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Pronunciation:

(KLON i deen & klor THAL i done)

U.S. Brand Names:

Clorpres®; Combipres® [DSC]

Synonyms:

Chlorthalidone and Clonidine

Generic Available:

Use:

Management of mild to moderate hypertension

Pregnancy Risk Factor:

Pregnancy Implications:

Refer to Clonidine monograph.

Lactation:

Clonidine: Enters breast milk/not recommended

Chlorthalidone: Enters breast milk/compatible

Adverse Reactions:

See individual agents.

Drug Interactions:

See individual agents.

Pharmacodynamics/Kinetics:

See individual agents.

Dosage:

Oral: 1 tablet 1-2 times/day; maximum: 0.6 mg clonidine and 30 mg chlorthalidone

Patient Education:

See individual agents. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to become pregnant. Breast-feeding is not recommended.

Cardiovascular Considerations:

Combination therapy for the treatment of hypertension should be individualized for each patient. Potential advantages for clonidine and chlorthalidone combination therapy may include improved compliance and synergistic reductions in blood pressure with an accomplished reduction in side effects. Thiazide therapy improves cardiovascular outcomes in patients with hypertension. See Special Cardiovascular Considerations for individual agents.

Dental Health: Effects on Dental Treatment:

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

No information available to require special precautions

Mental Health: Effects on Mental Status:

Drowsiness is common

Mental Health: Effects on Psychiatric Treatment:

Dry mouth, orthostatic hypotension, and sedation may be increased with concurrent psychotropic use; TCAs may antagonize clonidine's hypotensive effect; rare reports of blood dyscrasias; use caution with clozapine and carbamazepine; thiazides decrease lithium clearance resulting in elevated serum lithium levels and potential toxicity; monitor serum lithium levels

Dosage Forms:

Tablet:

0.1: Clonidine hydrochloride 0.1 mg and chlorthalidone 15 mg

0.2: Clonidine hydrochloride 0.2 mg and chlorthalidone 15 mg

0.3: Clonidine hydrochloride 0.3 mg and chlorthalidone 15 mg

References

Chobanian AV, Bakris GL, Black HR, et al, "The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report,"JAMA, 2003, 289(19):2560-71.

Kaplan NM and Sever PS, "Combination Therapy: A Key to Comprehensive Patient Care,"Am J Hypertens, 1997, 10(7 Pt 2):127S.

Moser M and Black HR, "The Role of Combination Therapy in the Treatment of Hypertension,"Am J Hypertens, 1998, 11(6 Pt 2):73S-8S, 95S-100S.

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