Overview
Bendroflumethiazide is a thiazide diuretic used primarily for the treatment of hypertension and edema associated with conditions such as congestive heart failure, hepatic cirrhosis, and renal dysfunction. It promotes sodium and water excretion by inhibiting sodium reabsorption in the distal convoluted tubule of the nephron.
Mechanism of Action
Bendroflumethiazide inhibits the sodium-chloride symporter in the distal convoluted tubule of the nephron, reducing sodium reabsorption and increasing excretion of sodium, chloride, and water. This leads to decreased plasma volume and peripheral vascular resistance, contributing to its antihypertensive effect.
Indications
- Hypertension
- Edema associated with congestive heart failure
- Edema associated with hepatic cirrhosis
- Edema associated with nephrotic syndrome
- Edema associated with corticosteroid or estrogen therapy
Dosage
For hypertension: Initial dose 2.5-5 mg once daily, maintenance dose 2.5-10 mg once daily. For edema: 5-20 mg once daily or in divided doses. Dosage should be individualized based on patient response and adjusted gradually.
Contraindications
- Anuria
- Hypersensitivity to bendroflumethiazide or sulfonamide-derived drugs
- Severe renal impairment
- Hepatic coma or pre-coma
Side Effects
- Hypokalemia
- Hyponatremia
- Hypochloremia
- Hyperglycemia
- Hyperuricemia
- Dizziness
- Headache
- Nausea
- Photosensitivity
- Muscle cramps
- Weakness
- Orthostatic hypotension
Interactions
- Lithium (increased lithium toxicity)
- Digoxin (increased risk of digoxin toxicity with hypokalemia)
- NSAIDs (may reduce antihypertensive effect)
- Corticosteroids (increased risk of hypokalemia)
- Antidiabetic agents (may require dosage adjustment)
- Other antihypertensive agents (additive effects)