Research Article Open Access

The "Forgotten Side Effect" of Thiazides

Arnon Blum1
  • 1 Baruch Padeh Poria Medical Center, Israel

Abstract

Problem statement: Thiazide diuretics are derived from benzodiazines. They inhibit Na+/Cl- re-absorption from the distal convoluted tubules in the kidneys by blocking the thiazide-sensitive Na+/Cl- symporter. They are recommended as first line treatment for hypertension in the US (JNC VII)[1] guidelines and in the National Institute of Health and Clinical Excellence/British Hypertension Society guidelines[2] and in the European (ESC/ESH)[3] guidelines. They have been shown to prevent hypertension-related morbidity and mortality, although the long term mechanism is not fully understood. Approach: Side effects include hypokalemia, increased serum cholesterol, impaired glucose intolerance, diabetes mellitus and impotence. Long term usage of thiazides is also linked to increased levels of homocysteine and a paradoxical effect in Diabetes Insipidus, where they reduce urine volume. However, there is a side effect that was ignored during the last 30 years-and that is the association with gall bladder disease. We would like to stress this side effect. Results: Thiazide diuretics have a “forgotten” side effect that was not mentioned among the well-known side effects of the drug. Conclusion: The mechanism is not completely understood, but the association is clear and physicians should be aware of that side effect.

American Journal of Pharmacology and Toxicology
Volume 4 No. 4, 2009, 174-176

DOI: https://doi.org/10.3844/ajptsp.2009.174.176

Submitted On: 2 December 2009 Published On: 31 December 2009

How to Cite: Blum, A. (2009). The "Forgotten Side Effect" of Thiazides. American Journal of Pharmacology and Toxicology, 4(4), 174-176. https://doi.org/10.3844/ajptsp.2009.174.176

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Keywords

  • Side effects
  • acute cholecystitis
  • thiazide diuretics