone may reduce the severity of edema by reducing intravascular volume and thereby reducing intravascular hydrostatic pressure.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Bone_fracture_prevention">Bone fracture prevention</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=5" title="Edit section: Bone fracture prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chlortalidone decreases mineral bone loss by promoting calcium retention by the kidney, and by directly stimulating <a href="/wiki/Osteoblast" title="Osteoblast">osteoblast</a> differentiation and bone mineral formation.<sup id="cite_ref-pmid17656470_26-0" class="reference"><a href="#cite_note-pmid17656470-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> A Cochrane review found tentative evidence that thiazide exposure was associated with a reduced risk of hip fracture.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> A secondary analysis of data from the ALLHAT study found that chlortalidone reduced risk of hip and pelvis fracture.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Kidney_stone_prevention">Kidney stone prevention</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=6" title="Edit section: Kidney stone prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chlortalidone reduces the amount of calcium excreted in urine, reducing the risk of <a href="/wiki/Calcium_oxalate" title="Calcium oxalate">calcium oxalate</a> <a href="/wiki/Kidney_stone" class="mw-redirect" title="Kidney stone">kidney stones</a>.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> In people who have had multiple episodes of calcium oxalate kidney stones, chlortalidone lowers the risk of having another episode of kidney stones.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> Chlortalidone is more effective than hydrochlorothiazide for lowering urine calcium levels and is therefore probably more effective.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Ménière's_disease"><span id="M.C3.A9ni.C3.A8re.27s_disease"></span>Ménière's disease</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=7" title="Edit section: Ménière's disease"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chlortalidone reduces the endolymph volume which reduces the hydrostatic pressure in the inner ear chambers; elevated endolymph pressure in the inner ear is thought to be the cause of <a href="/wiki/M%C3%A9ni%C3%A8re%27s_disease" title="Ménière's disease">Ménière's disease</a> or ’Endolymphatic hydrops.’ Synthesis of evidence from multiple small, low-quality studies indicates that chlortalidone or other thiazide diuretics are effective for Ménière's Disease.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Diabetes_insipidus">Diabetes insipidus</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=8" title="Edit section: Diabetes insipidus"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chlortalidone (or other thiazide medication) is a key component of treatment of <a href="/wiki/Nephrogenic_diabetes_insipidus" title="Nephrogenic diabetes insipidus">nephrogenic diabetes insipidus</a>. Nephrogenic diabetes insipidus occurs when the kidney is unable to concentrate urine because it has an inadequate response to vasopressin-dependent removal of free water from the renal tubular filtrate. By blocking sodium ion resorption in the <a href="/wiki/Distal_convoluted_tubule" title="Distal convoluted tubule">distal convoluted tubule</a>, chlortalidone induces an increase in excretion of sodium ion in urine (<a href="/wiki/Natriuresis" title="Natriuresis">natriuresis</a>). Giving chlortalidone while simultaneously restricting dietary sodium intake causes mild <a href="/wiki/Hypovolemia" title="Hypovolemia">hypovolemia</a> (low intravascular volume), which induces <a href="/wiki/Tonicity#Isotonicity" title="Tonicity">isotonic</a> reabsorption of solute from the <a href="/wiki/Proximal_renal_tubule" class="mw-redirect" title="Proximal renal tubule">proximal renal tubule</a>, reducing solute delivery in the <a href="/wiki/Renal_collecting_tubule" class="mw-redirect" title="Renal collecting tubule">renal collecting tubule</a> and renal medullary collecting duct. This reduced delivery of solute to the collecting tubule and <a href="/wiki/Collecting_duct_system" title="Collecting duct system">medullary collecting duct</a> allows increased water resorption and higher concentration of urine, which leads to reversal of nephrogenic diabetes insipidus by a means that is independent of <a href="/wiki/Vasopressin" title="Vasopressin">vasopressin</a>.