Spironolactone/Hydrochlorothiazide, Oral

What are other names for this medicine?

Type of medicine: diuretic

Generic and brand names: spironolactone and hydrochlorothiazide, oral; Aldactazide

What is this medicine used for?

This medicine is a combination of 2 diuretics taken by mouth to control high blood pressure or to remove excess water from your body.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• asthma
• diabetes
• gout
• high cholesterol or triglyceride levels
• kidney disease or kidney stones
• liver disease
• lupus
• pancreatitis
• problems with sodium, potassium, magnesium, calcium levels in your blood
• trouble urinating or an enlarged prostate

Tell your healthcare provider if you are taking potassium supplements or using other diuretics.

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

If you are taking this medicine to control your blood pressure, take it regularly as your healthcare provider prescribes. Check the label on the medicine for directions about your specific dose.

This medicine may increase how much and how often you urinate. Take the last dose of the day before 6 PM to avoid interrupting your sleep at night.

You may take this medicine with or without food. Taking it with food or milk may lessen the chance the drug will upset your stomach.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: drowsiness, weakness, fainting, dry mouth, increased urination, nausea, vomiting, diarrhea.

What should I watch out for?

Talk with your healthcare provider about whether you should follow a special diet. Do not use salt substitutes containing potassium without your healthcare provider's approval.

You will need to have lab tests regularly to see how this medicine affects you. Keep all appointments for these tests.

Contact your healthcare provider if you develop severe vomiting or diarrhea while you are taking this medicine.

This medicine may make your skin sensitive to the sun, which may lead to painful sunburns. While you are taking this medicine, avoid long exposure to the sun and sunlamps. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors. Do not use a sunlamp. If you get a severe sunburn, contact your healthcare provider right away.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help. Drinking alcohol while you are taking this medicine may cause your blood pressure to drop too low. Talk to your healthcare provider about this.

Diabetics: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; severe rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Severe stomach pain or diarrhea; nausea; vomiting; rash; itching; shortness of breath; numbness or tingling in hands, feet, or lips; sore throat; fever; cough; muscle weakness or cramps; confusion; irregular heartbeat; unusual bleeding or bruising; trouble urinating; very dry mouth; yellowish eyes or skin.

Other: Constipation, headache, tiredness, dizziness, stomach upset, loss of appetite, mild nausea, diarrhea, enlarged or painful breasts, irregular menstrual periods, change in sexual desire or ability.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as enalapril (Vasotec), lisinopril (Prinivil, Zestril), fosinopril (Monopril), captopril (Capoten), benazepril (Lotensin), and lisinopril (Zestoretic)
• barbiturates such as pentobarbital (Nembutal) and phenobarbital
• cholesterol-lowering medicines such as cholestyramine (Questran) and colestipol (Colestid)
• corticosteroids such as cortisone (Cortone), betamethasone (Celestone), dexamethasone, fludrocortisone (Florinef), hydrocortisone (Cortef, Hydrocortone, A-HydroCort), methylprednisolone (Medrol), prednisone (Meticorten), prednisolone (Delta-Cortef), and triamcinolone (Aristocort, Kenacort)
• dofetilide (Tikosyn)
• digoxin (Lanoxin)
• immunosuppressants such as cyclosporine (Neoral, Sandimmune, Gengraf) and tacrolimus (Prograf)
• lithium (Lithobid, Eskalith)
• insulin or other medicines for diabetes such as glyburide (DiaBeta, Micronase), glipizide (Glucotrol), repaglinide (Prandin), metformin (Glucophage), rosiglitazone (Avandia), and pioglitazone (Actos)
• methenamine (Hiprex, Urex)
• narcotics such as codeine, morphine, hydrocodone (Vicodin), and oxycodone (Percocet, Tylox)
• natural remedies such as dong quai, ephedra, ginseng, garlic, and yohimbe
• NSAIDs such as ibuprofen (Motrin, Advil, Nuprin), naproxen (Naprosyn, Aleve), ketoprofen, indomethacin (Indocin), and nabumetone (Relafen)
• other diuretics such as furosemide (Lasix), torsemide (Demadex), bumetanide (Bumex), hydrochlorothiazide (HydroDIURIL), amiloride, spironolactone (Aldactone), and triamterene (Dyrenium)
• other blood pressure medicines such as losartan (Cozaar), candesartan (Atacand), eprosartan (Teveten), olmesartan (Benicar), telmisartan (Micardis), valsartan (Diovan), and irbesartan (Avapro)
• potassium supplements or products high in potassium such as salt substitutes
• quinidine
• warfarin (Coumadin)

Do not drink alcohol while you are taking this medicine.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.