Assess renal function and sulfa allergy history before prescribing hydrochlorothiazide.
Absolute: sulfonamide hypersensitivity, anuria. Relative: severe renal/hepatic impairment, electrolyte imbalance, gout, and pregnancy when alternatives available.
Includes anaphylaxis, Stevens-Johnson syndrome, or angioedema with thiazides.
Ineffective when kidneys cannot produce urine; avoid use.
Diminished efficacy and increased risk of azotemia; consider loop diuretics instead.
Correct imbalances before initiating to prevent arrhythmias or neurologic complications.
Thiazides elevate uric acid; monitor levels and consider prophylaxis if recurrent gout occurs.
Monitor fasting glucose as thiazides may worsen glycemic control.