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Adverse_effects">Adverse effects</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=9" title="Edit section: Adverse effects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Some reviews have found a similar risk as hydrochlorothiazide,<sup id="cite_ref-Din2019_8-1" class="reference"><a href="#cite_note-Din2019-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Rou2018_9-1" class="reference"><a href="#cite_note-Rou2018-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> while other reviews found a higher risk of side effects.<sup id="cite_ref-Ace2019_1-4" class="reference"><a href="#cite_note-Ace2019-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Spr2015_10-2" class="reference"><a href="#cite_note-Spr2015-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <ul><li><a href="/wiki/Hypokalemia" title="Hypokalemia">Hypokalemia</a> (low blood potassium) occurs occasionally; the risk of hypokalemia is higher in persons who are magnesium deficient<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hypomagnesemia" class="mw-redirect" title="Hypomagnesemia">Hypomagnesemia</a> (low blood magnesium) a review of four clinical trials found that low blood magnesium occurred in 20% of persons within a few weeks of beginning treatment with 50 mg of chlortalidone daily.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> The risk of chlortalidone-associated hypomagnesemia is higher in persons with diabetes mellitus who have low dietary magnesium intake.</li> <li><a href="/wiki/Hyponatremia" title="Hyponatremia">Hyponatremia</a> (low blood sodium) occurred in 4.1% of subjects randomized to chlortalidone in the Systolic Hypertension in the Elderly Trial, compared to 1.3% of control subjects.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> The risk of hyponatremia varies from 5 per 100,000 person-years for those younger than 40 years of age to 730 per 100,000 person-years in those older than 80 years of age.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> Hyponatremia is more likely in persons with certain genetic variants of the prostaglandin transporter <a href="/wiki/SLCO2A1" class="mw-redirect" title="SLCO2A1">SLCO2A1</a> associated with elevated urinary PGE<sub>2</sub> and inappropriately low plasma ADH levels in the setting of low <a href="/wiki/Plasma_osmolality" title="Plasma osmolality">plasma osmolality</a>.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> Thiazide-associated hyponatremia is often more severe than loop diuretic-associated hyponatremia because the predominant action of thiazides occurs late in the tubular flow, reducing opportunity to apply additional corrective action further along the tubule.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hypercalcemia" class="mw-redirect" title="Hypercalcemia">Hypercalcemia</a> (high blood calcium level) can occur in normal persons exposed to chlortalidone but is more likely to occur when persons with sub-clinical <a href="/wiki/Hyperparathyroidism" title="Hyperparathyroidism">hyperparathyroidism</a> are exposed to chlortalidone.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hyperuricemia" title="Hyperuricemia">Hyperuricemia</a>, high levels of uric acid in the blood</li> <li><a href="/wiki/Hyperglycemia" title="Hyperglycemia">Hyperglycemia</a>, high blood sugar is more common in persons who are magnesium deficient</li> <li><a href="/wiki/Hyperlipidemia" title="Hyperlipidemia">Hyperlipidemia</a>, high cholesterol and triglycerides</li> <li><a href="/wiki/Headache" title="Headache">Headache</a></li> <li><a href="/wiki/Nausea" title="Nausea">Nausea</a>/<a href="/wiki/Vomiting" title="Vomiting">vomiting</a></li> <li><a href="/wiki/Photosensitivity" title="Photosensitivity">Photosensitivity</a> increased susceptibility to <a href="/wiki/Sunburn" title="Sunburn">sunburn</a> of skin with sun exposure</li> <li><a href="/wiki/Onycholysis" title="Onycholysis">Photoonycholysis</a> detachment of nails from nailbed with sun exposure<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Weight_gain" title="Weight gain">Weight gain</a></li> <li><a href="/wiki/Gout" title="Gout">Gout</a>; approximately doubles the risk<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Pancreatitis" title="Pancreatitis">Pancreatitis</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="Mechanism_of_action">Mechanism of action</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=10" title="Edit section: Mechanism of action"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chlortalidone reduces reabsorption of sodium and chloride primarily through inhibition of the Na<sup>+</sup>/Cl<sup>−</sup> symporter in the apical membrane of <a href="/wiki/Distal_convoluted_tubule" title="Distal convoluted tubule">distal convoluted tubule</a> cells in the kidney.<sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> Although chlortalidone is often referred to as a "thiazide-like" diuretic, it is unlike thiazide diuretics in that, in addition to its inhibition of the Na<sup>+</sup>/Cl<sup>−</sup> symporter, it also strongly inhibits multiple isoforms of carbonic anhydrase.<sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> Some of chlortalidone's diuretic effect is also due to this inhibition of carbonic anhydrase in the proximal tubule.<sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> Chronic exposure to chlortalidone decreases the <a href="/wiki/Glomerular_filtration_rate" title="Glomerular filtration rate">glomerular filtration rate</a>. Chlortalidone's diuretic effect is diminished in persons with kidney impairment. By increasing the delivery of sodium to the distal renal tubule, chlortalidone indirectly increases potassium excretion via the sodium-potassium exchange mechanism (i.e. apical ROMK/Na channels coupled with basolateral Na+/K ATPases). This can result in a <a href="/wiki/Hypokalemia" title="Hypokalemia">low blood concentration of potassium</a> and <a href="/wiki/Hypochloremia" title="Hypochloremia">chloride</a> as well as a mild <a href="/wiki/Metabolic_alkalosis" title="Metabolic alkalosis">metabolic alkalosis</a>; however, the diuretic effect of chlortalidone is not affected by the acid-base balance of the person being treated. </p><p>There is uncertainty about the mechanism of the blood pressure-lowering effect that occurs during chronic exposure to chlortalidone.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> Initially, diuretics lower blood pressure by decreasing <a href="/wiki/Cardiac_output" title="Cardiac output">cardiac output</a> and reducing plasma and extracellular fluid volume. Eventually, cardiac output returns to normal, and plasma and extracellular fluid volume return to slightly less than normal, but a reduction in <a href="/wiki/Peripheral_vascular_resistance" class="mw-redirect" title="Peripheral vascular resistance">peripheral vascular resistance</a> is maintained, thus resulting in an overall lower blood pressure. The reduction in intravascular volume induces an elevation in plasma <a href="/wiki/Renin" title="Renin">renin</a> activity and <a href="/wiki/Aldosterone" title="Aldosterone">aldosterone</a> secretion, further contributing to the potassium loss associated with thiazide diuretic therapy. </p> <div class="mw-heading mw-heading2"><h2 id="Pharmacokinetics">Pharmacokinetics</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=11" title="Edit section: Pharmacokinetics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chlortalidone is slowly absorbed from the gastrointestinal tract after oral ingestion. It has a long half-life and therefore a prolonged diuretic action, which results in continued diuretic effects despite a skipped dose. This prolonged action of chlortalidone despite missing doses may account for the higher efficacy of chlortalidone compared to the shorter half-life medication, hydrochlorothiazide. Chlortalidone is eliminated from the body mostly by the kidney, as unchanged drug. Thus, in persons with diminished kidney function, the clearance of chlortalidone is reduced and the elimination half-life is increased.<sup id="cite_ref-Singer_1985_48-0" class="reference"><a href="#cite_note-Singer_1985-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> </p><p>As with other thiazide diuretics, chlortalidone crosses the placenta and is excreted in breast milk.<sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> Chlortalidone may suppress lactation, and has been used for this indication. Due to its long half-life, chlortalidone may accumulate in newborns via breast milk, despite receiving only about 6% of the maternal weight-adjusted dose.<sup id="cite_ref-lactmed_50-0" class="reference"><a href="#cite_note-lactmed-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Chemistry">Chemistry</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=12" title="Edit section: Chemistry"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chlortalidone is in the sulfamoylbenzamide class. As it lacks the <a href="/wiki/Benzothiadiazine" title="Benzothiadiazine">benzothiadiazine</a> structure of the thiazide-type diuretics, it is called a thiazide-like diuretic.