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International generic name
Combined product
Drug form and composition
Tablets. One tablet contains: 0.150 mg Clonidine hydrochloride; 20 mg Chlortalidone.
Indications
Arterial hypertension (appropriate in cases with resistant to other antihypertensive
preparations).
Dosage and administration
The usual initial dose is ½ -1 tablet daily. If necessary the dose may be graduately
enhanced up to ½ - 1 tablet 2-3 times daily. The dosage and duration of the treatment
is determined by the doctor with the lowest effective dose to be used in order to
avoid the side effects of the preparation. Tablets should be taken with meal.
Contraindications
Hypersensitivity to any of preparation components; sick sinus sindrome; AV-block
II or III degree; peripheral circulation disorders; severe renal failure; hepatal
comma; cerebrovascular diseases; recent myocardial infarction or coronary artery
insufficiency; depressive syndrome; hypokalemia.
Special warnings and precautions
In patients with preexisting heart diseases administration of Chlophadon may
cause cardiac arrhythmias (bradycardia, arrhythmia). If renal failure exists the
preparation should be used under doctor’s control with monitoring of the creatine
clearance. Abrupt interruption of the medication may cause neurovegetative disorders
including anxiety, insomnia, headache, nausea, elevation of the blood pressure (discontinuation
syndrome). During the treatment with Clophadon alcohol should be avoided. In pregnant
women the preparation is indicated only in case the expected benefit exceeds the
adverse effect on the fetus. As the preparation components are eliminated in the
mother milk chlophadon should be used with care in nursing women, only in urgency.
In drivers and machinery operating persons the preparation should be administered
carefully, as it may provoke dizziness and orthostatic reactions.
Drug interactions
Tricycled antidepressants reduce effectivity of the preparation. Concomitant
administration with cardiac glycosides may cause bradycardia and AV - block. Chlophadon
reduces the hypoglycemic effect of the anti-diabetic preparations, which requires
correction of the dose. In concomitant treatment with nonsteroid antiinflammatory
drugs the diuretic and atihypertensive activity of the preparation is reduced. In
concomitant treatment with glycocorticoid preparations and carbenoxolone the hypokalemic
effect of Chlophadon is accentuated.
Adverse reactions
Fatigue; headache; orthostatic hypotension; “discontinuation syndrome” in case
of abrupt interruption of the treatment; A-V conduction disorders; bradycardia;
tremor; allergy rashes; photosensitization; nausea; vomiting. In long-term treatment:
gynecomasty; hypokalemia; tubular necrosis and interstitial nephritis; elevation
of the serum level of the cholesterol and triglycerides.
Pharmacological mechanisms
Chlophadon is an antihypertensive preparation, being combined medicine containing
the α-adrenergic agonist clonidine and the diuretic chlortalidone. Clonidine stimulates
the postsynaptic α 2 - receptors in the hypothalamus and presynaptic α 2 - receptors
in the nucleus of the tractus solitarius and in the peripheral synapses. The net
effect is reducing of the blood pressure, of the heart rate and of the general peripheral
vessel resistance. The renin plasma level is also reduced, whereas the renal circulation
and glomerular filtration remain unchanged. Conversely to reserpine, clonidine does
not stimulate, but reduces the stomach secretion. For this reason Chlophadon is
preferable in hypertensive patients with ulcer disease. Chlortalidone is a diuretic,
acting predominantly on the distal tubules and on the cortical segment of the ascending
limb of the Henle loop. This enhances excretion of the Na+ and Cl- in equivalent
quantities, i. e. potentiates the salt elimination. The preparation possesses moderate
antihypertensive effect, which is due to reduction of the blood volume and to reduction
of the sensitivity of the vessel wall to catecholamines and angiotensine II.
Supplied
50 tablets.
Expiry
2 years.
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