chlorthalidone / Generic mfg. - LARVOL DELTA

Efficacy and Safety of Olmesartan Associated With Chlorthalidone in Essential Arterial Hypertension Control (clinicaltrials.gov) - P3 | N=0 | Withdrawn | Sponsor: EMS | N=261 ➔ 0 | Not yet recruiting ➔ Withdrawn | Trial primary completion date: Jun 2026 ➔ Jun 2025

Enrollment change • Trial primary completion date • Trial withdrawal • Cardiovascular • Hypertension • Pulmonary Arterial Hypertension

Efficacy and Safety of Olmesartan Associated With Chlorthalidone Versus Benicar HCT® in Essential Hypertension Control (clinicaltrials.gov) - P3 | N=0 | Withdrawn | Sponsor: EMS | N=348 ➔ 0 | Not yet recruiting ➔ Withdrawn

Enrollment change • Trial withdrawal • Cardiovascular • Hypertension • Pulmonary Arterial Hypertension

Acute Kidney Injury from Mononuclear Cell-Predominated Interstitial Nephritis After Introduction of a Glucagon-Like Peptide-1 Receptor Agonist: A Case Report. (PubMed, Am J Case Rep) - "CASE REPORT A 63-year-old woman with stage 3b diabetic kidney disease and depressive disorder was prescribed dulaglutide 0.75 mg/week subcutaneously in August 2023 due to persistent albuminuria despite receiving the maximum tolerated dose of azilsartan...Azilsartan and chlorthalidone could then be successfully rechallenged...Nevertheless, this does not prevent the prescription of GLP-1 RAs to alleviate DKD progression in certain patients. Treatment includes drug discontinuation and steroid therapy in non-responders."

Journal • Acute Kidney Injury • CNS Disorders • Depression • Diabetic Nephropathy • Infectious Disease • Nephrology • Psychiatry • Renal Disease

Targeted Therapy or Tension: A Case of Tyrosine Kinase Inhibitor-Mediated Hypertensive Crisis in a Patient with Advanced Renal Cell Carcinoma (KIDNEY WEEK 2025) - "Case Description A 71-year-old woman with well-controlled hypertension on lisinopril 20 mg daily and prior RCC treated by radical nephrectomy and short-lived pembrolizumab (stopped for immune polyarthritis) began cabozantinib 40 mg daily for progression...Twelve weeks after stopping cabozantinib, she remained markedly hypertensive despite four agents (lisinopril 40 mg qd, nifedipine 120 mg qd, chlorthalidone 25 mg qd, spironolactone 25 mg qd)...Since then, she has been receiving Belzutifan (HIF-2α inhibitor) without adverse effects. ( Ref Fig1 ) Discussion Grade 1-3 HTN was observed in about 37% of patients in the METEOR Trial (Cabozantinib versus Everolimus in Advanced Renal-Cell Carcinoma), but frank hypertensive crisis (grade 4) and true resistant hypertension are very uncommon (<1 %). Presentation with hypertensive crisis prompts discontinuation of the TKI therapy."

Clinical • Metastases • Cardiovascular • Genito-urinary Cancer • Hypertension • Immunology • Oncology • Renal Cell Carcinoma • Renal Disease • Solid Tumor • EPAS1

CARDAMOM: Cardiac Effects of Mineralocorticoid Receptor Antagonism After Preeclampsia (clinicaltrials.gov) - P2 | N=90 | Not yet recruiting | Sponsor: Massachusetts General Hospital

New P2 trial • Cardiovascular • Gynecology • Hypertension

Early Lupus Nephritis (LN) Unmasked by Refractory Hypertension (HTN) and Pericarditis in Systemic Lupus Erythematosus (SLE) (KIDNEY WEEK 2025) - "He was diagnosed with SLE and started on corticosteroids, later transitioned to azathioprine and belimumab...He was maintained on prednisone 10 mg daily. Months later, he developed HTN refractory to amlodipine 10 mg, clonidine 0.2 mg, eplerenone 50 mg, and olmesartan 20 mg. Eplerenone was increased to 100 mg and chlorthalidone 25 mg added, but HTN persisted...In suspected proliferative LN, switching from azathioprine to mycophenolate mofetil is often favored...Timely biopsy and treatment adjustment are key to preserving renal function. Emerging therapies may support steroid-sparing approaches for glomerular and extraglomerular lupus manifestations."

