People’s Pharmacy: Diuretic linked to skin cancer
Q. For about two decades, I took the diuretic hydrochlorothiazide (HCTZ) to prevent recurring kidney stones. I’d had five years in a row dealing with these stones. Changing my diet and increasing my fluid intake didn’t help, but the drug did.
A Danish study came out noting an increased skin cancer risk from HCTZ. My basal cell carcinoma and squamous cell carcinoma lesions were removed eight years into taking this drug. The melanoma lesion on my scalp appeared the following year. By then, it had spread to my lungs and bones.
When the study came out, my oncologist discontinued the HCTZ. This was many years into my cancer journey, though. Luckily, I am in my second remission with immunotherapy every three weeks for the past five years.
A. Thiazide diuretics like HCTZ are taken by more than 20 million Americans on a daily basis. They are perceived as extremely safe medications for high blood pressure. In addition, they are prescribed to lower the risk of recurrent kidney stones.
You have identified a worrisome complication, though. These drugs make skin more sensitive to ultraviolet light, so sunburn is more likely. Researchers have detected an association between HCTZ and skin cancer (Journal of the American Academy of Dermatology, April 2018).
The link with melanoma is controversial. That said, people taking this diuretic should avoid direct sun exposure and ask a dermatologist to check their skin on a regular basis.
Q. Like many people with severe lifelong allergies, I can’t take systemic antihistamines. They cause me intolerable fatigue and painful nose dryness with nosebleeds.
While rinsing my nose helps, I have had the most success taking Mucinex for postnasal drip, my most bothersome symptom. It seems to break up thick mucus and allow me to breathe, swallow and sleep. Yet many doctors claim Mucinex doesn’t work any better than placebo. Do you have any insight?
A. Your experience is intriguing. There are at least a dozen different Mucinex products containing the mucolytic agent guaifenesin. Although the effectiveness of this ingredient against cough is rather controversial, some doctors report that it helps make mucus less thick and sticky (Respiratory Medicine Case Reports, Nov. 3, 2018).
Q. Several years ago I read your article about anticholinergic drugs. At that time, my husband and I were taking a sedating antihistamine every night for allergies and to help us sleep. We immediately stopped and within days noticed a major difference in brain function. All the “fog” cleared. At last, I could recall names and words that often escaped me previously.
My mom died of Alzheimer’s disease, and I feared that I might be in the early stages of early-onset Alzheimer’s. I am grateful to you for providing this important information.
A. Researchers keep confirming the connection between anticholinergic drugs and the risk of cognitive impairment (Neurology, online, Sept. 2). Many people are not aware that medications they take for granted could have anticholinergic activity. Sedating antihistamines, drugs for overactive bladder, some antidepressants and motion sickness medicine are just a few examples of AC drugs.
You can learn more about drugs that are often inappropriate for older people in our eGuide to Drugs and Older People. This online resource is available in the Health eGuides section of our website peoplespharmacy.com.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website peoplespharmacy.com.