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Spironolactone Plus

Generic Name: hydrochlorothiazide and spironolactone (hye dro klor oh THY a zide and spir ON oh LAK tone)
Brand Names: Aldactazide

What is Spironolactone Plus (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 other purposes not listed in this medication guide.

What is the most important information I should know about Spironolactone Plus (hydrochlorothiazide and spironolactone)?

Do 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, diabetes, a breathing disorder, gout, lupus, an allergy to sulfa drugs, or a pancreas disorder. Tell your doctor if you use a steroid or another blood pressure medicine.

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Avoid drinking alcohol, which can increase some of 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.

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 can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my doctor before taking Spironolactone Plus (hydrochlorothiazide and spironolactone)?

Do 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.

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

  • diabetes;

  • heart disease;

  • cirrhosis or other liver disease;

  • a breathing disorder;

  • gout;

  • lupus;

  • an allergy to sulfa drugs;

  • a pancreas disorder; or

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

If you have any of these conditions, you may need a dose adjustment or special tests to safely take hydrochlorothiazide and spironolactone.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. 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 Spironolactone Plus (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. Follow the directions on your prescription label.

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

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 on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled appointments.

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.

Store the tablets at room temperature away from heat, light, and moisture.

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?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include drowsiness, confusion, red skin rash, nausea, vomiting, or diarrhea.

What should I avoid while taking Spironolactone Plus (hydrochlorothiazide and spironolactone)?

Avoid drinking alcohol, which can increase some of the side effects of 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. Tell your doctor if you regularly use any of these medicines, or any other blood pressure medications.

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 can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and 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.

Spironolactone Plus (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:
  • 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).

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. Tell your doctor about any unusual or bothersome side effect.

See also: Side effects (in more detail)

What other drugs will affect Spironolactone Plus (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.

This list is not complete and there may be other drugs that can interact with 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 can provide more information about hydrochlorothiazide and spironolactone.
  • 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.
  • Disclaimer: 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.
Copyright 1996-2006 Cerner Multum, Inc. Version: 4.04. Revision Date: 03/31/2008 8:12:56 AM.
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