Spironolactone and Hydrochlorothiazide : Uses, Side Effects, Interactions & More
This medication should not be used when you first begin your treatment. You should take this medication only after the appropriate dosages of spironolactone and hydrochlorothiazide are individually established by your doctor.
Why is this medication prescribed?
The combination of spironolactone and hydrochlorothiazide is used to treat high blood pressure. This drug is also used to treat patients with edema (fluid retention) caused by various conditions, including heart, liver, or kidney disease. Spironolactone is in a class of medications called aldosterone receptor antagonists. It causes the kidneys to remove unnecessary water and sodium from the body into the urine, but reduces the loss of potassium from the body. Hydrochlorothiazide is in a class of medications called diuretics (“water pills”). It works by causing the kidneys to remove unnecessary water and salt from the body into the urine.
High blood pressure is a common condition and, when left untreated, it can cause damage to the brain, heart, blood vessels, kidneys, and other parts of the body. Damage to these organs can cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medications, making lifestyle changes will also help control your blood pressure. These changes include eating a diet low in fat and salt, maintaining a healthy weight, exercising for at least 30 minutes most days, not smoking, and consuming alcohol in moderation.
How should this medicine be used?
The combination of spironolactone and hydrochlorothiazide comes as a tablet to take by mouth. It is usually taken once or twice a day. To remind you to take spironolactone and hydrochlorothiazide, take them around the same time every day. If you are going to take it once a day, take it in the morning; If you are going to take it twice a day, take it in the morning and late afternoon to avoid going to the bathroom at night. Follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any parts you do not understand. Take spironolactone and hydrochlorothiazide exactly as directed. Do not take more or less, or take it more often than prescribed by your doctor.
This drug controls high blood pressure and edema, but it does not cure these conditions. Keep taking spironolactone and hydrochlorothiazide even if you feel fine. Do not stop taking spironolactone and hydrochlorothiazide without consulting your doctor.
Other uses for this medicine
This medicine is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before taking spironolactone and hydrochlorothiazide,
- Tell your doctor and pharmacist if you are allergic to spironolactone, hydrochlorothiazide, thiazide diuretics (“water pills”), sulfa drugs, penicillin, other medications, or any of the ingredients in spironolactone and hydrochlorothiazide tablets. Ask your pharmacist for a list of the ingredients.
- Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: aldosterone blocking medications such as eplerenone (Inspra), angiotensin converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril (Capoten), enalapril (Vasotec, in Vaseretic) , fosinopril, lisinopril (in Prinzide, in Zestoretic), moexipril (Univasc, in Uniretic), perindopril (Aceon), quinapril (Accupril, in Accuretic, in Quinaretic), ramipril (Altace) and trandolapril (Mavik, in Tarka); angiotensin II antagonists (angiotensin receptor blockers; ARBs) such as azilsartan (Edarbi, in Edarbyclor), candesartan (Atacand, in Atacand HCT), eprosartan (Teveten, in Teveten HCT), irbesartan (Avapro, in Avalide), losartan (Cozaar in Hyzaar), olmesartan (Benicar, in Azor, Benicar HCT), telmisartan (Micardis, in Micardis HCT, in Twynsta) and valsartan (Diovan, in Diovan HCT, Exforge); aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), indomethacin (Indocin, Tivorbex); cholestyramine (Prevalite); digoxin (Lanoxin); heparin and low molecular weight heparins such as enoxaparin (Lovenox); lithium (Lithobid); medications for diabetes or high blood pressure; potassium-sparing diuretics (“water pills”) such as amiloride (Midamor) or triamterene (Dyrenium, in Dyazide, in Maxzide); and potassium supplements. Your doctor may need to change the doses of your medications or monitor you closely for side effects.
- Tell your doctor if you have high levels of calcium or potassium in your blood or if you have or have ever had Addison’s disease or other conditions that can cause high potassium levels in the blood or kidney or liver disease. Your doctor may tell you not to take spironolactone and hydrochlorothiazide.
- Tell your doctor if you have or have ever had asthma, systemic lupus erythematosus (SLE, a chronic inflammatory disease), diabetes, or gout.
- Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking spironolactone and hydrochlorothiazide, call your doctor.
- If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking spironolactone and hydrochlorothiazide.
- You should know that this medicine may make you drowsy. Do not drive a car or operate machinery until you know how this medicine affects you.
- Remember that alcohol can increase the drowsiness caused by this drug.
What special dietary instructions should I follow?
Follow your doctor’s instructions for a low-salt or low-sodium diet and a daily exercise program. Avoid salt substitutes that contain potassium. Limit your intake of foods rich in potassium (for example, bananas, prunes, raisins, and orange juice). Ask your doctor for advice on how much of these foods to eat.
What should I do if I forget a dose?
Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for the one you forgot.
What side effects can this medication cause?
Spironolactone and hydrochlorothiazide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- loss of appetite
- stomach pain
- frequent urination
- enlarged or painful breasts
- irregular menstrual periods
- difficulty maintaining or achieving an erection
- vaginal bleeding in post-menopausal (‘after the change of life’, the end of monthly menstrual periods) women
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
- muscle weakness or cramps
- changes in vision or eye pain
- rapid, excessive weight loss
- slow or irregular heartbeat
- unusual bruising or bleeding
- yellowing of the skin or eyes
- skin rash
If you experience a serious side effect, you or your doctor can submit a report online to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
What should I know about storage and disposal of this medication?
Keep this medicine in the container it came in, tightly closed, and out of the reach of children. Store at room temperature and away from excess heat and moisture (not in the bathroom).
Unnecessary medications must be disposed of in special ways to ensure that pets, children, and others cannot consume them. However, you should not flush this medicine down the toilet. Instead, the best way to dispose of your medications is through a drug take-back program. Talk to your pharmacist or contact your local garbage / recycling department to find out about take-back programs in your community. See the FDA Safe Drug Disposal website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
It is important to keep all medicines out of the sight and reach of children, since many containers (such as those containing weekly pills and those for eye drops, creams, patches and inhalers) are not resistant to children and small children can easily open them. To protect young children from poisoning, always close the safety caps and immediately place the medicine in a safe place, one that is upright and out of their sight and reach. http://www.upandaway.org
In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim collapsed, had a seizure, is having trouble breathing, or is unable to wake up, immediately call 911 for emergency services.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly, and blood tests should be done occasionally.
Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.
It is important that you keep a written list of all prescription and over-the-counter (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you each time you visit a doctor or if you go into hospital. It is also important information to take with you in case of emergencies.
Brand names of combination products
- Aldactazide® (containing Spironolactone, Hydrochlorothiazide)
Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.