Ctd-T Dosage

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Consists of Chlorthalidone, Telmisartan

Dosage of Chlorthalidone (Ctd-T) in details

The dose of a drug and dosage of the drug are two different terminologies. Dose is defined as the quantity or amount of medicine given by the doctor or taken by the patient at a given period. Dosage is the regimen prescribed by the doctor about how many days and how many times per day the drug is to be taken in specified dose by the patient. The dose is expressed in mg for tablets or gm, micro gm sometimes, ml for syrups or drops for kids syrups. The dose is not fixed for a drug for all conditions, and it changes according to the condition or a disease. It also changes on the age of the patient.
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Chlorthalidone (Ctd-T) Dosage

Applies to the following strength(s): 50 mg; 25 mg; 100 mg; 15 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Edema

Initial dose: 50-100 mg orally once a day.

Maintenance dose: 25-100 mg once a day or

50-200 mg every other day.

Usual Adult Dose for Hypertension

Initial dose: 25 mg orally once a day (15 mg for Thalitone).

Maintenance dose: 25-100 mg once a day (15-50 mg for Thalitone).

Renal Dose Adjustments

Chlorthalidone (Ctd-T) is not expected to be filtered into the renal tubule (its site of action) when the glomerular filtration rate is less than 10 mL/min.

Liver Dose Adjustments

Data not available

Dose Adjustments

Dosage adjustments are recommended to be made no more frequently than weekly. Patients with liver disease or renal dysfunction should have dosage adjustments made cautiously.

Precautions

Chlorthalidone (Ctd-T) is contraindicated in patients with anuria.

Chlorthalidone (Ctd-T) therapy should be used with caution in severe renal disease. In patients with renal disease, Chlorthalidone (Ctd-T) or related drugs may precipitate azotemia. Cumulative effects may develop in patients with impaired renal function. If progressive renal impairment becomes evident, as indicated by a rising nonprotein nitrogen or blood urea nitrogen, a careful reappraisal of the treatment is necessary with consideration given to withholding or discontinuing diuretic therapy.

Chlorthalidone (Ctd-T) therapy should be used with caution in patients with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma.

Sensitivity reactions may be observed in patients with a history of allergy or bronchial asthma.

The possibility of exacerbation or activation of systemic lupus erythematosus has been observed with thiazide diuretics, which are structurally related to Chlorthalidone (Ctd-T). However, systemic lupus erythematosus has not been observed following Chlorthalidone (Ctd-T) administration.

Hypokalemia may develop with Chlorthalidone (Ctd-T) as with any other diuretic, especially with brisk diuresis when severe cirrhosis is present. Interference with adequate oral electrolyte intake will also contribute to hypokalemia.

Any chloride deficit is generally mild and usually does not require specific therapy except under extraordinary circumstances (as in liver disease or renal disease). Dilutional hyponatremia may be observed in edematous patients in hot weather, appropriate therapy is water restriction, rather than administration of salt except in rare instances when the hyponatremia is life threatening. In actual salt depletion, appropriate replacement is the treatment of choice.

Hyperuricemia may occur or frank gout may be precipitated in certain patients receiving Chlorthalidone (Ctd-T) therapy. Thiazide-like diuretics have been shown to increase the urinary excretion of magnesium, which may result in hypomagnesemia.

The antihypertensive effects Chlorthalidone (Ctd-T) may be enhanced in the post-sympathectomy patient.

Calcium excretion is decreased by thiazide-like agents. Pathological changes in the parathyroid gland with hypercalcemia and hypophosphatemia have been reported in few patients on thiazide therapy. The common complications of hyperparathyroidism such as renal lithiasis, bone resorption and peptic ulceration have not been observed.

Periodic determination of serum electrolytes to detect possible electrolyte imbalance should be conducted at appropriate intervals.

Electrolyte abnormalities (i.e., hypokalemia, hyponatremia) and glucose intolerance may occur during Chlorthalidone (Ctd-T) therapy.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

The maximum daily dose for hypertension is 100 mg (50 mg for Thalitone).

The maximum daily dose for edema is 200 mg (120 mg for Thalitone).

Periodic monitoring of electrolytes is recommended, particularly in elderly patients and in patients receiving a high dose.

More about Chlorthalidone (Ctd-T)

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What other drugs will affect Chlorthalidone (Ctd-T)?

Before using Chlorthalidone (Ctd-T), tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by Chlorthalidone (Ctd-T).

