Azilsartan + Chlorthalidone

Azilsartan + Chlorthalidone is a combination of two medicines: Azilsartan medoxomil and Chlorthalidone. Azilsartan medoxomil is an angiotensin receptor blocker (ARB) that blocks the hormone angiotensin, relaxing blood vessels and allowing blood to flow more smoothly. Chlorthalidone is a thiazide-like diuretic that removes extra water and certain electrolytes from the body, lowering blood pressure over time.

Common side effects include dizziness, tiredness, decreased potassium levels, decreased blood pressure, increased creatinine, and increased uric acid levels.

• Hypertension (high blood pressure)

Azilsartan displaces angiotensin II from the AT1 receptor, lowering blood pressure by antagonizing AT1-induced vasoconstriction, aldosterone release, catecholamine release, arginine vasopressin release, water absorption, and hypertrophic responses.

Chlorthalidone produces diuresis with increased excretion of sodium and chloride at the cortical diluting segment of the ascending limb of Henle's loop of the nephron.

Azilsartan blocks angiotensin II receptors, causing vasodilation and lowering blood pressure. Chlorthalidone removes excess water and sodium from the body, reducing blood volume and lowering blood pressure. Together, they effectively control hypertension.

Initial dose: 40 mg/12.5 mg once daily.

Dose adjustment: May increase to 40 mg/25 mg after 2-4 weeks to achieve blood pressure goals. Maximum daily dose: 40 mg/25 mg.

Switching from ARB or diuretic monotherapy: Initiate with 40 mg/12.5 mg once daily.

Special populations:

• Mild-moderate hepatic impairment: No dose adjustment needed for azilsartan
• Severe hepatic impairment: Azilsartan not studied
• Renal impairment (eGFR ≥30 mL/min/1.73 m²): No dose adjustment needed
• Severe renal impairment (eGFR <30): Safety and efficacy not established

Take this medicine in the dose and duration as advised by your doctor. Swallow the tablet whole; do not chew, crush, or break. May be taken with or without food, but take at a fixed time.

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.

• Dizziness
• Tiredness
• Hypokalemia (decreased potassium)
• Hypotension
• Increased creatinine
• Increased uric acid

• Do not use during pregnancy (fetal risk)
• Contraindicated with aliskiren in diabetic patients
• Caution in severe renal impairment
• Caution in volume-depleted or salt-depleted patients
• Monitor for electrolyte imbalances
• Caution when driving or operating machinery

• Hypersensitivity to azilsartan or chlorthalidone
• Anuria
• Concomitant use with aliskiren in diabetic patients
• Pregnancy

• NSAIDs (including COX-2 inhibitors): May cause deterioration of renal function, possible acute renal failure
• Aliskiren: Contraindicated with aliskiren in diabetic patients; increased risk of hypotension, hyperkalemia, renal dysfunction
• Lithium: Chlorthalidone reduces lithium clearance, increasing toxicity risk
• Other antihypertensives: Additive effects

[UNSAFE] Alcohol with Azilsartan + Chlorthalidone may cause excessive drowsiness. Avoid alcohol.

[CONSULT YOUR DOCTOR] Azilsartan + Chlorthalidone is unsafe during pregnancy (Category D). There is definite evidence of risk to the developing baby. May be prescribed in life-threatening situations if benefits outweigh risks.

[SAFE IF PRESCRIBED] Azilsartan + Chlorthalidone is safe during breastfeeding. Human studies suggest the drug does not pass into breastmilk in significant amounts and is not harmful to the baby.

Safety and efficacy in pediatric patients have not been established.

Caution in elderly patients (higher risk of volume depletion and renal dysfunction).

[CAUTION] Severe renal impairment (eGFR <30 mL/min/1.73 m²): Safety and efficacy not established.

[CAUTION] Caution in liver disease. Chlorthalidone may precipitate hepatic coma in severe liver disease.

Overdose may cause electrolyte imbalance, hypotension, and dehydration. Symptomatic and supportive treatment is recommended.

Store below 30°C, in a cool and dry place, protected from light. Keep out of reach of children.

Azilsartan Medoxomil (C₂₅H₂₀N₄O₅) + Chlorthalidone (C₁₄H₁₁ClN₂O₄S)