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Thiazides should be used with caution in severe renal disease because the drugs decrease the Glomerular filtration rate (GFR), may precipitate azotemia. Cumulative effects of the drug may develop in patients with impaired renal function. If progressive renal impairment becomes evident, careful reappraisal of therapy with consideration given to interrupting or discontinuing therapy.
Thiazides should be used with caution in patients with impaired hepatic function or progressive liver disease, particularly when potassium deficiency exists, because they may precipitate hepatic coma as a result of alterations in electrolyte balance. Discontinue immediately if signs of impending hepatic coma appear.
Allergic reactions are most likely to occur in patients with a history of allergy or bronchial asthma.
The possibility of exacerbation or activation of systemic lupus erythematosus has been reported.
