Dosing and uses of Enduron (methyclothiazide)
Adult dosage forms and strengths
tablet
- 2.5mg
- 5mg
Hypertension
2.5-5 mg PO qDay; if not controlled after 8-12 weeks, consider adding another antihypertensive agent
Edema
Indicated to relieve edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy
2.5 mg PO qDay; if needed, may increase, not to exceed 10 mg PO qDay
Renal Impairment
Contraindicated in anuria
Use with renal impairment may cause azotemia
Pediatric dosage forms and strengths
Safety and efficacy not established
Enduron (methyclothiazide) adverse (side) effects
Frequency not defined
Body as a whole: Headache, cramping, weakness
Cardiovascular: Orthostatic hypotension
Gastrointestinal: Pancreatitis, jaundice (intrahepatic cholestatic), sialadenitis, vomiting, diarrhea, nausea, gastric irritation, constipation, anorexia
Hematologic: Aplastic anemia, hemolytic anemia, agranulocytosis, leukopenia, thrombocytopenia
Hypersensitivity Reactions: Anaphylactic reactions, necrotizing angiitis (vasculitis, cutaneous vasculitis), Stevens-Johnson syndrome, respiratory distress including pneumonitis and pulmonary edema, fever, purpura, urticaria, rash, photosensitivity
Metabolic and Nutritional Disorders: Hyperglycemia, hyperuricemia, electrolyte imbalance
Neurologic: Vertigo, dizziness, paresthesias, muscle spasm, restlessness
Special senses: Transient blurred vision, xanthopsia
Urogenital: Glycosuria
Warnings
Contraindications
Hypersensitivity to methyclothiazide or sulfonamide-derivatives
Anuria
Cautions
Rare cases of sensitivity reactions have occurred with history of allergy or bronchial asthma
May cause hypokalemia
Fluid/electrolyte imbalance may occur
Caution with renal disease or significant impairment of renal function, since azotemia may occur
Hyponatremia/hypochloremia: Caution with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma
Possibility of exacerbation or activation of systemic lupus erythematosus has been reported
May precipitate hyperuricemia or frank gout
Latent diabetes mellitus may become manifest during thiazide administration
May cause increased concentrations of total serum cholesterol, total triglycerides, and low-density lipoproteins in some patients
May decrease urinary calcium excretion
Antihypertensive effects enhanced in postsympathectomy patient
Pregnancy and lactation
Pregnancy category: B; diuretics not recommended during pregnancy
Lactation: Distributed in breast milk; diuresis may affect breast milk production; not recommended
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Enduron (methyclothiazide)
Absorption: rapid oral absorption
Onset of action: 2 hr
Peak effect: 6 hr
Duration of action: 24 hr
Excretion: urine; primarily as inactive metabolite
Mechanism of action
Thiazide diuretic; inhibits renal tubular reabsorption of electrolytes; sodium and chloride excretion is greatly enhanced; potassium excretion also enhanced