Natriuran Uses

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What is Natriuran?

Natriuran is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Natriuran is also used to treat fluid retention (edema) that is caused by congestive heart failure, severe liver disease (cirrhosis), kidney disease, or treatment with a hormone or steroid medicine.

Natriuran is a diuretic (water pill). It reduces the amount of water in the body by increasing the flow of urine, which helps to lower blood pressure.

Natriuran is available only with your doctor's prescription.

Natriuran indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Treatment of arterial hypertension, essential or nephrogenic or isolated systolic. Treatment of stable, chronic heart failure of mild to moderate degree (New York Heart Association, NYHA: functional class II or III).

Oedema of specific origin

• Ascites due to cirrhosis of the liver in stable patients under close control.

• Oedema due to nephrotic syndrome.

Diabetes Insipidus.

How should I use Natriuran?

Use Natriuran as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Natriuran.

Uses of Natriuran in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications

Edema: Adjunctive treatment of edema associated with heart failure, renal impairment, hepatic cirrhosis, or corticosteroid and estrogen therapy.

Hypertension: Management of hypertension.

Guideline recommendations: The 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults recommends if monotherapy is warranted, in the absence of comorbidities (eg, cerebrovascular disease, chronic kidney disease, diabetes, heart failure, ischemic heart disease, etc), that thiazide-like diuretics or dihydropyridine calcium channel blockers may be preferred options due to improved cardiovascular endpoints (eg, prevention of heart failure and stroke). ACE inhibitors and ARBs are also acceptable for monotherapy. Combination therapy may be required to achieve blood pressure goals and is initially preferred in patients at high risk (stage 2 hypertension or atherosclerotic cardiovascular disease [ASCVD] risk ≥10%) (ACC/AHA [Whelton 2017]).

Off Label Uses

Calcium nephrolithiasis

Data from a prospective, double-blind, randomized, placebo-controlled study support the use of Natriuran for the prevention of recurrent calcium nephrolithiasis.

Based on the European Society of Endocrinology consensus statement on the standards of care for hypoparathyroidism in adults, the Endocrine Society guidelines on the management of hypoparathyroidism, and the European Society of Endocrinology guidelines on the treatment of chronic hypoparathyroidism, Natriuran, usually in combination with a low-salt diet, may be considered in the management of chronic hypoparathyroidism to reduce urinary calcium losses.

Natriuran description

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A benzenesulfonamide-phthalimidine that tautomerizes to a benzophenones form. It is considered a thiazide-like diuretic. [PubChem]

Natriuran dosage

Natriuran 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

Natriuran 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

Natriuran is contraindicated in patients with anuria.

Natriuran therapy should be used with caution in severe renal disease. In patients with renal disease, Natriuran 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.

Natriuran 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 Natriuran. However, systemic lupus erythematosus has not been observed following Natriuran administration.

Hypokalemia may develop with Natriuran 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 Natriuran therapy. Thiazide-like diuretics have been shown to increase the urinary excretion of magnesium, which may result in hypomagnesemia.

The antihypertensive effects Natriuran 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 Natriuran 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 Natriuran

Consumer resources

Professional resources

Related treatment guides

Natriuran interactions

See also:
What other drugs will affect Natriuran?

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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 Natriuran absorption.

Anticoagulants

May diminish anticoagulant effects.

Bile acid sequestrants

May reduce Natriuran absorption. Give Natriuran 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 Natriuran.

Sulfonylureas, insulin

May decrease hypoglycemic effect of sulfonylureas.

Laboratory Test Interactions

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

Natriuran side effects

See also:
What are the possible side effects of Natriuran?

Applies to Natriuran: oral tablet

In addition to its needed effects, some unwanted effects may be caused by Natriuran (the active ingredient contained in Natriuran). In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking Natriuran:

Incidence not known:

Minor Side Effects

Some of the side effects that can occur with Natriuran may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Incidence not known:

Natriuran contraindications

See also:
What is the most important information I should know about Natriuran?

Hypersensitivity to Natriuran, other sulfonamide-derived drugs, or any component of the formulation; anuria

Note: Although the FDA approved product labeling states this medication is contraindicated with other sulfonamide-containing drug classes, the scientific basis of this statement has been challenged. See "Warnings/Precautions" for more detail.

Documentation of allergenic cross-reactivity for drugs thiazide-type diuretics is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.

Active ingredient matches for Natriuran:

Chlorthalidone


List of Natriuran substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
Tablet; Oral; Chlorthalidone 25 mg (Novartis)
Tablet; Oral; Chlorthalidone 50 mg (Novartis)
Hygroton 50 mg x 5 x 10's (Novartis)$ 28.53
Hythalton M 100 mg Tablet (Nicholas Piramal India Ltd.)$ 0.04
KLORZID 6.25 MG TABLET 1 strip / 10 tablets each (Zydus Cadila)$ 0.53
Klorzid 6.25mg Tablet (Zydus Cadila)$ 0.05
New CH 12.5mg Tablet (Systopic Laboratories Pvt Ltd)$ 0.03
Tablet; Oral; Chlorthalidone 50 mg (Novopharm)
Tablet; Oral; Chlorthalidone 100 mg (Novopharm)
Thalizide 12.5mg TAB / 10 (IPCA Laboratories Ltd.)$ 0.20
Thalizide 12.5 mg Tablet (IPCA Laboratories Ltd.)$ 0.02
THALIZIDE 12.5 MG TABLET 1 strip / 10 tablets each (IPCA Laboratories Ltd.)$ 0.21
THALIZIDE tab 12.5 mg x 10's (IPCA Laboratories Ltd.)$ 0.21
Thalizide 12.5mg Tablet (IPCA Laboratories Ltd.)$ 0.02
THALORIC 12.5 MG TABLET 1 strip / 10 tablets each (Zuventus)$ 0.76
THALORIC 6.25 MG TABLET 1 strip / 10 tablets each (Zuventus)$ 0.54
THALORIC tab 6.25 mg x 10's (Zuventus)$ 0.54
THALORIC tab 12.5 mg x 10's (Zuventus)$ 0.76
Thaloric 12.5mg Tablet (Zuventus)$ 0.08
Thaloric 6.25mg Tablet (Zuventus)$ 0.05
THIAKLOR 12.5MG TABLET 1 strip / 10 tablets each (Emcure)$ 0.78
THIAKLOR 6.25 MG TABLET 1 strip / 10 tablets each (Emcure)$ 0.61
THIAKLOR tab 6.25 mg x 10's (Emcure)$ 0.53
THIAKLOR tab 12.5 mg x 1O (Emcure)$ 0.71
Thiaklor 6.25mg Tablet (Emcure)$ 0.07
THIOVAS 12.5 MG TABLET 1 strip / 10 tablets each (Lakshya Life Sciences)$ 0.83
THIOVAS 6.25 MG TABLET 1 strip / 10 tablets each (Lakshya Life Sciences)$ 0.63
Thiovas 12.5mg Tablet (Lakshya Life Sciences)$ 0.08
Thiovas 6.25mg Tablet (Lakshya Life Sciences)$ 0.06

References

  1. 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).
  2. PubChem. "chlorthalidone". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "chlorthalidone". http://www.drugbank.ca/drugs/DB00310 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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