Would you transition a patient with recurrent calcium nephrolithiasis and hypercalciuria from chlorthalidone to indapamide if they report sexual dysfunction side effects?

Yes. Indapamide is a thiazide-like diuretic that decreases urinary calcium excretion by increasing renal tubular reabsorption of calcium. In my experience, it is less likely to create sexual dysfunction than a true thiazide diuretic.

Stephen B. Erickson, MD

I have never done this in my personal practice. However, I certainly would not be opposed to trying this, as the effect on urinary calcium excretion should be similar between the 2 medications. Alternative approaches would include discontinuing diuretics altogether and doubling down on a low-salt di...

I would indeed. Given that both act on the NaCl cotransporter in DCT, I would not expect a dramatic difference, however.