Hydrochlorothiazide and spironolactone

Generic name: hydrochlorothiazide and spironolactone [ HYE-dro-KLOR-oh-THY-a-zide-and-spir-ON-oh-LAK-tone ]
Brand name: Aldactazide
Dosage form: oral tablet (25 mg-25 mg)
Drug class: Potassium sparing diuretics with thiazides

Medically reviewed by Drugs.com on Mar 31, 2025. Written by Cerner Multum.

What is hydrochlorothiazide and spironolactone?

Hydrochlorothiazide is a thiazide diuretic (water pill). Spironolactone is a potassium-sparing diuretic.

Hydrochlorothiazide and spironolactone is a combination medicine used to treat fluid retention (edema) in people with congestive heart failure, cirrhosis of the liver, or a kidney disorder called nephrotic syndrome. hydrochlorothiazide and spironolactone also treats high blood pressure (hypertension), or low potassium levels (hypokalemia) caused by using a diuretic.

Do not use this medicine for any condition that has not been checked by your doctor.

Hydrochlorothiazide and spironolactone may also be used for purposes not listed in this medication guide.

Hydrochlorothiazide and spironolactone side effects

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Hydrochlorothiazide and spironolactone may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• blurred vision, tunnel vision, eye pain, or seeing halos around lights;

• breast swelling and tenderness;

• low blood cell counts--easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath;

• high potassium level--nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement;

• low potassium level--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling; or

• low sodium level --headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.

Common side effects of hydrochlorothiazide and spironolactone may include:

• drowsiness, dizziness, lack of energy;

• leg cramps;

• weakness;

• feeling like you might pass out;

• severe pain in your upper stomach spreading to your back, nausea and vomiting; or

• electrolyte imbalance.

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.

Related/similar drugs

Warnings

You should not use hydrochlorothiazide and spironolactone if you have kidney problems, Addison's disease, high blood levels of calcium or potassium, an allergy to sulfa drugs, or if you are unable to urinate.

Before taking this medicine

You should not use this medicine if you are allergic to hydrochlorothiazide or spironolactone, or if you have:

• kidney disease or urination problems;

• liver disease;

• high levels of calcium or potassium in your blood;

• an allergy to sulfa drugs; or

• Addison's disease (an adrenal gland disorder).

Tell your doctor if you have ever had:

• cirrhosis or other liver disease;

• severe kidney disease;

• asthma or allergies;

• glaucoma;

• gout;

• diabetes; or

• lupus.

In animal studies, spironolactone caused certain types of tumors. It is not known whether tumors could occur in people using this medicine. Ask your doctor about your risk.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

You should not breastfeed while using this medicine.

This medicine is not approved for use by anyone younger than 18 years old.

How should I take hydrochlorothiazide and spironolactone?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Do not share hydrochlorothiazide and spironolactone with another person, even if they have the same symptoms you have.

You may need frequent medical tests.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using hydrochlorothiazide and spironolactone.

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 have high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Store at room temperature away from moisture and heat.

Hydrochlorothiazide and spironolactone dosing information

Usual Adult Dose for Hypertension:

Hydrochlorothiazide 50 to 100 mg-Spironolactone 50 to 100 mg orally daily in 1 to 2 divided doses

Uses:
-Treatment of essential hypertension when other measures are considered inadequate or inappropriate.
-Treatment of diuretic-induced hypokalemia in hypertensive patients when other measures are considered inappropriate.
-Treatment of hypertension.

Usual Adult Dose for Edema:

Hydrochlorothiazide 25 to 200 mg-Spironolactone 25 to 200 mg orally daily in 1 to 2 divided doses

Usual Adult Dose for Congestive Heart Failure:

Hydrochlorothiazide 25 to 200 mg-Spironolactone 25 to 200 mg orally daily in 1 to 2 divided doses

Uses:
-Management of edema and sodium retention when the patient is only partially responsive to, or is intolerant of, other therapeutic measures.
-Treatment of diuretic-induced hypokalemia in patients with congestive heart failure (CHF) when other measures are considered inappropriate.
-Treatment of patients with CHF taking digitalis when other therapies are considered inadequate or inappropriate.

Usual Adult Dose for Ascites:

Hydrochlorothiazide 25 to 200 mg-Spironolactone 25 to 200 mg orally daily in 1 to 2 divided doses

Use: Maintenance therapy together with bed rest and fluid and sodium restriction for cirrhosis of the liver accompanied by edema and/or ascites.

Usual Adult Dose for Nephrotic Syndrome:

Hydrochlorothiazide 25 to 200 mg-Spironolactone 25 to 200 mg orally daily in 1 to 2 divided doses

Use: For nephrotic patients when treatment of the underlying disease, restriction of fluid and sodium intake, and the use of other diuretics do not provide an adequate response.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include confusion, skin rash, nausea, vomiting, diarrhea, dizziness, and drowsiness.

What should I avoid while taking hydrochlorothiazide and spironolactone?

Hydrochlorothiazide may increase your risk of skin cancer. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Your doctor may want you to have skin examinations on a regular basis.

Drinking alcohol with hydrochlorothiazide and spironolactone can cause side effects.

Do not use potassium supplements or salt substitutes, unless your doctor has told you to.

Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

What other drugs will affect hydrochlorothiazide and spironolactone?

Using this medicine with other drugs that make you drowsy or lower your blood pressure can worsen these effects. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your other medicines, especially:

• cholestyramine;

• digoxin;

• lithium;

• heart or blood pressure medicine, especially another diuretic;

• insulin or oral diabetes medicine;

• medicine to prevent a blood clot;

• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others; or

• steroid medicine--dexamethasone, prednisone, or others.

This list is not complete. Other drugs may affect hydrochlorothiazide and spironolactone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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