Hydrochlorothiazide: Association with non-melanoma skin cancer (basal cell carcinoma, squamous cell carcinoma)

AstraZeneca would like to inform healthcare professionals of the association of non-melanoma skin cancer (NMSC) with the use of hydrochlorothiazide (HCTZ)-containing medicines. This safety concern was identified from two pharmacoepidemiological studies conducted in Danish nationwide data sources (i.e. Danish Cancer Registry and National Prescription Registry) which reported a cumulative dose-dependent association between HCTZ and NMSC. Healthcare professionals are advised that patients taking HCTZ alone or in combination with other medicines should be informed of the risk of NMSC and advised to check their skin for any new lesions or changes to existing ones. Patients should limit exposure to sunlight and UV rays and to use adequate protection when exposed to sunlight and UV rays.  Suspicious skin lesions should be examined and the use of HCTZ may also need to be carefully reconsidered in patients who have had previous skin cancer. The package insert of Atacand®Plus Tablet will be updated to reflect the risk of NMSC. Please refer to the letter for details.

Only abstracts of the Dear Healthcare Professional Letters (DHCPL) are provided on this website. Details of these letters can be found in the MOH Alert System, which is accessible via the Health Professionals Portal (HPP), a one-stop portal for all healthcare professionals in Singapore. Dentists, medical doctors and pharmacists may access HPP at https://hpp.moh.gov.sg and follow the procedures below to access the MOH Alert system.

Step 1: Select your profession under ‘For Healthcare Professionals’.

Step 2: Click on ‘Useful links’.

Step 3: Click on ‘MOH Alert’ and log in via Singpass.

Step 4: Click on ‘Drug Alerts’ or ‘Med Device Alerts’ to view the DHCPLs.