In reply: Howes writes that previous studies have not shown significant hyponatraemia with indapamide. Our article highlighted that hyponatraemia was reported in a much larger proportion of all types of adverse drug reactions to indapamide than to chlorothiazide in Australia. As we clearly acknowledged, "Voluntary reporting systems do not provide a basis for calculating incidence or robust risk estimates".
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- 1 Department of Clinical Pharmacology, St George Hospital, Kogarah, NSW.
- 2 Adverse Drug Reactions Unit, Therapeutic Goods Administration, Woden, ACT.
- 3 The University of Newcastle, Newcastle, NSW.