Chotalin Dosage/Direction for Use

Recommended Dose: Dosage of chlorthalidone should be individualized according to the patient's requirements and response.
If added to potent hypotensive agent regimen, initially reduce hypotensive dosage to avoid the possibility of severe hypotension.
Edema: Usual initial adult dosage: 50-100 mg daily in a single dose after breakfast.
Alternatively, initiate 100 mg every other day or 3 times a week; some patients require dosages of 150-200 mg daily or every other day.
Dosages more than 200 mg daily do not produce a greater response.
Maintenance dosage: Reduction of dosage to a lower level may be possible after several days or when nonedematous weight is attained.
Hypertension in Adults: Usual initial dosage: 12.5 mg once daily and a target dosage of 12.5-25 mg once daily are recommended. Usual maximum dosage is 25 mg once daily.
Target dosages of antihypertensive agents generally can be achieved within 2-4 weeks, but it may take up to several months. Therapy should be titrated until goal blood pressure is achieved.
If an adequate blood pressure response is not achieved with chlorthalidone monotherapy, another antihypertensive agent with demonstrated benefit may be added. If goal blood pressure is still not achieved with optimal dosages of 2 antihypertensive agents, a third drug may be added.
In patients who experience intolerance adverse effects with chlorthalidone, dosage reduction should be considered; if adverse effects worsen or fail to resolve, it may be necessary to discontinue the diuretic and switch to another class of antihypertensive agent.
Maintenance dosage: may often be lower than initial dosages.
Hypertension in Elderly: Initial dosage: 12.5-25 mg once daily or every other day; there is little advantage to using dose >25 mg daily. Because of the greater frequency of decreased hepatic, renal, and/or cardiac function and of concomitant disease and drug therapy in the elderly, initial dosage in the lower end of the usual range is recommended.
Hypertension in Pediatric Patients: Safety and efficacy have not been established.
Diabetes Insipidus: Initial dosage: 100 mg twice daily.
Maintenance dosage: 50 mg daily.
Dosage adjustment in renal impairment: CrCl ≥10 mL/minute: No dosage adjustment necessary. Use with caution because of risk of precipitating azotemia.
CrCl <10 mL/minute: Avoid use. Ineffective with low GRF.
Dosage adjustment in hepatic impairment: No dosage adjustment provided. Use with caution because of risk of precipitating hepatic coma.
Mode of Administration: Chlorthalidone is administered orally.