Home Drug Guide Bendroflumethiazide

Drug Guide

Generic Name

Bendroflumethiazide

Brand Names Naturetin-2.5, Naturetin-5, Naturetin-10

Classification

Therapeutic: Antihypertensive, Diuretic (Thiazide)

Pharmacological: Thiazide diuretic

FDA Approved Indications

Hypertension
Edema associated with heart failure, hepatic cirrhosis, or renal disease

Mechanism of Action

Inhibits sodium reabsorption in the distal convoluted tubule of the kidney, leading to increased excretion of sodium, chloride, potassium, and water, thereby reducing blood volume and blood pressure.

Dosage and Administration

Adult: Initially, 2.5 mg once daily. Dose may be increased gradually up to 10 mg daily based on patient response.

Pediatric: Not generally recommended for pediatric use due to limited data.

Geriatric: Start at lower doses due to increased risk of hypotension and electrolyte imbalance; monitor carefully.

Renal Impairment: Use with caution; dose adjustments may be necessary.

Hepatic Impairment: Use with caution, monitor closely; dose adjustments may be necessary.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed in body tissues and fluids.

Metabolism: Primarily metabolized in the liver; extent varies including some unchanged drug excreted renally.

Excretion: Excreted mainly in urine.

Half Life: Approximately 4-6 hours.

Contraindications

Hypersensitivity to bendroflumethiazide or sulfonamides
Anuria
Serious hepatic impairment

Precautions

Electrolyte imbalance (hypokalemia, hyponatremia)
Diabetes mellitus (may alter glucose control)
Gout (may precipitate attacks)
Pregnancy and lactation (use only if clearly needed)

Adverse Reactions - Common

Electrolyte imbalance (hypokalemia, hyponatremia) (Common)
Dizziness, hypotension (Common)
Gastrointestinal disturbances (Somewhat common)

Adverse Reactions - Serious

Electrolyte disturbances leading to arrhythmias (Serious)
Allergic reactions, including rash and Stevens-Johnson syndrome (Rare)

Drug-Drug Interactions

Lithium (increased toxicity)
Other antihypertensives (additive effect)
Corticosteroids (potentiation of electrolyte disturbances)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, electrolytes (potassium, sodium), renal function.

Diagnoses:

Risk for electrolyte imbalance
Risk for hypotension

Implementation: Administer with food to reduce gastrointestinal upset. Monitor electrolytes regularly.

Evaluation: Assess blood pressure, urinary output, and electrolyte status to evaluate treatment efficacy and safety.

Patient/Family Teaching

Take medication exactly as prescribed.
Monitor blood pressure at home.
Be aware of signs of electrolyte imbalance (muscle weakness, cramps).
Maintain adequate hydration.
Report any signs of allergic reaction or severe adverse effects.

Special Considerations

Black Box Warnings:

None specifically for bendroflumethiazide

Genetic Factors: Genetic variations affecting drug metabolism are not well characterized.

Lab Test Interference: May cause alterations in serum glucose and uric acid levels.

Overdose Management

Signs/Symptoms: Severe electrolyte disturbances, dehydration, hypotension, dizziness.

Treatment: Discontinue drug, provide supportive care, correct electrolyte imbalances, and monitor hemodynamic status.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended storage conditions.