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Safety of Hydrochlorothiazide in the Real World: A Commentary on the Italian Medicines Agency (AIFA) Pronouncements

• Page 1 of 3 • Magro et al. Int J Clin Cardiol 2019, 6:160 Citation: Magro VM, Coppola C, Boccalone E, Caturano M, Scala G, et al. (2019) Safety of Hydrochlorothiazide in the Real World: A Commentary on the Italian Medicines Agency (AIFA) Pronouncements. Int J Clin Cardiol 6:160. doi.org/10.23937/2378-2951/1410160 Accepted: October 12, 2019; Published: October 14, 2019 Copyright: © 2019 Magro VM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. volume, hyponatremia, hypercalcemia, hyperglycemia, dyslipidemia) [9]. Regarding the electrolyte imbalances, thiazide-induced hyponatremia is certainly an important medical condition, that is regularly present in the internal medicine departments and it causes substantial morbidity to frail patients, often elderly, who are taking hydrochlorothiazide, in subgroups of patients [10,11]. Equally not yet well understood is the mechanism by which hydrochlorothiazide interferes with the glucose homeostasis [12-14]. There is also a whole range of side effects, fortunately rarer, but described in the medical literature, ranging from the appearance of lupus [15], interstitial lung disease [16], even severe allergic states [17], pulmonary edema [18-20], all conditions linked to immunological changes induced by the molecule itself. The effect on the sense organs (hypoacusis) is more known and less rare (although investigated with low frequency, especially in the elderly subjects), with various reports from the organs of vigilance drug, for which there are well defined indications for the diagnosis of this adverse event (Austin Bradford-Hill criteria, Naranjo criteria), well applied in pharmacovigilance [21,22].