The effects of SU-5879 (Esidrix) in congestive heart failure and hypertension: A clinical evaluation

1.1. Su-5879 (hydrochlorothiazide, Ciba) has been demonstrated to be an effective diuretic of low toxicity in studies on 19 hospitalized and 17 outclinic patients in congestive heart failure.2.2. The diuretic effect is similar to that of the mercurials and chlorothiazide, in that there results mainly an outpouring of sodium and chloride, with a decrease in the levels of chloride and an increase of CO2 in the serum.3.3. A single dose of 200 mg. produces a conspicuous diuresis within about 2 hours after ingestion, and this is maintained for over 24 hours. Effective diuresis can also be achieved by doses of 50 mg. administered twice daily.4.4. Excretion of potassium was increased moderately, and in a few patients levels of serum potassium below 4.0 mEq./liter appeared after 1 week of therapy. However, only one patient in our series had clinical symptoms of hypopotassemia.5.5. Slight elevations in blood urea nitrogen after therapy were observed in some of our patients in congestive heart failure. None developed serious renal insufficiency. If oliguria develops and the blood urea nitrogen rises under treatment, the drug should be withdrawn.6.6. Significant reductions in blood pressure occurred in 18 of 26 hypertensive patients. The antihypertensive action of Su-5879 appears most promising.7.7. Su-5879 produced no serious complications in our cases. However, the resulting low values for serum potassium in a few of our patients, and the occasional moderate rises in values of blood urea nitrogen would, as with chlorothiazide, call for caution in long-term therapy.