{
 "query": "chlorthalidone / clonidine",
 "ingredient": "chlorthalidone / clonidine",
 "slug": "chlorthalidone-clonidine",
 "rxcui": "214418",
 "brands": [],
 "names": [
  "chlorthalidone / clonidine"
 ],
 "components": [
  {
   "ingredient": "chlorthalidone",
   "slug": "chlorthalidone",
   "grade": "B",
   "total": 87,
   "scores": {
    "safety": "A",
    "evidence": "D",
    "regulatory": "A",
    "conflict": "A",
    "options": "A"
   },
   "boxed": false,
   "controlled": false,
   "first_approval_fmt": "04/07/1960",
   "first_approval": "19600407"
  },
  {
   "ingredient": "clonidine",
   "slug": "clonidine",
   "grade": "A",
   "total": 90,
   "scores": {
    "safety": "A",
    "evidence": "B",
    "regulatory": "B",
    "conflict": "A",
    "options": "A"
   },
   "boxed": false,
   "controlled": false,
   "first_approval_fmt": "09/03/1974",
   "first_approval": "19740903"
  }
 ],
 "classes": [],
 "alternatives": [],
 "label": {},
 "faers": null,
 "faers_base": {
  "total": 20692304,
  "serious_share": 0.5742697381596559,
  "death_share": 0.09102355155810585
 },
 "recalls": [],
 "recall_total": 0,
 "drugsfda": {
  "first_approval": "19600407",
  "first_approval_fmt": "",
  "anda": 37,
  "nda": 0,
  "rems": false,
  "labeling_recent": 0
 },
 "trials": null,
 "pubmed": null,
 "payments": {
  "year": "2024",
  "usd": 0.0,
  "records": 0,
  "by_name": [],
  "names_checked": [
   "chlorthalidone / clonidine"
  ],
  "source": "bulk-index"
 },
 "partd": null,
 "mdl": [],
 "dsc": [],
 "settlements": [],
 "prescrire": null,
 "eml": null,
 "exposure": null,
 "scores": {
  "safety": {
   "score": 95,
   "letter": "A",
   "why": [
    "Graded by its riskiest ingredient, clonidine (95)",
    "2,381 FDA reports naming it as the suspect drug per million Medicare fills, 0.9x the median drug on this site",
    "Death share in reports is near or below the FAERS average (1.2x)",
    "Off-label use is among the five most-reported items: widely used beyond its approved evidence (-5)"
   ],
   "weight": 0.35
  },
  "evidence": {
   "score": 51,
   "letter": "D",
   "why": [
    "Graded by its riskiest ingredient, chlorthalidone (51)",
    "128 randomized trials and 13 systematic reviews/meta-analyses indexed in PubMed",
    "No Cochrane review found (-5)",
    "Only 42% of completed registered trials posted results (-8)"
   ],
   "weight": 0.25
  },
  "regulatory": {
   "score": 84,
   "letter": "B",
   "why": [
    "Graded by its riskiest ingredient, clonidine (84)",
    "Recalls since 2016: 0 Class I, 5 Class II, 5 Class III across 37 generic makers (-7)",
    "3 label changes approved since 2021 (-4)",
    "Label lists recent major changes to warnings or indications (-5)"
   ],
   "weight": 0.15
  },
  "conflict": {
   "score": 100,
   "letter": "A",
   "why": [
    "Graded by its riskiest ingredient, chlorthalidone (100)",
    "Pharma paid doctors $0 tied to this drug last year: negligible",
    "Not named in any pending federal MDL"
   ],
   "weight": 0.15
  },
  "options": {
   "score": 100,
   "letter": "A",
   "why": [
    "Graded by its riskiest ingredient, chlorthalidone (100)",
    "Generic versions approved (47 applications)",
    "6 same-class alternatives exist"
   ],
   "weight": 0.1
  }
 },
 "total": 84,
 "grade": "B",
 "questions": [
  "This is a fixed combination of chlorthalidone and clonidine. Why both together, instead of only the one I need?",
  "The most-reported problems in FDA's adverse event data are fatigue, nausea, diarrhoea. How would we recognize and handle those?",
  "Off-label use is among the most-reported items for this drug. Is my use on-label, and if not, what evidence supports it?",
  "Why this one over clopamide, indapamide, mefruside? What would make you pick one of those instead?",
  "What result are we expecting, by when, and what is the plan if it does not happen?",
  "If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)",
  "The most-reported problems in FDA's adverse event data are fatigue, headache. How would we recognize and handle those?",
  "Why this one over apraclonidine, brimonidine, dipivefrin? What would make you pick one of those instead?"
 ]
}