The Long-Acting,
Low-Dose Diuretic

A Guideline-Preferred Diuretic Option1,2
24-Hr Blood Pressure Control3
Proven Cardiovascular Outcomes4,5
12.5mg Once-Daily Tablet

Why HemiClor’s Long Duration of Action Matters

  • With a half-life of 40–60 hours, long-acting chlorthalidone provides sustained 24-hour BP control3
  • Consistent BP control across the day and night is associated with lower CV risk, especially during morning BP peaks6
  • SHEP4 and ALLHAT5 provided significant clinical evidence that 12.5 mg chlorthalidone lowers CV morbidity and mortality

Why HemiClor’s Low Dose Tablet Matters

  • 2025 AHA/ACC Guideline-Aligned: 12.5 mg is identified as the lowest chlorthalidone dose for initial and add-on therapy2,7
  • Effective: 12.5 mg delivers ≈ 80% of the BP lowering effect of 25 mg chlorthalidone,3 and is more potent than HCTZ on a mg-to-mg basis2
  • Tolerable: Low-dose may help minimize dose-related adverse effects, improving overall tolerability7
  • Practical: 12.5 mg tablet supports individualized titration,7 and eliminates the need for pill-splitting

2025 AHA/ACC Hypertension Guideline

For the Management of Hypertension in Adults2

Initial Treatment

Chlorthalidone 12.5–25 mg may be preferred for its longer duration of action and greater BP control compared with HCTZ on a mg-to-mg basis.2

Resistant Hypertension Treatment

Replacing HCTZ with chlorthalidone 12.5-25 mg has been shown to maximize diuretic therapy, providing additional BP reduction and CV protection.2


Abbreviations: American Heart Association (AHA); American College of Cardiology (ACC); Blood Pressure (BP); Cardiovascular (CV); Hydrochlorothiazide (HCTZ)

24-HR Blood Pressure Control


THE GUIDELINE-RECOMMENDED INITIAL DAILY DOSE2

12.5 mg chlorthalidone delivers 24-hr BP control—and ≈ 80% of the BP-lowering effect of 25 mg3

HemiClor offers the guideline-recommended 12.5 mg initial daily dose in a once-daily tablet²

A randomized, double-blind, multifactorial study demonstrated that chlorthalidone 12.5 mg maintained 24-hour BP control, achieved ≈ 80% of 25 mg’s antihypertensive effect, and showed a lower incidence of hypokalemia.3,8

24-Hour Blood Pressure Control3,8

Both 12.5 mg and 25 mg demonstrated 24-hour BP reduction on ABPM, including early morning hours when cardiovascular risk peaks

Abbreviations: Systolic Blood Pressure (SBP); Ambulatory Blood Pressure Measurement (ABPM).

Blood Pressure-Lowering Effect3,8

12.5 mg provided ≈ 80% of the BP-lowering effect observed at 25 mg over a 24-hr dosing interval:

Reduction in trough SBP ABPM after 8 weeks:

  • 12.5 mg by 12.7 mmHg
  • 25 mg by 15.9 mmHg

Lower Incidence of Hypokalemia8

Hypokalemia occurred ≈ 5 times more frequently with chlorthalidone 25 mg than with 12.5 mg3

Observed frequency after 8 weeks:

  • 25 mg – 11.9 %(19/160)
  • 12.5 mg – 2.6 % (4/156)

The efficacy of a once daily dose of chlorthalidone 12.5 mg
for the treatment of hypertension in adults is derived from
a published randomized, double-blind, multinational, study (Sica et al, 2012).7

Type: Randomized, double-blind, multifactorial, parallel-group study

Population: Adults with stage 1–2 hypertension

Intervention: Chlorthalidone 12.5 mg (n=157) or 25 mg (n=159) once daily

Note: The full study included additional arms (chlorthalidone + azilsartan and azilsartan monotherapy); results shown are from the chlorthalidone monotherapy arms

Duration: 8 weeks

Primary Endpoint: Change from baseline in 24-hour
ambulatory systolic blood pressure

Secondary Endpoints: Changes in clinic-measured BP,
daytime and nighttime ABPM, responder rates, safety/
tolerability

CARDIOVASCULAR RISK REDUCTION

IN LANDMARK CLINICAL OUTCOMES TRIALS4,5

Stepped-care therapy with 12.5 mg chlorthalidone demonstrated significant cardiovascular benefits4,5