Cardiovascular • Glomerulonephritis • Hypertension • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology • Ocular Inflammation • Pulmonary Disease • Renal Disease • Respiratory Diseases • Systemic Lupus Erythematosus

Indapamide and Chlorthalidone to Reduce Urine Supersaturation for Secondary Prevention of Kidney Stones: Randomized, Double-Blind, Crossover Trial (INDAPACHLOR Trial) (KIDNEY WEEK 2025) - P2 | "The NOSTONE trial recently demonstrated that hydrochlorothiazide (HCT) has limited efficacy in preventing recurrence. The study was initially expected to conclude by the end of 2027; however, current recruiting rates indicate it may finish earlier than anticipated. Conclusion No conclusions available — study in progress."

Clinical • Nephrology • Renal Calculi

SLC34A3 Variants Associated with Urinary Stone Disease and Hypercalciuria in the Mayo Clinic Biobank (KIDNEY WEEK 2025) - "Additionally, 16 carriers of the p.Ser192Leu variant were identified in the SF group, and both patients with urinary data were hypercalciuric (median 441 mg/day while on chlorthalidone)...Conclusion Rare variants in SLC34A3 are enriched in SF, suggesting a significant genetic contribution to USD risk. Among these, hypercalciuria is common, but further research is needed to determine the clinical implications of these findings."

Urolithiasis

Hypocalcemia and Recurrent Kidney Stones: A Diagnostic Challenge (KIDNEY WEEK 2025) - "Pharmacologic management included chlorthalidone, calcitriol, and potassium citrate...In contrast, symptomatic patients should receive a minimal effective dose of calcium and activated vitamin D to minimize the risk of nephrocalcinosis. A low sodium and phosphorus diet is also advised in patients with hypoparathyroidism to reduce hypercalciuria and manage calcium-phosphate balance effectively."

Endocrine Disorders • Genetic Disorders • Hypoparathyroidism • Metabolic Disorders • Nephrology • Renal Calculi • Renal Disease • CASR • ERBB3

Computational Pathogenicity Prediction of Autosomal Recessive Aquaporin 2 (AQP2) Mutations (ArM) (KIDNEY WEEK 2025) - "Case Description A cognitively delayed adult female patient presented with severe hypernatremia (177 mmol/L) and 15L/d dDAVP-unresponsive polyuria...She improved on chlorthalidone/low Na diet...Discussion The scarcity of in vivo NDI phenotypes and limited access to in vitro ArM functional assays require in silico VUS pathogenicity predictions by emerging AI/neural nets using evolutionary/ensemble/protein-LLMs. Yet, while “AI solved the fold,” modeling folding accuracy lags, as exemplified by a 3D-improbable ArM with a water-accessible nonpolar Pro167 in lieu of a buried highly conserved polar aa in a water channel, a striking irony."

Nephrology • Renal Disease

Afferent Renal Nerve Activity Drives Chlorthalidone-Induced Salt Intake (KIDNEY WEEK 2025) - "Funding Other NIH Support Background High salt intake is a global public health concern and is linked to the development of hypertension, kidney disease, and millions of preventable deaths annually. CTD induced increases in ARNA were reduced by co-treatment with amiloride to 27.8%. Conclusion These studies support the hypothesis that ARDN decreases salt intake through an ENaC dependent mechanism, potentially leading to a novel treatment for high salt intake."

Anesthesia • Cardiovascular • Hypertension • Nephrology • Renal Disease

Not Just One Answer: A Case of Resistant Hypertension with Overlapping Etiologies (KIDNEY WEEK 2025) - "Despite adherence to a low sodium diet, CPAP and a six-drug regimen including amlodipine 10mg, metoprolol 150mg, lisinopril 40mg, terazosin 20mg, chlorthalidone 25mg, and spironolactone 25mg daily, BP remained elevated at 160-180/80-90 mm Hg...He remained on metoprolol ER 50mg, diltiazem 240mg, furosemide 20mg daily for his hypertrophic cardiomyopathy...A concurrent renal artery stenosis was managed with angioplasty that helped bring his BP to goal. With this case, we highlight the importance of identifying and understanding the pathophysiology of secondary causes of resistant hypertension."