This list is not complete and there may be other drugs that can interact with Chlorthalidone (Ctd-T). Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Chlorthalidone (Ctd-T) interactions

Interactions are the effects that happen when the drug is taken along with the food or when taken with other medications. Suppose if you are taking a drug Chlorthalidone (Ctd-T), it may have interactions with specific foods and specific medications. It will not interact with all foods and medications. The interactions vary from drug to drug. You need to be aware of interactions of the medicine you take. Most medications may interact with alcohol, tobacco, so be cautious.
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Allopurinol

Concurrent use may increase incidence of hypersensitivity reactions to allopurinol.

Amphotericin B, corticosteroids

May intensify potassium depletion.

Anticholinergics

May increase Chlorthalidone (Ctd-T) absorption.

Anticoagulants

May diminish anticoagulant effects.

Bile acid sequestrants

May reduce Chlorthalidone (Ctd-T) absorption. Give Chlorthalidone (Ctd-T) at least 2 h before bile acid sequestrant.

Calcium salts

Hypercalcemia may develop.

Diazoxide

May cause hyperglycemia.

Digitalis glycosides

Diuretic-induced hypokalemia and hypomagnesemia may precipitate digitalis-induced arrhythmias.

Lithium

May decrease renal excretion of lithium.

Loop diuretics

Synergistic effects may result in profound diuresis and serious electrolyte abnormalities.

Methenamines, NSAIDs

May decrease effectiveness of Chlorthalidone (Ctd-T).

Sulfonylureas, insulin

May decrease hypoglycemic effect of sulfonylureas.

Laboratory Test Interactions

Increased serum bilirubin levels. Serum magnesium levels in uremic patients may be increased.

Dosage of Telmisartan (Ctd-T) in details

The dose of a drug and dosage of the drug are two different terminologies. Dose is defined as the quantity or amount of medicine given by the doctor or taken by the patient at a given period. Dosage is the regimen prescribed by the doctor about how many days and how many times per day the drug is to be taken in specified dose by the patient. The dose is expressed in mg for tablets or gm, micro gm sometimes, ml for syrups or drops for kids syrups. The dose is not fixed for a drug for all conditions, and it changes according to the condition or a disease. It also changes on the age of the patient.
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Telmisartan (Ctd-T) Dosage

Generic name: TELMISARTAN 20mg

Dosage form: tablet

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

2.1  Hypertension

Dosage must be individualized. The usual starting dose of Telmisartan (Ctd-T) tablets is 40 mg once a day. Blood pressure response is dose-related over the range of 20 to 80 mg.

Most of the antihypertensive effect is apparent within 2 weeks and maximal reduction is generally attained after 4 weeks. When additional blood pressure reduction beyond that achieved with 80 mg Telmisartan (Ctd-T) is required, a diuretic may be added.

No initial dosage adjustment is necessary for elderly patients or patients with renal impairment, including those on hemodialysis. Patients on dialysis may develop orthostatic hypotension; their blood pressure should be closely monitored.

Telmisartan (Ctd-T) tablets may be administered with other antihypertensive agents.

Telmisartan (Ctd-T) tablets may be administered with or without food.

2.2  Cardiovascular Risk Reduction

The recommended dose of Telmisartan (Ctd-T) tablets is 80 mg once a day and can be administered with or without food. It is not known whether doses lower than 80 mg of telmisartan are effective in reducing the risk of cardiovascular morbidity and mortality.

When initiating Telmisartan (Ctd-T) therapy for cardiovascular risk reduction, monitoring of blood pressure is recommended, and if appropriate, adjustment of medications that lower blood pressure may be necessary.

More about Telmisartan (Ctd-T) (telmisartan)

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What other drugs will affect Telmisartan (Ctd-T)?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with telmisartan, especially:

This list is not complete. Other drugs may interact with telmisartan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Telmisartan (Ctd-T) interactions

Interactions are the effects that happen when the drug is taken along with the food or when taken with other medications. Suppose if you are taking a drug Telmisartan (Ctd-T), it may have interactions with specific foods and specific medications. It will not interact with all foods and medications. The interactions vary from drug to drug. You need to be aware of interactions of the medicine you take. Most medications may interact with alcohol, tobacco, so be cautious.
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Interaction Studies have only been Performed in Adults: As with other medicinal products acting on the renin-angiotensin-aldosterone system, telmisartan may provoke hyperkalemia. The risk may increase in case of treatment combination with other medicinal products that may also provoke hyperkalemia [salt substitutes containing potassium, potassium-sparing diuretics, ACE inhibitors, angiotensin II receptor antagonists, NSAIDs (including selective COX-2 inhibitors), heparin, immunosuppressives (cyclosporin or tacrolimus) and trimethoprim].

