Bendrofluazide

Bendrofluazide

[1 tablet 3 cents]

ADMINISTRATION ROUTES:

  • PO, NG

ALTERNATIVE NAMES:

  • Neo-naclex

ICU INDICATIONS:

  1. 2nd line diuretic
  2. hypertension (usually inpatients already on this medication)

PRESENTATION AND ADMINISTRATION:

  • PO / NG:
    2.5mg and 5mg tablets (white)
    Store below 25°C. Protect from light.
    Tablets can be crushed for NG administration.

DOSAGE:

  • PO:
    2.5-10mg daily

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

  • When given in ICU patients, dose as in normal renal function.

DOSAGE IN PAEDIATRICS:

  • 0.1-0.2mg/kg daily

CLINICAL PHARMACOLOGY:

  • Inhibits the renal tubular absorption of salt and water. Sodium and chloride ions are excreted in equivalent proportions, and there is little or no disturbance of the acid/base equilibrium. Initiates diuresis in about 2 hours and maintains a steady diuresis lasting for about 12 hours. The mechanism whereby the thiazides exert their antihypertensive effect has not been clearly established. In non-oedematous patients there may be little noticeable diuretic effect.

CONTRAINDICATIONS:

  1. Severe renal or hepatic failure
  2. hypersensitivity to bendrofluazide or other sulphonamide-like medicines
  3. Addison’sdisease
  4. Treatment with lithium

WARNINGS

  • In cirrhosis of the liver, thiazides may precipitate hepatic encephalopathy. Thiazides may aggravate existing diabetes mellitus and cause symptoms in patients with latent disease. Bendrofluazide may impair control of diabetes in patients receiving sulphonylureas. Serum uric acid levels may be raised in some patients, with or without gout.

PRECAUTIONS

  • General:
    Thiazide diuretics may precipitate hypokalaemia
  • Laboratory Tests:
    No tests additional to standard ICU tests are indicated.
  • Drug/Laboratory Test Interactions:
    None known

IMPORTANT DRUG INTERACTIONS FOR THE ICU

  • The renal clearance of lithium carbonate is reduced. Bendrofluazide should not be administered concurrently with lithium carbonate. Bendrofluazide may impair control of diabetes in patients receiving sulphonylureas The use of allopurinol and thiazides in patients with renal dysfunction should be avoided: severe hypersensitivity vasculitis has been reported.

ADVERSE REACTIONS

  • Body as a Whole:
    Anaphylaxis
  • Digestive System:
    gastric irritation, diarrhoea or constipation, pancreatitis, hepatic encephalopathy
  • Musculoskeletal Systemc:
    precipitation of gout, muscle cramps
  • Hematological system:
    Thrombocytopaenia
  • Metabolic:
    Hypokalaemia, hyponatraemia

Critical Care Drug Manual

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