Hydrochlorothiazide Side Effects and Considerations

Electrolyte Disturbances and Renal Effects

• The British Journal of Pharmacology reports that higher risk groups for hydrochlorothiazide side effects include various populations, and renal function decline is dose-dependent, with higher doses causing more rapid decline in eGFR 1
• The risk of renal function decline and increased risk of end-stage renal disease with prolonged use is also noted by the British Journal of Pharmacology 1

Metabolic and Cardiovascular Side Effects

• The Nature Reviews Nephrology states that chronic hypercholesterolemia may develop with long-term use of hydrochlorothiazide 3

Patient Monitoring and Dose Considerations

• The Praxis Medical Insights recommends monitoring electrolytes and renal function within 4 weeks of initiation or dose escalation, and continue monitoring every 3-6 months once stable 4
• Reducing the dose from 25 mg to 12.5 mg preserves most blood pressure-lowering effect while reducing adverse effects, as noted by the Praxis Medical Insights 2