Why should hydrochlorothiazide be stopped in patients experiencing gout flares?

Hydrochlorothiazide should be stopped in patients experiencing gout flares because it increases uric acid levels in the body. Thiazide diuretics, like hydrochlorothiazide, can reduce the renal excretion of uric acid, leading to an accumulation in the serum. This elevated uric acid level is a critical factor in the pathophysiology of gout, as it can precipitate the formation of urate crystals in the joints, triggering sudden inflammation and pain characteristic of a gout attack.

In managing patients with a history of gout, it is essential to consider medications that avoid exacerbation of their condition. While certain diuretics may be necessary for the management of hypertension or fluid retention, their potential to elevate uric acid levels makes them unsuitable during gout flares.