a-t READERS QUESTIONS AND COMMENTS

SKIN CANCER WITH HYDROCHLOROTHIAZIDE
... is xipamide (e.g. XIPAGAMMA) an alternative?

With interest I read your article on diuretics triggering non-melanoma skin cancer (a-t 2018; 49: 85-7). However, I found that data on xipamide (XIPAGAMMA and similar generics), which is used very frequently was lacking. What is the situation there in terms of carcinogenicity and data on the prevention of damage caused by high blood pressure?

N.N. (name etc. stated in a-t 12/2018)
Conflict of interest: none

In Germany, xipamide (XIPAGAMMA and similar generics) is prescribed three times as frequently as a single substance preparation as the single substance chlorthalidone preparation HYGROTON (1). At an international level, however, xipamide is a less commonly used diuretic, and it is a decidedly little-investigated drug. We could not find any studies on the clinical benefit of xipamide in the treatment of hypertension. The few randomised studies available in that indication are small and based on surrogate endpoints. Xipamide therefore does not appear to us to be an expedient alternative to hydrochlorothiazide (ESIDRIX, generics). We were also unable to find any studies on whether xipamide, which can have a photosensitising effect like other diuretics (2), triggers skin cancer, -Ed.

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