Chlorthalidone, a thiazide-like diuretic, is recognized in the 2017 American College of Cardiology/American Heart Association guideline as the preferred diuretic for hypertension management, based on its extended half-life and demonstrated cardiovascular outcome benefits.

Pivotal trials, including the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial as well as the Systolic Hypertension in the Elderly Program used 12.5 mg as the initial dose in stepped-care approaches, showing reductions in cardiovascular event rates and supporting its continued use as a first-line option.

The availability of a 12.5-mg tablet, known as HemiClor, may enable more precise dose titration and support individualized treatment strategies, particularly in patients at risk for dose-related adverse effects. According to the prescribing information, adverse metabolic effects, including hypokalemia and hyperuricemia, could be associated with higher doses, indicating that initiating therapy at a lower dose may reduce these risks.

The introduction of a 12.5-mg dose aligns with current recommendations and may provide additional flexibility in managing patients with stage I or stage II hypertension, noted William B. White, MD, Professor Emeritus at the University of Connecticut School of Medicine and former President of the American Society of Hypertension.

HemiClor is indicated to lower blood pressure, thereby reducing the risk of fatal and nonfatal cardiovascular events such as stroke and myocardial infarction. HemiClor shouldn't be used in patients with anuria or in those who have a known hypersensitivity to chlorthalidone or drugs derived from sulfonamides. Common adverse effects include electrolyte imbalances, dizziness, and gastrointestinal symptoms. HemiClor is expected to be available in May 2025.

Source: PRM Pharma