Chlorothiazide

May aggravate digitalis toxicity

Sensitivity reactions may occur with or without history of allergy or asthma

Patients allergic to sulfa may show cross-sensitivity

May deleteriously alter lipid/glucose metabolism

Risk of male sexual dysfunction

Use with caution in severe renal disease. In patients with renal disease, thiazides may precipitate azotemia; cumulative effects of drug may develop in patients with impaired renal function.

Thiazides should be used with caution in patients with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma

Thiazides may add to or potentiate the action of other antihypertensive drugs

Sensitivity reactions may occur in patients with or without a history of allergy or bronchial asthma; the possibility of exacerbation or activation of systemic lupus erythematosus has been reported

Lithium generally should not be given with diuretics

Although any chloride deficit is generally mild and usually does not require specific treatment except under extraordinary circumstances (as in liver disease or renal disease), chloride replacement may be required in the treatment of metabolic alkalosis

Dilutional hyponatremia may occur in edematous patients in hot weather; appropriate therapy is water restriction, rather than administration of salt, except in rare instances when the hyponatremia is life-threatening; in actual salt depletion, appropriate replacement is therapy of choice

Hyperuricemia may occur or acute gout may be precipitated in certain patients receiving thiazides

In diabetic patients dosage adjustments of insulin or oral hypoglycemic agents may be required; hyperglycemia may occur with thiazide diuretics; latent diabetes mellitus may become manifest during thiazide therapy

The antihypertensive effects of drug may be enhanced in the post-sympathectomy patient