english.prescrire.org > Spotlight > Archives : 2020 > Increased risk of skin cancer with hydrochlorothiazide: what are the practical consequences?

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Increased risk of skin cancer with hydrochlorothiazide: what are the practical consequences?

Queries and Comments In 2018, Prescrire reported the findings of two case-control studies that showed an increased risk of non-melanoma skin cancers in patients treated with hydrochlorothiazide, a first-choice antihypertensive drug. Does the evidence available in 2020 affect this drug's harm-benefit balance in hypertension?

In practice : Inform and monitor

  • Chlortalidone, and hydrochlorothiazide when the former is unavailable, are still the first‑choice drugs for most patients with hypertension as of 2020, despite the increased risk of skin cancer.
     
  • Patients treated with hydrochlorothiazide should be informed that, because of this risk, it is important to use sun protection, to monitor for any lesions suggestive of skin cancer and to have them checked.
     
  • It also seems prudent to avoid hydrochlorothiazide in patients who already have skin cancer, including melanoma, and in patients taking immunosuppressants, especially following transplantation.

©Prescrire 1 July 2020

Source: "Queries and Comments. Increased risk of skin cancer with hydrochlorothiazide: what are the practical consequences?" Prescrire International 2020; 29 (217): 186-187. Subscribers only.

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See also:

“Hydrochlorothiazide:
skin cancers”
Prescrire Int 2018;
27 (199): 297.
Pdf, subscribers only

“Treating essential
hypertension. The first choice
is usually a thiazide diuretic”
Prescrire Int 2014;
23 (152): 215-220.
Pdf, subscribers only

“Hypertension and diabetes.
If chlortalidoneis unavailable,
an ACE inhibitor is
the first choice”
Prescrire Int 2017;
26 (183): 155-160.
Pdf, subscribers only


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