chlorothiazide + Rauwolfia serpentina

chlorothiazide + Rauwolfia serpentina is a combination antihypertensive therapy evaluated in the National Heart, Lung, and Blood Institute (NHLBI) 'Treatment of Mild Hypertension' study. The combination consists of chlorothiazide, a thiazide diuretic, and Rauwolfia serpentina, a botanical preparation containing alkaloids such as reserpine. Chlorothiazide works by inhibiting the sodium-chloride symporter (SLC12A3) in the distal convoluted tubule of the kidney, promoting diuresis and reducing blood volume. Rauwolfia serpentina acts as a sympatholytic agent by irreversibly inhibiting the vesicular monoamine transporter (VMAT), which leads to the depletion of norepinephrine, dopamine, and serotonin from presynaptic vesicles in both the central and peripheral nervous systems. This dual mechanism effectively reduces peripheral vascular resistance and cardiac output. Although historically significant in the 1950s and 1960s, the use of Rauwolfia-based treatments has largely been discontinued in favor of modern antihypertensives due to a high incidence of side effects, including severe clinical depression, sedation, and peptic ulceration.

Brand names

DiupresSerpasilRaudixin

Other names

Rauwolfia alkaloidsIndian SnakerootSarpagandhachlorothiazide + reserpine