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Popular Blood Pressure Medications Linked to Lip Cancer
A wide variety of commonly used presciption and over-the-counter medications may make the skin more sensitive to the sun, increasing the risks for sunburn and heat rash. Antihistamines, estrogen and progesterone (used for birth control as well as hormone replacement), nonsteroidal anti-inflammatory drugs (including ibuprofen and naproxen), many antibiotics, and some antidepressant medications can all have this effect, known as photosensitivity.
Hydrochlorothiazide (HCTZ), a popular antihypertensive and diuretic medication, is another photosensitizer. First introduced in 1958, HCTZ accounts for over 130 million prescriptions per year in the U.S. Since it is a fairly weak drug, it is often used in combination with other blood pressure medications. Although less likely, other blood pressure medications may also have this effect.
Lip cancer is a relatively uncommon cancer, affecting approximately 13 out of every 100,000 people, but its incidence has increased substantially over the past 40 years. Important risk factors include sun exposure, smoking, and viral infections. Because of HCTZ's photosensitizing effect, researchers with California's Kaiser Permanente healthcare system, in collaboration with Stanford University, combed through the medical records of tens of thousands of individuals to see if there might be a connection between blood pressure drugs and lip cancer.
Limiting their search to those who had taken the drugs for at least five years, the team found that the use of HCTZ was associated with a greater than four-fold increase in the incidence of lip cancer. Nifedipine, another popular blood pressure medication, appeared to double the risk, while lisinopril and atenolol did not appear to have this effect.
Since lip cancer is relatively rare, and high blood pressure so common, HCTZ and nifedipine will continue to be important options for medical treatment. This study only addressed lip cancer, but it is certainly possible that the drugs might raise the risk for other forms of skin cancer. If you take these drugs and spend a good amount of time outdoors, it is reasonable to ask your doctor whether other medications may be more appropriate for you. And it's good to get in the habit of using sun protection on all exposed skin, no matter what medications you may take.
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