chlorthalidone + spironolactone

Chlorthalidone + spironolactone is a combination therapy consisting of a thiazide-like diuretic and a mineralocorticoid receptor antagonist (MRA). Chlorthalidone acts by inhibiting sodium reabsorption in the distal convoluted tubule through the blockade of the sodium-chloride symporter, leading to increased excretion of sodium and water. Spironolactone is a competitive antagonist of the mineralocorticoid receptor, primarily in the distal tubule and collecting duct, which inhibits the action of aldosterone to promote sodium excretion while retaining potassium. This combination is specifically being evaluated for its synergistic potential in treating poorly controlled hypertension, particularly in patients with moderate to advanced chronic kidney disease (CKD). The combination aims to provide robust blood pressure lowering while mitigating the risk of hypokalemia often associated with thiazide-like diuretics. It is currently the subject of the LODESTAR trial sponsored by the VA Office of Research and Development.

Other names

chlorthalidone and spironolactonespironolactone and chlorthalidone