Hydrochlorothiazide (hye-droe-klor-oh-THYE-a-zide), Spironolactone (spir-on-oh-LAK-tone)
Treats fluid retention (edema) in patients with congestive heart failure, liver cirrhosis, or nephrotic syndrome. Also treats high blood pressure. This medicine combines 2 diuretics (water pills).
There may be other brand names for this medicine.
When This Medicine Should Not Be Used
You should not use this medicine if you have had an allergic reaction to spironolactone, hydrochlorothiazide, or sulfa drugs (such as sulfamethoxazole/trimethoprim, sulfasalazine, sulfisoxazole, Azulfidine®, Bactrim®, Gantrisin®, or Septra®). You should not use this medicine if you are not able to urinate (anuria), have severe kidney disease, severe liver disease, or high blood potassium (hyperkalemia). You should not use this medicine if you are also using potassium supplements or salt substitutes, or certain diuretics such as amiloride (Midamor®, Moduretic®), triamterene (Dyazide®, Dyrenium®, Maxzide®), or other products containing spironolactone (Aldactone®).
How to Use This Medicine
- Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
- Carefully follow your doctor's instructions about any special diet. Be sure to drink plenty of fluids if you exercise, sweat more than usual, or have diarrhea or vomiting.
If a dose is missed:
- If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
How to Store and Dispose of This Medicine
- Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you are also using cholestyramine (Questran®), colestipol (Colestid®), cyclosporine (Gengraf®, Neoral®, Sandimmune®), digoxin (Lanoxin®), lithium (Eskalith®, Lithobid®), norepinephrine, tubocurarine, diabetes medicine (such as glipizide, glyburide, insulin, metformin, or Glucotrol®), pain or arthritis medicine (such as aspirin, indomethacin, Advil®, Aleve®, Indocin®, Motrin®, Orudis®, or Relafen®), a steroid medicine (such as cortisone, prednisone, or Medrol®), other diuretic or water pill (such as furosemide, torsemide, Demadex®, or Lasix®), or other blood pressure medicine (such as enalapril, lisinopril, Accupril®, Altace®, Lotensin®, Lotrel®, Monopril®, Prinivil®, Zestoretic®, or Zestril®).
- You may feel more lightheaded, dizzy, or faint if you drink alcohol or take narcotic pain relievers or sleeping pills with this medicine. Tell your doctor if you drink alcohol or use pain relievers or sleeping pills.
Warnings While Using This Medicine
- Make sure your doctor knows if you are pregnant or breastfeeding or if you have kidney disease, liver disease, diabetes, glaucoma, gout, high cholesterol or fats in the blood, menstrual problems, pancreas problems, systemic lupus erythematosus (SLE or lupus), mineral imbalance (such as high calcium or low chloride, magnesium, potassium, or sodium), or a history of asthma.
- This medicine will not cure your high blood pressure, but it does help control it if you take it as directed. You may have to take high blood pressure medicine for the rest of your life.
- Stop using this medicine and check with your doctor right away if you are confused or have trouble breathing; fast or uneven heartbeats; numbness or tingling in the hands, feet, or lips; or weakness. These may be signs of too much potassium in your blood (hyperkalemia).
- Stop using this medicine and check with your doctor immediately if you have blurred vision, difficulty in reading, eye pain, or any other change in vision during or after treatment. This could be a sign of a serious eye problem. Your doctor will want you to have your eyes checked by an ophthalmologist (eye doctor).
- This medicine may make you dizzy, drowsy, or lightheaded. Do not drive, use machines, or do anything else that could be dangerous if you are not alert. Dizziness may be worse if you lose too much water from your body. You can lose water by sweating, having diarrhea, or vomiting. Tell your doctor if this medicine makes you feel lightheaded or dizzy after you have been vomiting or had diarrhea.
- Use extra care if you exercise or if the weather is hot. Heavy sweating can cause dehydration (loss of too much water) or electrolyte imbalances (loss of sodium, potassium, or magnesium in the body).
- This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.
- This medicine may cause swelling of the breasts (gynecomastia) and breast pain in some patients. Talk to your doctor if you have questions about this.
- Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
- Your blood pressure may go up if you stop using this medicine. High blood pressure usually has no symptoms. Do not stop using the medicine without asking your doctor even if you feel well.
- Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood and urine tests may be needed to check for unwanted effects.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
- Blistering, peeling, or red skin rash
- Blurred vision or changes in vision
- Change in how much or how often you urinate
- Confusion, fast or uneven heartbeat, trouble breathing, or numbness or tingling in hands, feet, or lips
- Dry mouth, increased thirst, muscle cramps, nausea, or vomiting
- Fever, chills, cough, hoarseness, and body aches
- Lightheadedness or fainting
- Problems urinating, pain in side or lower back
- Severe diarrhea
- Unusual bleeding or bruising
- Unusual tiredness or weakness
If you notice these less serious side effects, talk with your doctor:
- Breast enlargement in men
- Breast tenderness, changes in hair growth, or irregular menstrual periods in women
- Mild nausea, vomiting, diarrhea, or stomach cramps
- Mild skin rash or itching