Lowering blood pressure with HemiClor
reduces the risk of fatal and nonfatal
cardiovascular events7

NHLBI-sponsored trials (SHEP and ALLHAT) demonstrated the clinical value of initiating stepped-care therapy with 12.5 mg chlorthalidone.4,5


The Systolic Hypertension in the Elderly Program (SHEP)4

Stepped-care therapy initiated with 12.5 mg
chlorthalidone significantly reduced the incidence of major CV events compared to placebo4

  • Stroke by 36% (p=0.0003) with a 5-year absolute benefit of 30 events per 1,000 participants
  • All cardiovascular events by 32% with a 5-year absolute benefit of 55 events per 1,000
    participants
  • Heart Failure by 80% (p=0.002) in patients with evidence of prior myocardial infarction

The Systolic Hypertension in the Elderly Program (SHEP)4

Type: Multicenter, randomized, double-blind, placebo-controlled outcomes trial in older adults with isolated systolic hypertension

Sponsor: National Heart, Lung, and Blood Institute (NHLBI)

Population: 4,736 adults aged ≥60 years with isolated systolic hypertension (SBP ≥160 mmHg and DBP <90 mmHg)

Intervention: Stepped-care therapy initiated with 12.5 mg chlorthalidone

Comparator: Placebo

Mean Follow-up: 4.5 years

Primary Endpoint: Fatal and non-fatal stroke

Secondary Endpoints: Myocardial infarction, coronary heart
disease, all-cause mortality, congestive heart failure

HemiClor is indicated for the treatment of hypertension, to lower blood pressure. BP-lowering reduces the risk of fatal and nonfatal CV events. These benefits have been specifically observed in controlled trials (SHEP, ALLHAT) utilizing 12.5 mg chlorthalidone.4,5,7

The Antihypertensive and Lipid-Lowering Treatment to
Prevent Heart Attack Trial (ALLHAT)5

After 4.9 years, stepped-care therapy initiated with 12.5mg chlorthalidone significantly reduced stoke, CV events and heart failure*

  • 15% fewer strokes vs. lisinopril (p = 0.02)
  • 19% lower heart failure incidence vs. lisinopril (p < 0.001)
  • 38% lower heart failure incidence vs. amlodipine
    (p < 0.001)
  • 10% reduction in CV events vs. lisinopril (p < 0.001)

*There was no difference in the primary outcome across treatment groups.

The Antihypertensive and Lipid-Lowering Treatment to
Prevent Heart Attack Trial (ALLHAT)4

Type: Randomized, double-blind, active-controlled, multicenter
outcomes trial

Sponsor: National Heart, Lung, and Blood Institute (NHLBI)

Population: 33,357 adults aged ≥55 years with hypertension and at least one additional cardiovascular risk factor

Initial Stepped-Care Interventions:

  • Chlorthalidone (12.5 once daily; titrated to 25 mg
    if needed)
  • Amlodipine (2.5–10 mg daily)
  • Lisinopril (10–40 mg daily)
  • (Doxazosin arm discontinued early due to higher risk of heart failure)

Mean Follow-up: 4.9 years

Primary Endpoint: Combined fatal coronary heart disease (CHD) or nonfatal myocardial infarction (MI)

Secondary Endpoints: All-cause mortality, stroke, combinedcardiovascular disease (CVD), heart failure, and other major CV events

RESISTANT HYPERTENSION
2025 AHA/ACC HYPERTENSION GUIDELINE:

RESISTANT HYPERTENSION

Replacing HCTZ with chlorthalidone 12.5-25 mg may maximize diuretic therapy2

Long-acting HemiClor delivers 24-hour BP control and proven CV outcomes3-5

Patients with resistant hypertension have a ≥ 50% higher risk of heart attack, stroke, kidney failure, and CV death compared with patients whose blood pressure responds to treatment.2

A High-Risk Condition2

  • Definition: BP ≥130/80 mm Hg despite ≥3 antihypertensive
    agents (including a diuretic), or controlled BP requiring ≥4 drugs.2
  • Prevalence: affects 8.5% to 20% of U.S. adults being treated
    for hypertension; is more common in Black populations2

Why HemiClor is a Guideline-Preferred Diuretic Option in Resistant Hypertension2

  • Efficacy: greater potency, longer acting, more sustained BP control
  • Proven Outcomes: reduced CV events in landmark trials
  • Clinical Populations: may offer additional BP reduction and cardiovascular protection in patients with:
  • prior MI, Stroke
  • Chronic Kidney Disease ≥ Stage 4

HEMICLOR therapy should be initiated with the lowest possible dose. The recommended adult initial dose is 12.5 mg or 25 mg.

