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Hydrochlorothiazide / spironolactone Side Effects

For the Consumer

Applies to hydrochlorothiazide / spironolactone: oral tablet

Along with its needed effects, hydrochlorothiazide/spironolactone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking hydrochlorothiazide / spironolactone:

Incidence not known
  • Abdominal or stomach cramping, burning, or tenderness
  • back or leg pains
  • blistering, peeling, or loosening of the skin
  • bloody or black, tarry stools
  • bloody or cloudy urine
  • blue lips and fingernails
  • blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chest pain
  • clay-colored stools
  • clear or bloody discharge from the nipple
  • confusion
  • cough or hoarseness
  • dark urine
  • decreased appetite
  • diarrhea
  • difficult, fast, or noisy breathing
  • difficulty with swallowing
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fast or irregular heartbeat
  • fever with or without chills
  • flushed, dry skin
  • fruit-like breath odor
  • general body swelling
  • general feeling of discomfort or illness
  • greatly decreased frequency of urination or amount of urine
  • hives or welts, skin rash
  • increased hunger
  • increased thirst
  • inverted nipple
  • joint pain, stiffness, or swelling
  • lower back or side pain
  • lump in the breast or under the arm
  • muscle cramps or pain
  • nausea and vomiting
  • numbness, tingling, pain, or weakness in the hands, feet, or lips
  • painful or difficult urination
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pinpoint red or purple spots on the skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red, irritated eyes
  • redness or swelling of the breast
  • redness, soreness, or itching skin
  • seizures
  • sore on the skin of the breast that does not heal
  • sores, ulcers, or white spots on the lips or in the mouth
  • swelling of the face, hands, fingers, feet, or lower legs
  • swollen, painful, or tender lymph glands in the neck, armpit, or groin
  • tightness in the chest
  • trembling
  • troubled breathing
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur while taking hydrochlorothiazide / spironolactone:

Symptoms of overdose
  • Difficulty with sleeping
  • disorientation
  • drowsiness to profound coma
  • hallucination
  • lethargy
  • lightheadedness
  • mood or other mental changes
  • rash with flat lesions or small raised lesions on the skin

Some side effects of hydrochlorothiazide / spironolactone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known
  • Absent, missed, or irregular menstrual periods
  • bleeding after menopause
  • burning feeling in the chest or stomach
  • discoloration of the skin
  • feeling of constant movement of self or surroundings
  • inability to have or keep an erection
  • increased sensitivity of the skin to sunlight
  • muscle spasm
  • restlessness
  • sensation of spinning
  • severe sunburn
  • stomach upset
  • stopping of menstrual bleeding
  • swelling of the breasts or breast soreness in both females and males

For Healthcare Professionals

Applies to hydrochlorothiazide / spironolactone: oral tablet


Frequency not reported: Gynecomastia[Ref]


Frequency not reported: Weakness, fever, vertigo

Frequency not reported: Breast pain, fever[Ref]


Frequency not reported: Hypotension, orthostatic hypotension, necrotizing angitis, vasculitis

Frequency not reported: Vasculitis[Ref]


Frequency not reported: Pancreatitis, intrahepatic cholestatic jaundice

Frequency not reported: Mixed cholestatic/hepatocellular toxicity[Ref]


Frequency not reported: Diarrhea, vomiting, sialoadenitis, cramping, constipation, gastric irritation, nausea

Frequency not reported: Gastric bleeding, ulceration, gastritis, diarrhea, cramping, nausea, vomiting[Ref]


Frequency not reported: Anorexia, electrolyte imbalance, hyperglycemia, hyperuricemia

Frequency not reported: Hyperkalemia, electrolyte disturbances[Ref]


Frequency not reported: Acute myopia, acute angle closure glaucoma, transient blurred vision, xanthopsia[Ref]


Frequency not reported: Aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia

Frequency not reported: Leukopenia, agranulocytosis, thrombocytopenia[Ref]


Frequency not reported: Anaphylactic reactions

Frequency not reported: Anaphylactic reactions[Ref]


Frequency not reported: Cutaneous vasculitis, photosensitivity, urticaria, rash, purpura, erythema multiforme, pruritus

Frequency not reported: Urticaria, maculopapular or erythematous cutaneous eruptions, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms, alopecia, pruritus[Ref]


Frequency not reported: Pneumonitis, pulmonary edema[Ref]


Frequency not reported: Glycosuria

Frequency not reported: Inability to achieve or maintain erection, irregular menses or amenorrhea, postmenopausal bleeding[Ref]


Frequency not reported: Muscle spasm

Frequency not reported: Leg cramps[Ref]

Nervous system

Frequency not reported: Paresthesias, dizziness, headache

Frequency not reported: Lethargy, ataxia, dizziness, headache, drowsiness[Ref]


Frequency not reported: Restlessness

Frequency not reported: Mental confusion[Ref]


Frequency not reported: Renal failure, renal dysfunction, interstitial nephritis

Frequency not reported: Renal dysfunction, renal failure[Ref]


Frequency not reported: Carcinoma of the breast[Ref]


1. "Product Information. Aldactazide (hydrochlorothiazide-spironolactone)." Pfizer U.S. Pharmaceuticals Group, New York, NY.

Some side effects of hydrochlorothiazide / spironolactone may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.