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> Chlortalidone is freely soluble in <a href="/wiki/Dimethylacetamide" title="Dimethylacetamide">dimethylacetamide</a> (DMA), <a href="/wiki/Dimethylformamide" title="Dimethylformamide">dimethylformamide</a> (DMF), <a href="/wiki/Dimethylsulfoxide" class="mw-redirect" title="Dimethylsulfoxide">dimethylsulfoxide</a> (DMSO), and <a href="/wiki/Methanol" title="Methanol">methanol</a>; it is also soluble in warm <a href="/wiki/Ethanol" title="Ethanol">ethanol</a>.<sup id="cite_ref-Singer_1985_48-1" class="reference"><a href="#cite_note-Singer_1985-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> </p><p>Chlortalidone is the official name of the medication according to the (<a href="/wiki/International_Nonproprietary_Name" class="mw-redirect" title="International Nonproprietary Name">INN</a>/<a href="/wiki/British_Approved_Name" title="British Approved Name">BAN</a>), which is the medication naming system coordinated by the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a>. Chlorthalidone is the official name of the medication according to the (<a href="/wiki/United_States_Adopted_Name" title="United States Adopted Name">USAN</a>), which is the medication naming system coordinated by the USAN Council, which is co-sponsored by the <a href="/wiki/American_Medical_Association" title="American Medical Association">American Medical Association</a> (AMA), the <a href="/wiki/United_States_Pharmacopeial_Convention" class="mw-redirect" title="United States Pharmacopeial Convention">United States Pharmacopeial Convention</a> (USP), and the <a href="/wiki/American_Pharmacists_Association" title="American Pharmacists Association">American Pharmacists Association</a> (APhA). </p> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=13" title="Edit section: Society and culture"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chlortalidone is banned for some sports (including <a href="/wiki/Cricket_(sport)" class="mw-redirect" title="Cricket (sport)">cricket</a>) because it is a <a href="/wiki/Diuretic" title="Diuretic">diuretic</a>, and can be used to reduce body weight or to mask the concomitant use of performance-enhancing drugs.<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> Sports such as <a href="/wiki/Wrestling" title="Wrestling">wrestling</a> or <a href="/wiki/Boxing" title="Boxing">boxing</a> categorize athletes according to body weight; taking a diuretic such as chlortalidone may lower body weight, and thereby permit an athlete to compete in a lighter weight class, which would provide an advantage. Diuretics such as chlortalidone also reduce the urine concentration of concomitantly-taken performance-enhancing drugs or of their metabolites, thus making it more difficult to detect these drugs using urine testing.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Chlortalidone&action=edit&section=14" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-Ace2019-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-Ace2019_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Ace2019_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Ace2019_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Ace2019_1-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Ace2019_1-4"><sup><i><b>e</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFAcelajadoHughesOparilCalhoun2019" class="citation journal cs1">Acelajado MC, Hughes ZH, Oparil S, Calhoun DA (March 2019). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469348">"Treatment of Resistant and Refractory Hypertension"</a>. <i>Circ. Res</i>. <b>124</b> (7): 1061–1070. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1161%2FCIRCRESAHA.118.312156">10.1161/CIRCRESAHA.118.312156</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469348">6469348</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30920924">30920924</a>. <q>A long-acting thiazide-like diuretic, specifically chlorthalidone, if available, is recommended over hydrochlorothiazide (HCTZ) given its superior efficacy and clear benefit demonstrated in multiple outcome studies of hypertension.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Circ.+Res.