Formulary
Bendroflumethiazide: Indications, Dosing, Side Effects and Interactions
Bendroflumethiazide clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Bendroflumethiazide: Indications, Dosing, Side Effects and Interactions
Bendroflumethiazide clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Oedema**
- **Adult** (By Mouth): Initially 5-10 mg once daily or on alternate days, dose to be taken in the morning, then maintenance 5-10 mg 1-3 times a week.
**Hypertension**
- **Adult** (By Mouth): 2.5 mg once daily, dose to be taken in the morning, higher doses are rarely necessary.
**Hypertension for bendroflumethiazide**
- **Child 1 month-1 year** (By mouth): 50-100 micrograms/kg once daily, dose to be adjusted according to response.
- **Child 2-11 years** (By mouth): Initially 50-400 micrograms/kg once daily (max. per dose 10 mg), then maintenance 50-100 micrograms/kg once daily (max. per dose 10 mg), dose to be adjusted according to response.
- **Child 12-17 years** (By mouth): 2.5 mg once daily, dose to be taken as a single dose in the morning, higher doses are rarely necessary.
**Oedema in heart failure, renal disease and hepatic disease, Pulmonary oedema for bendroflumethiazide**
- **Child 1 month-1 year** (By mouth): 50-100 micrograms/kg once daily, dose to be adjusted according to response.
- **Child 2-11 years** (By mouth): Initially 50-400 micrograms/kg once daily (max. per dose 10 mg), then maintenance 50-100 micrograms/kg once daily (max. per dose 10 mg), dose to be adjusted according to response.
- **Child 12-17 years** (By mouth): Initially 5-10 mg once daily or on alternate days, dose to be taken as a single dose in the morning, dose to be adjusted according to response; maximum 10 mg per day.
Cautions
For all thiazides and related diuretics Diabetes; gout; risk of hypokalaemia; systemic lupus erythematosus Cautions, further information Existing conditions Thiazides and related diuretics can exacerbate diabetes, gout, and systemic lupus erythematosus. Potassium loss Hypokalaemia can occur with thiazides and related diuretics. Hypokalaemia is dangerous in severe cardiovascular disease and in patients also being treated with cardiac glycosides. Often the use of potassium-sparing diuretics avoids the need to take potassium supplements. In hepatic impairment, hypokalaemia caused by diuretics can precipitate encephalopathy. Elderly Lower initial doses of diuretics may be necessary in the elderly because they are particularly susceptible to the side-effects. The dose should then be adjusted according to renal function. M Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information). Potentially inappropriate: with current significant hypokalaemia (serum potassium less than 3 mmol/L), hyponatraemia (serum sodium less than 130 mmol/L), or hypercalcaemia (corrected serum calcium greater than 2.65 mmol/L)-contra-indicated; hypokalaemia, hyponatraemia, and hypercalcaemia can be precipitated by a thiazide diuretic with a history of gout (gout can be precipitated by a thiazide diuretic)
Contraindications
For all thiazides and related diuretics Addison's disease; hypercalcaemia; hyponatraemia; refractory hypokalaemia; symptomatic hyperuricaemia
Side effects
For all thiazides and related diuretics Common or very common Alkalosis hypochloraemic; constipation; diarrhoea; dizziness; electrolyte imbalance; erectile dysfunction; fatigue; headache; hyperglycaemia; hyperuricaemia; nausea; postural hypotension; skin reactions; vomiting Uncommon Agranulocytosis; aplastic anaemia; leucopenia; pancreatitis; photosensitivity reaction; thrombocytopenia Rare or very rare Paraesthesia Side-effects For bendroflumethiazide Frequency not known Blood disorder; cholestasis; gastrointestinal disorder; gout; neutropenia; pneumonitis; pulmonary oedema; severe cutaneous adverse reactions (SCARs)
Pregnancy
For all thiazides and related diuretics Thiazides and related diuretics should not be used to treat gestational hypertension. They may cause neonatal thrombocytopenia, bone marrow suppression, jaundice, electrolyte disturbances, and hypoglycaemia; placental perfusion may also be reduced. Stimulation of labour, uterine inertia, and meconium staining have also been reported.
Breast feeding
The amount present in milk is too small to be harmful. Large doses may suppress lactation.
Hepatic impairment
For all thiazides and related diuretics In general, manufacturer advises caution in mild to moderate impairment; avoid in severe impairment.
Renal impairment
For all thiazides and related diuretics In general, manufacturers advise caution in mild to moderate impairment (risk of electrolyte imbalance and reduced renal function); avoid in severe impairment (ineffective if creatinine clearance less than 30 mL/minute). See Prescribing in renal impairment .
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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