Thiazide Diuretics
  • Potassium —Probable Need for Supplementation
  • Magnesium —Supplementation Possibly Helpful
  • Calcium —Possible Dangerous Interaction
  • Coenzyme Q 10 (CoQ 10 ) —Supplementation Possibly Helpful
  • Zinc —Supplementation Possibly Helpful
  • Licorice —Possible Dangerous Interaction
En Español (Spanish Version)

Thiazide diuretics are commonly used to treat hypertension .

Drugs in this family include:
  • Bendroflumethiazide (Naturetin)
  • Benzthiazide (Exna)
  • Chlorothiazide (Diurigen, Diuril)
  • Chlorthalidone (Hygroton, Thalitone)
  • Hydrochlorothiazide (Esidrix, Ezide, HydroDIURIL, Hydro-Par, Microzide, Oretic)
  • Hydroflumethiazide (Diucardin, Saluron)
  • Indapamide (Lozol)
  • Methyclothiazide (Aquatensen, Enduron)
  • Metolazone (Mykrox,  Zaroxolyn)
  • Polythiazide (Renese)
  • Quinethazone (Hydromox)
  • Trichlormethiazide (Diurese, Metahydrin, Naqua)
  • and others

Probable Need for Supplementation
Thiazide diuretics cause a constant and significant loss of potassium. The classic treatment for this is to eat bananas and drink orange juice. Potassium supplements are also frequently prescribed.

Medications that combine thiazides and potassium-sparing diuretics might produce an unpredictable effect on potassium levels in the body. If you are taking such medications, do not increase your potassium intake except on the advice of your physician.

Supplementation Possibly Helpful
Long-term use (more than 6 months) of thiazide diuretics might lead to magnesium deficiency. 1,2,3 In turn, this loss of magnesium can increase the depletion of potassium. 4

Since magnesium deficiency is common anyway, if you take thiazide diuretics it would certainly make sense to take magnesium supplements at the US Dietary Reference Intake dosage.

Possible Dangerous Interaction
When taken over the long term, thiazide diuretics tend to increase levels of calcium by decreasing the amount excreted by the body and, indirectly, by affecting vitamin D. 5-8 It's not likely that this will cause a problem. However, since greatly increased calcium levels in the body can cause side effects such as calcium deposits, if you are using thiazide diuretics you should consult with your physician on the proper dose of calcium and vitamin D for you.

Supplementation Possibly Helpful
Preliminary evidence suggests that thiazide diuretics might impair the body's ability to synthesize coenzyme Q 10 (CoQ 10 ), 9 a substance important for normal heart function. Although we don't know for sure that taking CoQ 10 supplements will provide any specific benefit, supplementing with CoQ 10 on general principle might be a good idea.

Supplementation Possibly Helpful
Reportedly, thiazide diuretics can cause loss of zinc in the urine. 10 Since zinc deficiency is relatively common, you should probably make sure that you get enough zinc when using these drugs.

Possible Dangerous Interaction
If you are using thiazide diuretics, do not take licorice root. Licorice root could exacerbate the potassium depletion caused by thiazides. 11 However, the special form of licorice known as DGL (deglycyrrhizinated licorice) should not cause this problem.




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Last Reviewed August 2013



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