&rft.atitle=Treatment+of+Resistant+and+Refractory+Hypertension&rft.volume=124&rft.issue=7&rft.pages=1061-1070&rft.date=2019-03&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6469348%23id-name%3DPMC&rft_id=info%3Apmid%2F30920924&rft_id=info%3Adoi%2F10.1161%2FCIRCRESAHA.118.312156&rft.aulast=Acelajado&rft.aufirst=MC&rft.au=Hughes%2C+ZH&rft.au=Oparil%2C+S&rft.au=Calhoun%2C+DA&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6469348&rfr_id=info%3Asid%2Fen.wikipedia.org%3AChlortalidone" class="Z3988"></span></span> </li> <li id="cite_note-AHFS2019-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-AHFS2019_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-AHFS2019_2-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-AHFS2019_2-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-AHFS2019_2-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-AHFS2019_2-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-AHFS2019_2-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-AHFS2019_2-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-AHFS2019_2-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-AHFS2019_2-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-AHFS2019_2-9"><sup><i><b>j</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.drugs.com/monograph/chlorthalidone.html">"Chlorthalidone Monograph for Professionals"</a>. <i>Drugs.com</i>. 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cs1"><a rel="nofollow" class="external text" href="https://www.bbc.com/sport/cricket/35185202">"Yasir Shah provisionally suspended after failed drugs test"</a>. <i>BBC News</i>. 27 December 2015.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=BBC+News&rft.atitle=Yasir+Shah+provisionally+suspended+after+failed+drugs+test&rft.date=2015-12-27&rft_id=https%3A%2F%2Fwww.bbc.com%2Fsport%2Fcricket%2F35185202&rfr_id=info%3Asid%2Fen.wikipedia.org%3AChlortalidone" class="Z3988"></span></span> </li> </ol></div></div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output 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"}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Symporter_inhibitors" title="Template:Symporter inhibitors"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Symporter_inhibitors" title="Template talk:Symporter inhibitors"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Symporter_inhibitors" title="Special:EditPage/Template:Symporter inhibitors"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Symporter_inhibitors" style="font-size:114%;margin:0 4em"><a href="/wiki/Symporter" title="Symporter">Symporter</a> <a href="/wiki/Transporter_inhibitor" class="mw-redirect" title="Transporter inhibitor">inhibitors</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Sodium-chloride_symporter" title="Sodium-chloride symporter">Na<sup>+</sup>-Cl<sup>−</sup></a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><b><a href="/wiki/Thiazide" title="Thiazide">Thiazides</a>:</b> <a href="/wiki/Bendroflumethiazide" title="Bendroflumethiazide">Bendroflumethiazide</a></li> <li><a href="/wiki/Chlorothiazide" title="Chlorothiazide">Chlorothiazide</a></li> <li><a href="/wiki/Cyclopenthiazide" title="Cyclopenthiazide">Cyclopenthiazide</a></li> <li><a href="/wiki/Cyclothiazide" title="Cyclothiazide">Cyclothiazide</a></li> <li><a href="/wiki/Hydrochlorothiazide" title="Hydrochlorothiazide">Hydrochlorothiazide</a></li> <li><a href="/wiki/Hydroflumethiazide" title="Hydroflumethiazide">Hydroflumethiazide</a></li> <li><a href="/wiki/Methyclothiazide" title="Methyclothiazide">Methyclothiazide</a></li> <li><a href="/wiki/Polythiazide" title="Polythiazide">Polythiazide</a></li> <li><a href="/wiki/Trichlormethiazide" title="Trichlormethiazide">Trichlormethiazide</a>; <b>Others:</b> <a class="mw-selflink selflink">Chlortalidone (chlorthalidone)</a></li> <li><a href="/wiki/Metolazone" title="Metolazone">Metolazone</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Sodium_potassium_chloride_symporter_inhibitors" class="mw-redirect" title="Sodium potassium chloride symporter inhibitors">Na<sup>+</sup>-K<sup>+</sup>-Cl<sup>−</sup></a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bumetanide" title="Bumetanide">Bumetanide</a></li> <li><a href="/wiki/Furosemide" title="Furosemide">Furosemide</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div><i><b>See also:</b> <a href="/wiki/Template:Receptor_modulators" title="Template:Receptor modulators">Receptor/signaling modulators</a></i></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-labelledby="Diuretics_(C03)" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Diuretics" title="Template:Diuretics"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Diuretics" title="Template talk:Diuretics"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Diuretics" title="Special:EditPage/Template:Diuretics"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diuretics_(C03)" style="font-size:114%;margin:0 4em"><a href="/wiki/Diuretic" title="Diuretic">Diuretics</a> (<a