Thursday, July 19, 2007

Chlorthalidone for blood pressure

I'm not joking about this issue. It is easier for doctors to write HCTZ than to write chlorthalidone, even though study after study has shown that chlorthalidone is a better drug...if you want to prescribe chlorthalidone, you have to write out all 14 letters.
---William Elliott, MD Rush Presbyterian St. Luke's Medical Center in Chicago

So are we docs really that lazy that 10 letters come between us and better care for hypertension? Sort of, that and habit--always have written for the water pill HCTZ (hydrochlorothiazide) and always will. Also the lack of recent literature on the superiority of chlorthalidone (man I don't even like typing that sucker) AND the fact that all the standard twofer drugs for hypertension as in two drugs in one tablet are HCTZ plus whatever. Except for Tenoretic which is now known as atenolol/chlorthalidone which is even a bigger drag to write out.

At least three large studies have shown that patients on CTD (there, see, it can be abbreviated) have better outcomes than those on HCTZ with respect to blood pressure control and, more importantly, 58 percent less coronary heart disease and 41 percent fewer deaths.

Am I going to start writing for CTD? Not only does that mean all those extra letters all day long, it means pulling out the other med (lisinopril, Diovan, Cozaar to name a few) and writing out all those letters in a separate script along with the one for CTD plus asking patients to cough up an extra co-pay as the twofer becomes two.


rlbates said...

Chlorthalidone doesn't roll off the tongue as easily as HCTZ. Another reason it may not get used. Now if we could use CTD and get away with it......

Mauigirl said...

Interesting - both my husband and I are on hydrochlorothiazide for high blood pressure. Maybe we'll ask our doctor about this substitute, especially for my husband who still struggles to keep his pressure down with three meds.

Love your blogs - am going to add them to my links. Thanks for commenting on mine!