Hydrochlorothiazide
Thiazide diuretic
Brand names: Microzide, HCTZ
Oral health effects
Xerostomia
Diuresis-related dry mouth is common.
Mechanism: Reduced body fluid volume lowers salivary output.
Clinical management: Hydration, salivary substitutes, high-fluoride caries prevention.
Lichenoid reaction / photosensitivity
Thiazides can cause oral lichenoid reactions and lip photosensitivity.
Clinical management: Biopsy uncertain lesions; counsel on lip sun protection.
Dizziness on standing (orthostatic hypotension)
The label lists orthostatic hypotension, which may be aggravated by alcohol, barbiturates or narcotics; volume depletion from diuresis adds to the risk. Frequency is not quantified.
Clinical management: Raise the chair back slowly at the end of the appointment, let the patient sit upright for 1–2 minutes before standing, and steady them as they get up. Take extra care in older patients, after long supine procedures and when other blood-pressure-lowering drugs are taken.
Sources
- A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Wolff A, Joshi RK, Ekström J, et al. Drugs in R&D, 2017.
- A review and guide to drug-associated oral adverse effects-Oral mucosal and lichenoid reactions. Part 2. Teoh L, Moses G, McCullough MJ. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2019.
- Hydrochlorothiazide prescribing information (FDA label) A-S Medication Solutions / DailyMed, 2023.