href="/wiki/ATC_code_C03" title="ATC code C03">C03</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Sulfonamide_(medicine)" title="Sulfonamide (medicine)">Sulfonamides</a><br />(and <a href="/wiki/Etacrynic_acid" title="Etacrynic acid">etacrynic acid</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Carbonic_anhydrase_inhibitor" title="Carbonic anhydrase inhibitor">CA inhibitors</a> (at <a href="/wiki/Proximal_tubule" title="Proximal tubule">PT</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acetazolamide" title="Acetazolamide">Acetazolamide</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Loop_diuretic" title="Loop diuretic">Loop</a> (<a href="/wiki/Na-K-Cl_cotransporter" class="mw-redirect" title="Na-K-Cl cotransporter">Na-K-Cl</a> at <a href="/wiki/Thick_ascending_limb_of_loop_of_Henle" class="mw-redirect" title="Thick ascending limb of loop of Henle">AL</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Furosemide" title="Furosemide">Furosemide</a><sup>#</sup></li> <li><a href="/wiki/Azosemide" title="Azosemide">Azosemide</a></li> <li><a href="/wiki/Bumetanide" title="Bumetanide">Bumetanide</a></li> <li><a href="/wiki/Etacrynic_acid" title="Etacrynic acid">Etacrynic acid</a></li> <li><a href="/wiki/Etozolin" title="Etozolin">Etozolin</a></li> <li><a href="/wiki/Indacrinone" title="Indacrinone">Indacrinone</a></li> <li><a href="/wiki/Muzolimine" title="Muzolimine">Muzolimine</a></li> <li><a href="/wiki/Ozolinone" title="Ozolinone">Ozolinone</a></li> <li><a href="/wiki/Piretanide" title="Piretanide">Piretanide</a></li> <li><a href="/wiki/Tienilic_acid" title="Tienilic acid">Tienilic acid</a><sup>‡</sup></li> <li><a href="/wiki/Torasemide" title="Torasemide">Torasemide</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Thiazide" title="Thiazide">Thiazides</a> (<a href="/wiki/Sodium-chloride_symporter" title="Sodium-chloride symporter">Na-Cl</a> at <a href="/wiki/Distal_convoluted_tubule" title="Distal convoluted tubule">DCT</a>,<br /><a href="/wiki/Diuretic#Calcium-sparing_diuretics" title="Diuretic">Calcium-sparing</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Altizide" title="Altizide">Altizide</a></li> <li><a href="/wiki/Bendroflumethiazide" title="Bendroflumethiazide">Bendroflumethiazide</a></li> <li><a href="/wiki/Butizide" title="Butizide">Butizide</a></li> <li><a href="/wiki/Chlorothiazide" title="Chlorothiazide">Chlorothiazide</a></li> <li><a href="/wiki/Cyclopenthiazide" title="Cyclopenthiazide">Cyclopenthiazide</a></li> <li><a href="/wiki/Cyclothiazide" title="Cyclothiazide">Cyclothiazide</a></li> <li><a href="/wiki/Epitizide" title="Epitizide">Epitizide</a></li> <li><a href="/wiki/Hydrochlorothiazide" title="Hydrochlorothiazide">Hydrochlorothiazide</a></li> <li><a href="/wiki/Hydroflumethiazide" title="Hydroflumethiazide">Hydroflumethiazide</a></li> <li><a href="/wiki/Mebutizide" title="Mebutizide">Mebutizide</a></li> <li><a href="/wiki/Methyclothiazide" title="Methyclothiazide">Methyclothiazide</a></li> <li><a href="/wiki/Polythiazide" title="Polythiazide">Polythiazide</a></li> <li><a href="/wiki/Trichlormethiazide" title="Trichlormethiazide">Trichlormethiazide</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Thiazide-like_diuretic" title="Thiazide-like diuretic">Thiazide-likes</a> (primarily <a href="/wiki/Distal_convoluted_tubule" title="Distal convoluted tubule">DCT</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a class="mw-selflink selflink">Chlortalidone</a></li> <li><a href="/wiki/Clofenamide" title="Clofenamide">Clofenamide</a></li> <li><a href="/wiki/Clopamide" title="Clopamide">Clopamide</a></li> <li><a href="/wiki/Clorexolone" title="Clorexolone">Clorexolone</a></li> <li><a href="/wiki/Fenquizone" title="Fenquizone">Fenquizone</a></li> <li><a href="/wiki/Indapamide" title="Indapamide">Indapamide</a></li> <li><a href="/wiki/Mefruside" title="Mefruside">Mefruside</a></li> <li><a href="/wiki/Meticrane" title="Meticrane">Meticrane</a></li> <li><a href="/wiki/Metolazone" title="Metolazone">Metolazone</a></li> <li><a href="/wiki/Quinethazone" title="Quinethazone">Quinethazone</a></li> <li><a href="/wiki/Xipamide" title="Xipamide">Xipamide</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Potassium-sparing_diuretic" title="Potassium-sparing diuretic">Potassium-sparing</a> (at <a href="/wiki/Collecting_duct_system" title="Collecting duct system">CD</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Epithelial_sodium_channel_blocker" title="Epithelial sodium channel blocker">ESC