Clinical • Cardiomyopathy • Cardiovascular • Endocrine Disorders • Hypertension • Hypertrophic Cardiomyopathy • Nephrology • Renal Calculi

Unmasking of a Heterozygous SLC12A3 Mutation (KIDNEY WEEK 2025) - "The patient had been prescribed amlodipine, and 12.5 mg hydrochlorothiazide (HCTZ) was added, but later changed to 25 mg chlorthalidone (CTD). Finally, glucose intolerance is associated with thiazide diuretics and is attributable, in part, to K depletion. Changes in serum electrolytes (A) and glucose (B) in response to K repletion and insulin, respectively"

Cardiovascular • Diabetes • Dyslipidemia • Heart Failure • Hypertension • Metabolic Disorders • SLC2A3

CaOx Stone Prevention (clinicaltrials.gov) - P4 | N=80 | Recruiting | Sponsor: Icahn School of Medicine at Mount Sinai

New P4 trial • Nephrology • Renal Calculi

Univariate and multivariate signal processing spectrophotometric determination of an antihypertensive combination in line with the United Nations sustainable development goals. (PubMed, Sci Rep) - "This study's primary goal was to compare and validate univariate and multivariate spectrophotometric techniques for analyzing fixed-dose antihypertensive formulations of Telmisartan (TEL), Chlorthalidone (CHT), and Amlodipine (AML). This study also aligns with several UN Sustainable Development Goals (UN-SDGs), emphasizing commitment to green pharmaceutical research. Sustainability was verified using the NQS index, confirming the method's compliance with responsible analytical practices."

Journal • Acute Myelogenous Leukemia • Cardiovascular • Hypertension

BEYOND THE USUAL SUSPECTS: HYPOXEMIA DUE TO PULMONARY VASODILATION IN CALCIUM CHANNEL BLOCKER OVERDOSE (CHEST 2025) - "CASE PRESENTATION: A 41-year-old male with hypertension, asthma, and obstructive sleep apnea (OSA) presented after an intentional overdose of 90 days' worth of amlodipine (10 mg) and chlorthalidone (25 mg)... This case underscores the potential for CCB toxicity to induce hypoxia via impaired HPV and V/Q mismatch, a mechanism distinct from the more commonly recognized systemic effects of these agents. Clinicians should consider this rare but physiologically plausible cause of unexplained hypoxemia, particularly in patients with a history of CCB overdose. The spontaneous resolution of hypoxemia in the outpatient setting further supports a transient drug-related effect rather than an underlying structural or chronic pulmonary pathology."

Acute Respiratory Distress Syndrome • Asthma • Cardiovascular • CNS Disorders • Hypertension • Immunology • Infectious Disease • Interstitial Lung Disease • Obstructive Sleep Apnea • Pneumonia • Pulmonary Arterial Hypertension • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Sleep Disorder

HYPERTENSIVE EMERGENCY DUE TO RESISTANT HYPERTENSION REQUIRING SEVEN MEDICATIONS (CHEST 2025) - "The patient was eventually weaned off labetalol infusion and transitioned to oral medications which were up-titrated to maximum doses of carvedilol, chlorthalidone, clonidine, nifedipine, spironolactone, hydralazine and valsartan before nicardipine infusion was weaned off improving systolic BP (SBP) to 130s mmHg before discharge. HE should be treated immediately with intravenous antihypertensives to avoid further end-organ damage."

Addiction (Opioid and Alcohol) • Cardiovascular • Cerebral Hemorrhage • Chronic Kidney Disease • CNS Disorders • Congestive Heart Failure • Endocrine Disorders • Heart Failure • Hematological Disorders • Hypertension • Ischemic stroke • Nephrology • Nicotine Addiction • Ophthalmology • Renal Disease • Respiratory Diseases • Subarachnoid Hemorrhage

Projected Savings for Urolithiasis Medications Purchased via Mark Cuban Cost Plus Drug Company in Medicare. (PubMed, Urol Pract) - "Using MCCPDC prices, savings were generated for all drugs at the median prices under Part D except hydrochlorothiazide and tiopronin. Depending on dosage, estimated annual savings at the median percentile prices for part D were: allopurinol $2.3-15.7 million (M), chlorthalidone $14-26M, indapamide $0.9-1.7M, penicillamine $2.3M, and potassium citrate $12.1-19.1M...DTC online pharmacies offer affordable alternatives for cash-pay customers purchasing urolithiasis medications. Replacing Part D formulary with MCCPDC pricing could yield significant savings for five generic urolithiasis medications."

