Why is chlorthalidone underused?

When doctors choose a thiazide diuretic, they often reach for hydrochlorothiazide (HCTZ). However, chlorthalidone is just as inexpensive, and may be more effective. Is it simply the fact that chlorthalidone doesn’t have a commonly-used abbreviation?

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  • Louis

    I’ve personally never used it, but I have heard that it caused much more hypokalemia than HCTZ. There’s a good SERMO post from several months ago about the same topic. Let’s not forget that Chlorthalidone was the thiazide diuretic that was used in the ALLHAT trial. Most probably feel that the effect seen in ALLHAT was a class-effect and not specific to just Chlorthalidone.

  • Anonymous

    In my experience, significant hypokalemia is more common with chlorthalidone that it is with HCTZ. This may be due to the duration of the diuretic effect. The antihypertensive effect of HCTZ appears to be of much longer duration than the diuretic effect.

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