bendroflumethiazide

Action and Spectrum

Actions and spectrum: 

Action 

bendroflumethiazide primarily acts on the kidneys to increase the excretion of sodium and water from the body, which reduces the overall blood volume and subsequently lowers blood pressure. The exact mechanism of action involves inhibiting sodium and chloride reabsorption in the distal renal tubules. This results in increased urine production, decreased blood volume, and lower blood pressure. 

Spectrum 

• Hypertension: bendroflumethiazide is commonly prescribed to treat hypertension. By reducing blood volume and relaxing blood vessels, it helps to decrease blood pressure & reduce the risk of cardiovascular events. 
• Edema: It can also be used to treat edema associated with various conditions like congestive heart failure, liver cirrhosis, and kidney disorders. Thiazide diuretics like bendroflumethiazide help the body eliminate excess fluid, relieving swelling, and edema. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Electrolyte imbalance 

postural hypotension 

hyperglycaemia 

Rashes 

blood disorders 

intrahepatic cholestasis 

Pancreatitis 

photosensitivity 

altered plasma concentration 

GI effects 

gout 

Black Box Warning

Black Box Warning: 

It does not have a black box warning associated with bendroflumethiazide. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Hypersensitivity: Individuals with a known hypersensitivity or allergy to bendroflumethiazide or any of its components should not use this medication. 
• Anuria: bendroflumethiazide is a diuretic, and it works by increasing urine production. It should be avoided in individuals with anuria, which is a condition characterized by the absence of urine production. Using a diuretic in such cases can be ineffective and potentially harmful. 
• Severe kidney dysfunction: bendroflumethiazide is excreted primarily through the kidneys. If a person has severe kidney impairment, the medication may not be suitable because it could exacerbate electrolyte imbalances and worsen kidney function. 
• Severe liver disease: Individuals with severe liver disease may be at risk of complications when using bendroflumethiazide. The medication’s clearance and metabolism can be affected by liver impairment. 
• Gout: bendroflumethiazide can increase uric acid levels in the blood, which may trigger or worsen gout attacks. It is contraindicated in individuals with a history of gout.

Caution: 

• Electrolyte Imbalances: bendroflumethiazide can lead to electrolyte imbalances, including low potassium (hypokalemia), low sodium (hyponatremia), and changes in other electrolytes.  
• Dehydration: bendroflumethiazide is a diuretic, and excessive fluid loss can lead to dehydration. Individuals using this medication should be cautious about staying adequately hydrated, especially in hot weather or during physical activity. 
• Pregnancy and Breastfeeding: If you are pregnant or breastfeeding, the use of bendroflumethiazide should be carefully evaluated by your healthcare provider. They will consider the potential risks and benefits and may recommend alternative treatments. 
• Orthostatic Hypotension: bendroflumethiazide can lead to low blood pressure when changing positions (orthostatic hypotension). Be cautious when getting up from a sitting or lying position to avoid dizziness or fainting.

Comorbidities: 

• Diabetes: Individuals with diabetes should be cautious when using bendroflumethiazide because it can affect blood sugar levels. Blood glucose should be monitored closely, and adjustments to diabetes management may be necessary. 
• Hypothyroidism: bendroflumethiazide can affect thyroid function tests, potentially complicating the management of hypothyroidism. Close monitoring and coordination with an endocrinologist may be necessary in such cases. 
• Systemic Lupus Erythematosus (SLE): bendroflumethiazide may exacerbate the symptoms of SLE. Patients with this autoimmune condition may need alternative treatments. 
• Pancreatitis: bendroflumethiazide can, in rare cases, be associated with pancreatitis. Individuals with a history of pancreatitis or at risk for it may need special consideration. 
• Chronic Obstructive Pulmonary Disease (COPD): bendroflumethiazide may cause electrolyte imbalances and metabolic disturbances that can affect individuals with COPD. Healthcare providers need to manage these issues carefully. 

