Bendroflumethiazide

Bendroflumethiazide (Bendrofluazide): Uses, Side effects

Chemical Structure:

Chemical Structure of Bendroflumethiazide

Class of drug: Thiazide diuretic

Mode of action:

Enhances diuresis by decreasing sodium (Na+) reabsorption at the distal convoluted tubule (DCT) of the nephron

Medicinal forms available:

Tablets and ‘on-request’ oral suspensions

Some brands available:

Naturetin, Aprinox

Indications and dose:

Oedema

Adult

Initially 5–10 mg once daily or on alternate days, dose to be taken in the morning, then maintenance 5–10 mg 1–3 times a week 

Hypertension

Adult

2.5 mg daily, dose to be taken in the morning, higher doses are rarely necessary 

Contraindications:

·      Anuria

·      Addison’s disease

·      Hypercalcemia

·      Hyponatremia

·      Symptomatic hyperuricemia

·      Refractory hypokalemia

Cautions:

·      Diabetes

·      Gout

·      Systemic lupus erythematosus

·      Risk of hypokalemia

·      Hypotension

Interactions:

Aceclofenac – risk of acute renal failure

Allopurinol – risk of hypersensitivity reactions

Amiodarone – causes hypokalemia with increased risk of torsade de pointes

Artemether – causes hypokalemia with increased risk of torsade de pointes

Aspirin – risk of acute renal failure

Calcium – risk of hypercalcemia

Celecoxib – risk of acute renal failure

Chlorpromazine – causes hypokalemia with increased risk of torsade de pointes

Citalopram – causes hypokalemia with increased risk of torsade de pointes

Clarithromycin – causes hypokalemia with increased risk of torsade de pointes

Clomipramine – causes hypokalemia with increased risk of torsade de pointes

Diclofenac – risk of acute renal failure

Digoxin – risk of hypokalemia increase digoxin toxicity

Erythromycin – causes hypokalemia with increased risk of torsade de pointes

Fluconazole – causes hypokalemia with increased risk of torsade de pointes

Haloperidol – causes hypokalemia with increased risk of torsade de pointes

Ibuprofen – risk of acute renal failure

Mefenamic acid – risk of acute renal failure

Naproxen – risk of acute renal failure

Piroxicam – risk of acute renal failure

Quinine – causes hypokalemia with increased risk of torsade de pointes

Risperidone – causes hypokalemia with increased risk of torsade de pointes

Sildenafil – risk of hypotension and also causes hypokalemia with increased risk of torsade de pointes

Side effects/adverse effects:

·      Hypercalcemia

·      Electrolyte imbalance

·      Hyperglycemia

·      Erectile dysfunction

·      Nausea

·      Postural hypotension

·      Dizziness

·      Dry mouth

·      Skin reactions

·      Diarrhea

·      Constipation

·      Headache

·      Fatigue

Pregnancy:

Thiazide and thiazide-like diuretics should not be used in pregnancy to treat gestational hypertension.

Breastfeeding:

Amount present in milk is too small to be harmful; however, large doses may suppress lactation.

Hepatic impairment:

Use with caution in mild-to-moderate impairment; avoid in severe impairment.

Renal impairment:

Avoid if eGFR is less than 30 mL/minute/1.73m2

Monitoring requirements:

Monitor electrolytes

Other drugs in class:

·      Chlorothiazide

·      Chlorthalidone

·      Hydrochlorothiazide

·      Indapamide

·      Metolazone

WRITTEN AND EDITED RESPECTIVELY BY:

Dr. Asantewaa Owusu-Agyei, PharmD

Dr. Asantewaa Owusu-Agyei is a practicing pharmacist at the Korle-Bu Teaching Hospital. She loves to read medical journals relating to infectious diseases and also enjoys watching medical movies.

Chief Editor at Wapomu.com

MPSGH, MRPharmS, MPhil.

Isaiah Amoo is a practicing community pharmacist in good standing with the Pharmacy Council of Ghana who has meaningful experience in academia and industrial pharmacy. He is a member of the Royal Pharmaceutical Society, England, UK and currently pursuing his overseas pharmacy assessment programme (MSc) at Aston University, UK. He had his MPhil degree in Pharmaceutical Chemistry at Kwame Nkrumah University of Science and Technology. He has about 5 years’ experience as a community Pharmacist and has also taught in academic institutions like KNUST, Kumasi Technical University, Royal Ann College of Health, and G-Health Consult. He likes to spend time reading medical research articles and loves sharing his knowledge with others.

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