Generic Name: hydrochlorothiazide and spironolactone (HYE dro KLOR oh THY a zide and spir ON oh LAK tone)
Brand Names: Aldactazide
What is hydrochlorothiazide and spironolactone?
Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.
Spironolactone is a potassium-sparing diuretic that also prevents your body from absorbing too much salt and keeps your potassium levels from getting too low.
The combination of hydrochlorothiazide and spironolactone is used to treat fluid retention (edema) in people with congestive heart failure, cirrhosis of the liver, or a kidney disorder called nephrotic syndrome. This medication also treats high blood pressure (hypertension).
Hydrochlorothiazide and spironolactone may also be used for purposes not listed in this medication guide.
What is the most important information I should know about hydrochlorothiazide and spironolactone?
You should not use this medication if you have kidney disease, urination problems, or high levels of potassium in your blood. Do not use potassium supplements while you are taking hydrochlorothiazide and spironolactone.
Before using this medication, tell your doctor if you have heart or liver disease, glaucoma, diabetes, a breathing disorder, gout, lupus, a pancreas disorder, an allergy to sulfa drugs or penicillin. Tell your doctor if you use a steroid or another blood pressure medicine.
Drinking alcohol can increase certain side effects of hydrochlorothiazide and spironolactone.
Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective.
Do not use salt substitutes or low-sodium milk products that contain potassium. These products could cause your potassium levels to get too high while you are taking hydrochlorothiazide and spironolactone.
Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.
This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
What should I discuss with my doctor before taking hydrochlorothiazide and spironolactone?
You should not use this medication if you are allergic to hydrochlorothiazide or spironolactone, or if you have:
- kidney disease or are unable to urinate;
high potassium levels (hyperkalemia); or
if you are taking potassium supplements.
To make sure you can safely take hydrochlorothiazide and spironolactone, tell your doctor if you have any of these other conditions:
diabetes;
heart disease;
cirrhosis or other liver disease;
glaucoma;
a breathing disorder;
gout;
lupus;
an allergy to sulfa drugs or penicillin;
a pancreas disorder; or
if you are using another blood pressure medication or a steroid.
FDA pregnancy category C. It is not known whether hydrochlorothiazide and spironolactone will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Hydrochlorothiazide passes into breast milk and could cause harm to a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
How should I take hydrochlorothiazide and spironolactone?
Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Your doctor may occasionally change your dose to make sure you get the best results.
Take each dose with a full glass of water.
To be sure this medication is not causing harmful effects, your blood will need to be tested often. Your kidney or liver function may also need to be tested. Visit your doctor regularly.
Hydrochlorothiazide can interfere with the results of a thyroid test. Tell any doctor who treats you that you are using a thiazide diuretic.
If you need surgery, tell the surgeon ahead of time that you are using hydrochlorothiazide and spironolactone. You may need to stop using the medicine for a short time. If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life. Store at room temperature away from moisture and heat.
See also: Hydrochlorothiazide and spironolactone dosage (in more detail)
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include drowsiness, confusion, red skin rash, nausea, vomiting, or diarrhea.
What should I avoid while taking hydrochlorothiazide and spironolactone?
Drinking alcohol can increase certain side effects of hydrochlorothiazide and spironolactone. Do not use salt substitutes or low-sodium milk products that contain potassium. These products could cause your potassium levels to get too high while you are taking hydrochlorothiazide and spironolactone.
Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective.
This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.
Hydrochlorothiazide and spironolactone side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have a serious side effect such as:
eye pain, vision problems;
numbness or tingly feeling;
muscle pain or weakness;
slow, fast, or uneven heartbeat;
feeling drowsy, restless, or light-headed;
urinating less than usual or not at all;
shallow breathing;
tremors, confusion;
nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Less serious side effects may include:
mild nausea or vomiting;
dizziness, headache;
gas, stomach pain; or
skin rash.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Hydrochlorothiazide and spironolactone Dosing Information
Usual Adult Dose for Hypertension:
Initial dose: 2 tablets (hydrochlorothiazide 25 mg-spironolactone 25 mg) orally once a day or 1 tablet (hydrochlorothiazide 50 mg-spironolactone 50 mg) orally once a day.