Pregnancy / Lactation

Pregnancy consideration: pregnancy category: C 

Lactation: excreted into human milk: unknown  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

bendroflumethiazide is a thiazide diuretic commonly used in the treatment of hypertension and edema. Its pharmacology involves inhibiting the reabsorption of sodium and chloride ions in the distal renal tubules, leading to increased urine production and subsequent reduction in blood volume. This mechanism results in decreased blood pressure and reduced fluid retention. bendroflumethiazide’s onset of action typically occurs within a few hours after administration, and its effects can last for 12 to 24 hours. It is administered orally, and its duration of action makes it suitable for once-daily dosing.  

Pharmacodynamics: 

• Diuretic Action: bendroflumethiazide primarily acts on the kidneys to increase the excretion of sodium and water from the body. It inhibits the sodium and chloride ions reabsorption in the distal renal tubules, leading to increased sodium and water excretion in the urine. This results in a reduction in blood volume and a decrease in blood pressure. 
• Antihypertensive Effect: bendroflumethiazide’s diuretic effect reduces blood volume, leading to a decrease in preload (the amount of blood returning to the heart) and afterload (the resistance the heart must pump against), which helps lower blood pressure. It is particularly effective in the treatment of hypertension. 
• Electrolyte Imbalances: Thiazide diuretics like bendroflumethiazide can lead to electrolyte imbalances. They can cause the loss of potassium (hypokalemia), sodium, chloride, and other electrolytes. It is important to monitor these electrolyte levels and adjust treatment as needed to prevent adverse effects. 
• Vasodilation: While the primary effect is diuresis, thiazide diuretics like bendroflumethiazide can also cause mild vasodilation, which may contribute to their antihypertensive action.

Pharmacokinetics: 

Absorption 

bendroflumethiazide is administered orally in tablet form. After oral administration, it gets well absorbed from gastrointestinal tract, particularly in stomach and small intestine. The absorption process can be influenced by factors like the formulation of the drug and the presence of food in the stomach. 

Distribution 

Once absorbed, bendroflumethiazide is distributed throughout the body, primarily in the bloodstream. It is not bound to plasma proteins, which allows it to be distributed into various tissues. Its distribution may be influenced by factors such as plasma protein levels and blood flow to different body tissues. 

Metabolism 

bendroflumethiazide does not undergo significant metabolism in the body. It is primarily excreted unchanged or as inactive metabolites in the urine. 

Elimination and excretion 

bendroflumethiazide is primarily excreted by the kidneys. It is filtered through the glomerulus, and a portion of it is reabsorbed in the renal tubules. 

Adminstartion

Administration: 

• Dosage: The specific dosage of bendroflumethiazide will depend on the individual patient’s condition, such as hypertension or edema, and should be determined by a healthcare provider. The typical starting dose for hypertension is 2.5 mg to 5 mg taken once daily, usually in the morning. 
• Frequency: bendroflumethiazide is usually taken as a once-daily dose. Taking it in the morning is common because the diuretic effect can lead to increased urination, and it is often preferable to experience this effect during the day rather than at night. 
• Stay Hydrated: Ensure that you maintain adequate hydration while taking bendroflumethiazide, especially in hot weather or during physical activity. Diuretics can lead to fluid loss and dehydration, so drink enough water to compensate for this effect. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: bendroflumethiazide 

Pronounced: (ben-dro-floo-muh-THYE-uh-zide)  

Why do we use bendroflumethiazide? 

bendroflumethiazide is commonly prescribed to treat high blood pressure (hypertension). It works by reducing blood volume through increased urine production, leading to a decrease in blood pressure. It is often used as a first-line treatment for hypertension or in combination with other antihypertensive medications.

bendroflumethiazide can be used to treat edema, which is the accumulation of excess fluid in the body’s tissues. It is particularly helpful in cases of edema associated with conditions like congestive heart failure, liver cirrhosis, kidney disorders, and other medical conditions where fluid retention is a concern.