Adverse effects associated with thiazide diuretics
The most commonly reported problem is the
development of hypokalemia. In addition, the thiazides can impair glucose tolerance
(interfering with the release of insulin and blockade of peripheral glucose uptake)
causing hyperglycemia. Hypercalcemia can occur as well as hypophosphatemia and
hypomagnesemia. In the latter situation, arrhythmias have developed in patients treated
with digoxin or who also had hypokalemia. In adults with underlying renal disease or liver
disease, the condition can be aggravated during therapy with hydrochlorothiazide.
Hypersensitivity reactions including skin reactions, photosensitivity, and bone marrow
suppression have been reported in adults. Finally, hydrochlorothiazide has been associated
with the development of cholestatic hepatitis and the development of the syndrome of
inappropriate ADH secretion (SIADH). (Roberts. Drug Therapy in Infants.
Philadelphia: W. B. Saunders, 1984:246).