Maintenance dose: The initial dosage may be divided into two daily doses, and increased as tolerated approximately every two to four days to a maximum recommended total daily dose of hydrochlorothiazide 100 mg-spironolactone 100 mg.
Usual Adult Dose for Edema:
Initial dose: 4 tablets (hydrochlorothiazide 25 mg-spironolactone 25 mg) orally once a day or 2 tablets (hydrochlorothiazide 50 mg-spironolactone 50 mg) orally once a day.
Maintenance dose: The initial dosage may be divided into two to four daily doses, and increased as tolerated approximately every two to four days to a maximum recommended total daily dose of hydrochlorothiazide 200 mg-spironolactone 200 mg. The risk of side effects increases significantly with dosages greater than the maximum recommended dose.
Usual Adult Dose for Congestive Heart Failure:
Initial dose: 4 tablets (hydrochlorothiazide 25 mg-spironolactone 25 mg) orally once a day or 2 tablets (hydrochlorothiazide 50 mg-spironolactone 50 mg) orally once a day.
Maintenance dose: The initial dosage may be divided into two to four daily doses, and increased as tolerated approximately every two to four days to a maximum recommended total daily dose of hydrochlorothiazide 200 mg-spironolactone 200 mg. The risk of side effects increases significantly with dosages greater than the maximum recommended dose.
Usual Adult Dose for Ascites:
Initial dose: 4 tablets (hydrochlorothiazide 25 mg-spironolactone 25 mg) orally once a day or 2 tablets (hydrochlorothiazide 50 mg-spironolactone 50 mg) orally once a day.
Maintenance dose: If there is inadequate diuresis after two to four days, this dosage should be increased as tolerated approximately every two to three days to a maximum recommended total daily dose of hydrochlorothiazide 200 mg-spironolactone 200 mg.
Usual Adult Dose for Nephrotic Syndrome:
Initial dose: 4 tablets (hydrochlorothiazide 25 mg-spironolactone 25 mg) orally once a day or 2 tablets (hydrochlorothiazide 50 mg-spironolactone 50 mg) orally once a day.
Maintenance dose: The initial dosage may be divided into two to four daily doses, and increased as tolerated approximately every two to four days to a maximum recommended total daily dose of hydrochlorothiazide 200 mg-spironolactone 200 mg. The risk of side effects increases significantly with dosages greater than the maximum recommended dose.
What other drugs will affect hydrochlorothiazide and spironolactone?
Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to light-headedness caused by hydrochlorothiazide and spironolactone. Tell your doctor if you regularly use any of these medicines, or any other blood pressure medications.
Tell your doctor about all other medicines you use, especially:
lithium (Eskalith, Lithobid);
digoxin (Lanoxin);
steroids (prednisone and others);
a blood thinner such as warfarin (Coumadin, Jantoven);
insulin or diabetes medicine taken by mouth;
an ACE inhibitor such as benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others; or
indomethacin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others.
This list is not complete and other drugs may interact with hydrochlorothiazide and spironolactone. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
More hydrochlorothiazide and spironolactone resources
- Hydrochlorothiazide and spironolactone Side Effects (in more detail)
- Hydrochlorothiazide and spironolactone Dosage
- Hydrochlorothiazide and spironolactone Use in Pregnancy & Breastfeeding
- Drug Images
- Hydrochlorothiazide and spironolactone Drug Interactions
- Hydrochlorothiazide and spironolactone Support Group
- 2 Reviews for Hydrochlorothiazide and spironolactone - Add your own review/rating
Compare hydrochlorothiazide and spironolactone with other medications
- Ascites
- Edema
- Heart Failure
- High Blood Pressure
- Nephrotic Syndrome
Where can I get more information?
- Your pharmacist can provide more information about hydrochlorothiazide and spironolactone.
See also: hydrochlorothiazide and spironolactone side effects (in more detail)
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