The occurrence of hyperkalemia depends on associated risk factors. The risk is increased in case of the previously mentioned treatment combinations. The risk is particularly high in combination with potassium sparing-diuretics and when combined with salt substitutes containing potassium. A combination with ACE inhibitors or NSAIDs, for example, presents a lesser risk provided that precautions for use are strictly followed.

Concomitant Use Not Recommended: Potassium-Sparing Diuretics or Potassium Supplements: Angiotensin II receptor antagonists eg, telmisartan, attenuate diuretic induced potassium loss. Potassium-sparing diuretics eg, spironolactone, eplerenone, triamterene or amiloride, potassium supplements or potassium-containing salt substitutes may lead to a significant increase in serum potassium. If concomitant use is indicated because of documented hypokalemia, they should be used with caution and with frequent monitoring of serum potassium.

Lithium: Reversible increases in serum lithium concentrations and toxicity have been reported during concomitant administration of lithium with ACE inhibitors and with angiotensin II receptor antagonists, including telmisartan. If use of the combination proves necessary, careful monitoring of serum lithium levels is recommended.

Concomitant Use Requiring Caution: Nonteroidal Anti-Inflammatory Medicinal Products: NSAIDs (ie, acetylsalicylic acid at anti-inflammatory dosage regimens, COX-2 inhibitors and non-selective NSAIDs) may reduce the antihypertensive effect of angiotensin II receptor antagonists.

In some patients with compromised renal function (eg, dehydrated patients or elderly patients with compromised renal function), the co-administration of angiotensin II receptor antagonists and agents that inhibit cyclo-oxygenase may result in further deterioration of renal function, including possible acute renal failure, which is usually reversible. Therefore, the combination should be administered with caution, especially in the elderly. Patients should be adequately hydrated and consideration should be given to monitoring of renal function after initiation of concomitant therapy and periodically thereafter.

In 1 study the co-administration of telmisartan and ramipril led to an increase of up to 2.5-fold in the AUC0-24 and Cmax of ramipril and ramiprilat. The clinical relevance of this observation is not known.

Diuretics (Thiazide or Loop Diuretics): Prior treatment with high dose diuretics eg, furosemide (loop diuretic) and hydrochlorothiazide (thiazide diuretic) may result in volume depletion, and in a risk of hypotension when initiating therapy with telmisartan.

To be Taken into Account with Concomitant Use: Other Antihypertensive Agents: The blood pressure lowering effect of telmisartan can be increased by concomitant use of other antihypertensive medicinal products.

Based on their pharmacological properties it can be expected that the following medicinal products may potentiate the hypotensive effects of all antihypertensives including telmisartan: Baclofen, amifostine. Furthermore, orthostatic hypotension may be aggravated by alcohol, barbiturates, narcotics or antidepressants.

Corticosteroids (Systemic Route): Reduction of the antihypertensive effect.

Teli 80: Digoxin: When telmisartan was co-administered with digoxin, median increases in digoxin Cmax (49%) and in trough concentration (20%) were observed. It is therefore recommended that digoxin levels be monitored when initiating, adjusting and discontinuing telmisartan to avoid possible over- or under-digitalization.

Warfarin: Telmisartan administered for 10 days slightly decreased the mean warfarin trough plasma concentration; this decrease did not result in a change in international normalized ratio (INR).

Other Drugs: Co-administration of telmisartan did not result in a clinically significant interaction with acetaminophen, amlodipine, glibenclamide, simvastatin, hydrochlorothiazide or ibuprofen. Telmisartan is not metabolized by the CYP450 system and had no effects in vitro on CYP450 enzymes, except for some inhibition of CYP2C19. Telmisartan is not expected to interact with drugs that inhibit CYP450 enzymes; it is also not expected to interact with drugs metabolized by CYP450 enzymes, except for possible inhibition of the metabolism of drugs metabolized by CYP2C19.

Incompatibilities: Not applicable.



References

  1. DailyMed. "AMLODIPINE BESYLATE; TELMISARTAN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. DailyMed. "ATENOLOL; CHLORTHALIDONE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  3. FDA/SPL Indexing Data. "U5SYW473RQ: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Ctd-T are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Ctd-T. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

2 consumers reported frequency of use

How frequently do I need to take Ctd-T?
It was reported by ndrugs.com website users that Ctd-T should ideally be taken Once in a day as the most common frequency of the Ctd-T. You should you adhere strictly to the instructions and guidelines provided by your doctor on how frequently this Ctd-T should be taken. Get another patient's view on how frequent the capsule should be used by clicking here.
Users%
Once in a day2
100.0%


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Information checked by Dr. Sachin Kumar, MD Pharmacology

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