Journal • Medicare • Reimbursement • US reimbursement • Nephrology • Renal Calculi • Urolithiasis

LC-MS/MS-based simultaneous quantification of chlorthalidone and cilnidipine in rat plasma: Pharmacokinetic evaluation, green analytical assessment, and DoE-driven optimization. (PubMed, J Pharmacol Toxicol Methods) - "Detection was achieved in positive electrospray ionization mode using multiple reaction monitoring, with transitions of m/z 339.8909 → 85.0951 for chlorthalidone, m/z 493.5237 → 300.1587 for cilnidipine, and m/z 515.6423 → 342.6158 for telmisartan, employed as the internal standard. The method exhibited strong analyte stability and was successfully applied to the pharmacokinetic evaluation of both drugs in Wistar rats. This DoE-optimized LC-MS/MS platform offers a selective, reliable, and environmentally conscious analytical solution for the preclinical assessment of chlorthalidone and cilnidipine."

Journal • PK/PD data • Preclinical

Green and White Analytical Chemistry: Advances, Comparisons, Future Perspectives, and a Proposal for Green Financing Model for Analytical Chemistry. (PubMed, J Pharm Sci) - "We analyze WAC's aspects within the development of stability-indicating High-Performance Thin-Layer Chromatography (HPTLC) methods for thiocolchicoside and aceclofenac. We further illustrate WAC's practical utility through the development of a green RP-HPLC method for azilsartan, medoxomil, chlorthalidone, and cilnidipine in human plasma, where a WAC-assisted AQbD strategy led to a validated, sustainable, and cost-effective procedure with an excellent white WAC score...This paper conducts a NOISE (needs, opportunities, improvements, strengths, exceptions) analysis of WAC, emphasizing the change it brings to existing Green Analytical Chemistry methodology. Finally, it proposes Green Financing for Analytical Chemistry (GFAC), a dedicated funding model designed to promote innovations which are aligned to GAC and WAC goals and bridge the gaps in current practices."

Financing • Journal • Review

Title: Prescription Trends of Hydrochlorothiazide vs. Chlorthalidone in the United States (2019-2024). (PubMed, Am J Hypertens) - "The FDA warning and DCP report were associated with a decline in hydrochlorothiazide and chlorthalidone prescriptions, while the DCP report slowed chlorthalidone prescribing."

Journal • Cardiovascular • Genetic Disorders • Hypertension • Non-melanoma Skin Cancer • Skin Cancer • Solid Tumor

Aldosterone, the Mineralocorticoid Receptor, and Cardiovascular Disease in Obesity (clinicaltrials.gov) - P4 | N=79 | Completed | Sponsor: Brigham and Women's Hospital | Active, not recruiting ➔ Completed | Trial completion date: Feb 2026 ➔ Sep 2025 | Trial primary completion date: Jan 2026 ➔ Sep 2025

Trial completion • Trial completion date • Trial primary completion date • Cardiovascular • Genetic Disorders • Hypertension • Metabolic Disorders • Obesity

DOCK: Diuretics and Volume Overload in Early CKD (clinicaltrials.gov) - P4 | N=46 | Recruiting | Sponsor: VA Office of Research and Development | Trial completion date: Oct 2025 ➔ Dec 2025 | Trial primary completion date: Sep 2025 ➔ Dec 2025

Trial completion date • Trial primary completion date • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Hypertension • Nephrology • Renal Disease

Efficacy and Safety of a Novel Triple Single-Pill For Uncontrolled Hypertension: the OPTION TREAT Trial. (PubMed, JACC Adv) - P3 | "In patients with uncontrolled hypertension, a novel triple single-pill containing candesartan cilexetil, amlodipine, and chlorthalidone improved BP control at 12 weeks and had a reasonable safety profile. (Efficacy and Safety of a Novel Triple Single-Pill Combination Therapy Compared with an Active Control in Patients with Uncontrolled Hypertension [OPTION TREAT]: NCT05920005)."

Clinical • Journal • Cardiovascular • Hypertension

Comparison of cardiovascular outcomes between chlorthalidone and hydrochlorothiazide in hypertensive patients (ESC-WCC 2025) - "The incidence of hypokalemia was 19.2% in the chlorthalidone group versus 16.7% in the hydrochlorothiazide group (p = 0.07). Conclusions In hypertensive patients, chlorthalidone and hydrochlorothiazide showed comparable cardiovascular outcomes and safety profiles."

Clinical • Cardiovascular • Hypertension • Myocardial Infarction