Mild hypercalcemia while on hydrochlorothiazide should be managed by:

Mild hypercalcemia while on hydrochlorothiazide should be managed by:

• A. Stopping hydrochlorothiazide and rechecking calcium with BMP
• B. Increasing hydrochlorothiazide dose
• C. Switching to another thiazide
• D. Prescribing calcium supplements

Answer: (A)

Thiazide diuretics, like hydrochlorothiazide, increase calcium reabsorption in the distal tubule. That can lead to mild hypercalcemia in some patients. The best initial management is to stop the drug and recheck calcium (typically with a BMP that includes calcium and kidney function). If calcium returns to normal after stopping, the hypercalcemia was likely drug-related and no further immediate workup is needed beyond routine follow-up. If calcium remains high, evaluate for other causes such as primary hyperparathyroidism or malignancy. Increasing the diuretic would worsen calcium; switching to another thiazide would likely produce the same effect; giving calcium supplements would raise calcium further.

Thiazide diuretics, like hydrochlorothiazide, increase calcium reabsorption in the distal tubule. That can lead to mild hypercalcemia in some patients. The best initial management is to stop the drug and recheck calcium (typically with a BMP that includes calcium and kidney function). If calcium returns to normal after stopping, the hypercalcemia was likely drug-related and no further immediate workup is needed beyond routine follow-up. If calcium remains high, evaluate for other causes such as primary hyperparathyroidism or malignancy. Increasing the diuretic would worsen calcium; switching to another thiazide would likely produce the same effect; giving calcium supplements would raise calcium further.