What are common side effects of hydrochlorothiazide (HCTZ)?

Hydrochlorothiazide (HCTZ) is a thiazide diuretic commonly used to manage hypertension and edema. One of the well-documented side effects of HCTZ is the potential for metabolic changes, including elevated glucose levels and elevated lipids. This can occur due to the medication's impact on insulin sensitivity and lipid metabolism. As a result, patients on HCTZ may experience increases in blood glucose and lipid levels over time, which are important considerations in managing patients with or at risk for metabolic syndrome or diabetes.

In contrast, common side effects of diuretics like HCTZ typically also include electrolyte imbalances, such as hypokalemia—which represents one of the concerns with this medication. However, in this case, the focus is on metabolic effects, particularly those related to glucose and lipid levels, making the choice of elevated glucose and elevated lipids a significant and clinically relevant side effect of hydrochlorothiazide.