The most frequently expected adverse drug reactions among patients receiving thiazide-like diuretics are electrolyte abnormalities and metabolic disturbances.

Monitor for hyponatremia and hypokalemia, increased glucose, uric acid, and calcium levels.

Monitor patients with history of acute gout unless patient is on uric acid-lowering therapy.

pATIENT ACCESS

Pharmacy saving programs may help provide additional savings to patients at thousands of pharmacies nationwide

Your patients may be able to reduce out-of-pocket costs for Hemiclor by using common pharmacy savings programs, such as SaveHealth, GoodRx, SingleCare, or WellRx.

Using SaveHealth, for example, patients may be able to purchase a 30-day supply of HemiClor for as little as $12.15.*

* Based on publicly available data from SaveHealth www.savehealth.com/hemiclor) accessed 10/1/2025.

Prices may change without notice and may not be available in all locations.

Your patients may reduce out-of-pocket costs for Hemiclor® by using common pharmacy savings programs, such as SaveHealth, GoodRx, SingleCare, or WellRx.

These programs are not insurance and are not affiliated with PRM Pharma. They are subject to their own terms and conditions. Prices vary by pharmacy, location, and program.

Links to all outside sites are provided as a resource and do not imply an endorsement or recommendation by PRM Pharma, LLC.

References
  1. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension. 2018;71(6):e13–e115. doi:10.1161/HYP.0000000000000065.
  2. Jones DW, Ferdinand KC, Taler SJ, Johnson HM, Shimbo D, Abdalla M, Altieri MM, Bansal N, Bello NA, Bress AP, Carter J, Cohen JB, Collins KJ, Commodore-Mensah Y, Davis LL, Egan B, Khan SS, Lloyd-Jones DM, Mazurek Melnyk B, Mistry EA, Ogunniyi MO, Schott SL, Smith SC Jr, Talbot AW, Vongpatanasin W, Watson KE, Whelton PK, Williamson JD. 2025 AHA/ACC/ AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. https://doi.org/10.1016/j.jacc.2025.05.007.
  3. Sica D, Bakris GL, White WB, et al. Blood pressure-lowering efficacy of the fixed-dose combination of azilsartan medoxomil and chlorthalidone: a factorial study. J Clin Hypertens (Greenwich). 2012;14(5):284-292. doi:10.1111/j.17517176. 2012.00616.x
  4. Prevention of Stroke by Antihypertensive Drug Treatment in Older Patients with Isolated Systolic Hypertension Final Results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA. 1991;265(1):3255- 3264.
  5. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) [published correction appears in JAMA 2003 Jan 8;289(2):178] [published correction appears in JAMA. 2004 May 12;291(18):2196] JAMA.2002;288(23):2981-2997. doi:10.1001/doi:10.1001/jama.288.23.2981
  6. Kario K, Pickering TG, Umeda Y, et al. (2003). Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensive patients: a prospective study. Circulation, 107(10), 1401–1406. https://doi.org/10.1161/01.CIR. 0000056521.67546.AA
  7. PRM Pharma, LLC. (2025). HemiClor (chlorthalidone) tablets, for oral use: Prescribing information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drug satfda_docs/label/2025/218647s000lbl.pdf
  8. ClinicalTrials.gov. NCT00847626. Efficacy and Safety of Azilsartan Medoxomil Combined with Chlorthalidone in Participants With Moderate to Severe Hypertension.
  9. U.S. Food and Drug Administration. (2011). Hydrochlorothiazide tablets, USP: Prescribing information (NDA 040735 & 040770). https://www.accessdata.fda.gov/drugsatfda _docs/label/2011/040735s004,040770s003lbl.pdf
  10. Burnier M, Bakris G, Williams B. Redefining diuretics use in hypertension: why select a thiazide-like diuretic? J Hypertens. 2019;37:1574–1586.