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Generic Name: hydrochlorothiazide and spironolactone (hy dro klor oh THI a zide and speer on oh LAK tone)
Brand Names: Aldactazide, Spironolactone Plus

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.

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 other than those listed in this medication guide.

What is the most important information I should know about hydrochlorothiazide and spironolactone?

Before using this medication, tell your doctor if you have heart or liver disease, diabetes, a breathing disorder, gout, lupus, or a pancreas disorder. Tell your doctor if you use a steroid or another blood pressure medicine.

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

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.

What should I discuss with my doctor before taking hydrochlorothiazide and spironolactone?

• kidney disease or are unable to urinate;

• an allergy to sulfa drugs;

• high potassium levels (hyperkalemia); or

• if you are taking potassium supplements.

Before using hydrochlorothiazide and spironolactone, tell your doctor if you have:

• diabetes;

• heart disease;

• cirrhosis or other liver disease;

• a breathing disorder;

• gout;

• lupus;

• a pancreas disorder; or

• if you are using another blood pressure medication or a steroid.

If you have any of these conditions, you may not be able to use hydrochlorothiazide and spironolactone, or you may need a dosage adjustment or special tests during treatment.

How should I take hydrochlorothiazide and spironolactone?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your kidney or liver function may also need to be tested. It is important that you not miss any scheduled visits to your doctor.

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 to have any type of surgery, tell the surgeon ahead of time that you are taking 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 fine. High blood pressure often has no symptoms.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

What should I avoid while taking hydrochlorothiazide and spironolactone?

Avoid using other medicines that make you light-headed (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to the 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.

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

• 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; or

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Continue using hydrochlorothiazide and spironolactone and talk with your doctor if you have any of these less serious side effects:

• mild nausea or vomiting;

• dizziness, headache;

• gas, stomach pain; or

• skin rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect hydrochlorothiazide and spironolactone?

Before taking this medication, tell your doctor if you are using any of the following drugs:

• lithium;

• digoxin (Lanoxin);

• steroids (prednisone and others);

• a blood thinner such as warfarin (Coumadin);

• insulin or diabetes medicine taken by mouth;

• an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), lisinopril (Prinivil, Zestril), ramipril (Altace), and others; or

• indomethacin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Motrin, Advil), diclofenac (Voltaren), naproxen (Aleve, Naprosyn), piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others.

If you are using any of these drugs, you may not be able to use hydrochlorothiazide and spironolactone, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect hydrochlorothiazide and spironolactone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has additional information about hydrochlorothiazide and spironolactone written for health professionals that you may read.

What does my medication look like?

Hydrochlorothiazide and spironolactone is available with a prescription under the brand name Aldactazide. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Hydrochlorothiazide/spironolactone strengths are as follows:

• Aldactazide 25 mg/25 mg--round, tan, film-coated tablets

• Aldactazide 50 mg/50 mg--oblong, tan, film-coated tablets

• 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.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.