Diuretics and zinc

Distal tubule diuretics (DTDs), including chlorothiazide, hydrochlorothiazide, bendroflumethiazide, chlorthialidone and xipamide, have been found to increase urinary zinc output through a poorly understood mechanism which could involve both direct and hormone-mediated processes. Significant zinc depletion may occur during long-term administration of DTDs, principally in conditions associated with diminished total body zinc levels such as hepatic cirrhosis, diabetes mellitus, gastro-intestinal disorders and several renal diseases. Attention to the early symptoms of zinc deficiency such as hypogeusia, hyposmia, abnormal dark adaptation and impotence and the monitoring of serum zinc levels are advisable during long-term treatment with common DTDs.