blockers</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Amiloride" title="Amiloride">Amiloride</a><sup>#</sup></li> <li><a href="/wiki/Benzamil" title="Benzamil">Benzamil</a></li> <li><a href="/wiki/Triamterene" title="Triamterene">Triamterene</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Antimineralocorticoid" class="mw-redirect" title="Antimineralocorticoid">Aldosterone antagonists</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Spirolactone" title="Spirolactone">Spirolactones</a></i> <ul><li><a href="/wiki/Spironolactone" title="Spironolactone">Spironolactone</a><sup>#</sup></li> <li><a href="/wiki/Canrenone" title="Canrenone">Canrenone</a></li> <li><a href="/wiki/Eplerenone" title="Eplerenone">Eplerenone</a></li> <li><a href="/wiki/Potassium_canrenoate" title="Potassium canrenoate">Potassium canrenoate</a></li></ul></li></ul> <ul><li><i><a href="/wiki/Nonsteroidal" title="Nonsteroidal">Nonsteroidal</a></i> <ul><li><a href="/wiki/Finerenone" title="Finerenone">Finerenone</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Osmotic_diuretic" title="Osmotic diuretic">Osmotic diuretics</a> (<a href="/wiki/Proximal_tubule" title="Proximal tubule">PT</a>, <a href="/wiki/Descending_limb_of_loop_of_Henle" title="Descending limb of loop of Henle">DL</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Mannitol" title="Mannitol">Mannitol</a><sup>#</sup></li> <li><a href="/wiki/Glycerol" title="Glycerol">Glycerol</a></li> <li><a href="/wiki/Urea" title="Urea">Urea</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vasopressin_receptor_antagonist" title="Vasopressin receptor antagonist">Vasopressin receptor inhibitors</a><br />(<a href="/wiki/Distal_convoluted_tubule" title="Distal convoluted tubule">DCT</a> and <a href="/wiki/Collecting_duct" class="mw-redirect" title="Collecting duct">CD</a>)</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Vasopressin_receptor_antagonist#Vaptans" title="Vasopressin receptor antagonist">Vaptans</a></i> <ul><li><a href="/wiki/Conivaptan" title="Conivaptan">Conivaptan</a></li> <li><a href="/wiki/Mozavaptan" title="Mozavaptan">Mozavaptan</a></li> <li><a href="/wiki/Satavaptan" title="Satavaptan">Satavaptan</a></li> <li><a href="/wiki/Tolvaptan" title="Tolvaptan">Tolvaptan</a></li></ul></li></ul> <ul><li><i><a href="/wiki/Vasopressin_receptor_antagonist#Demeclocycline_and_lithium" title="Vasopressin receptor antagonist">Others</a></i> <ul><li><a href="/wiki/Demeclocycline" title="Demeclocycline">Demeclocycline</a></li> <li><a href="/wiki/Lithium_carbonate" title="Lithium carbonate">Lithium carbonate</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ethanol" title="Ethanol">Ethanol</a>, <a href="/wiki/Isopropanol" class="mw-redirect" title="Isopropanol">Isopropanol</a>, <a href="/wiki/Tert-Amyl_alcohol" title="Tert-Amyl alcohol">2M2B</a></li> <li><i><a href="/wiki/Mercurial_diuretic" title="Mercurial diuretic">mercurial diuretics</a></i> (<a href="/wiki/Chlormerodrin" title="Chlormerodrin">Chlormerodrin</a>, <a href="/wiki/Mersalyl" title="Mersalyl">Mersalyl</a>, <a href="/wiki/Meralluride" title="Meralluride">Meralluride</a>)</li> <li><a href="/wiki/Theobromine" title="Theobromine">Theobromine</a></li> <li><a href="/wiki/Cicletanine" title="Cicletanine">Cicletanine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Combination products</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hydrochlorothiazide/triamterene" title="Hydrochlorothiazide/triamterene">Hydrochlorothiazide/triamterene</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="background: transparent; padding: 0px;"><div><div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table></div> <style data-mw-deduplicate="TemplateStyles:r1130092004">.mw-parser-output .portal-bar{font-size:88%;font-weight:bold;display:flex;justify-content:center;align-items:baseline}.mw-parser-output .portal-bar-bordered{padding:0 2em;background-color:#fdfdfd;border:1px solid #a2a9b1;clear:both;margin:1em auto 0}.mw-parser-output .portal-bar-related{font-size:100%;justify-content:flex-start}.mw-parser-output .portal-bar-unbordered{padding:0 1.7em;margin-left:0}.mw-parser-output .portal-bar-header{margin:0 1em 0 0.5em;flex:0 0 auto;min-height:24px}.mw-parser-output .portal-bar-content{display:flex;flex-flow:row wrap;flex:0 1 auto;padding:0.15em 0;column-gap:1em;align-items:baseline;margin:0;list-style:none}.mw-parser-output .portal-bar-content-related{margin:0;list-style:none}.mw-parser-output .portal-bar-item{display:inline-block;margin:0.15em 0.2em;min-height:24px;line-height:24px}@media screen and 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