Mechanism of Action

Thiazide diuretics lower blood pressure by inhibiting the Na+/Cl transporter in the distal convoluted tubule of the kidney nephron to decrease reabsorption of sodium chloride (NaCl).1

Indications for Use

  • Diabetes Insipidus
  • Edema (swelling)
  • Hypertension (high blood pressure)
  • Nephrocalcinosis (calcium deposits in the kidney)

Note: The above FDA approved indications vary among members of the thiazide diuretic drug class.

Common Adverse Effects

  • Hyperglycemia (high levels of blood sugar)
  • Hyperlipidemia (high levels of blood lipids)
  • Hyperuricemia (high levels of blood uric acid)
  • Hypokalemia (low blood levels of potassium)
  • Hypotension (low blood pressure)

Avoid Use in the Following Populations

  • Endurance athletes2
  • Collegiate Athletes2

Fitness Related Physiological Effects

Physiological FactorEffect
Heart RateNo Effect2
Blood PressureDecrease1
Cardiac OutputDecrease2
Stroke VolumeDecrease2
Vascular ResistanceDecrease2
Plasma VolumeSignificant Decrease2
EnduranceNo Effect or Decrease2

List of Thiazide Diuretics

  • Bebdroflumethiazide (Naturetin)
  • Chlorothiazide (Diuril)
  • Chlorthalidone (Thalitone)
  • Hydrochlorothiazide (Microzide)
  • Hydroflumethiazide (Saluron)
  • Indapamide (Lozol)
  • Methyclothiazide (Aquatensen, Enduron)
  • Metolazone (Mykrox, Zaroxolyn)
  • Polythiazide (Renese)


  1. Katzung, B., & Trevor, A. J. (2015). Basic and clinical pharmacology. New York: Mcgraw-Hill.
  2. Niedfeldt, MW. Managing Hypertension in Athletes and Physically Active Patients. American Family Physician 2002; 66(3):445-452.