Diuretic-Related Side Effects: Development and Treatment

Domenic A. Sica, MD

In This Article

Adverse Effects of Diuretics

Diuretic-related side effects can be separated into several categories, including those with well- worked-out mechanisms such as electrolyte defects and/or metabolic abnormalities and occurrences, such as impotence, which are mechanistically less well understood. In addition, various drug-drug interactions are recognized to occur with diuretics.

Diuretic-related side effects are more common and of a greater intensity with loop diuretics. Thiazide-related side effects are somewhat more common with longer-acting compounds, such as chlorthalidone and metolazone. Among the thiazide-type diuretics, indapamide has been touted by some as distinctive in not causing significant metabolic derangements; however, when it is given in equivalent doses to HCTZ, there is little that separates these two drugs relative to side effects.