hydrochlorothiazide and spironolactone

(hye dro klor oh THYE a zide/speer on oh LAK tone)
Aldactazide, Spironolactone Plus

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

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To reduce nighttime urination, take hydrochlorothiazide and spironolactone before 6 p.m. and preferably in the morning.

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Take hydrochlorothiazide and spironolactone with food or milk to lessen stomach upset.

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Do not use salt substitutes or low-sodium milk products that contain potassium while taking hydrochlorothiazide and spironolactone. These products could cause very high levels of potassium in your blood. Ask your doctor or pharmacist about any salt substitutes you are taking.

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Use caution when driving, operating machinery, or performing other hazardous activities. Hydrochlorothiazide and spironolactone may cause dizziness. If you experience dizziness, avoid these activities.

What is hydrochlorothiazide and spironolactone?

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Hydrochlorothiazide is a thiazide diuretic (water pill). It decreases the amount of fluid in your body by increasing the amount of salt and water you lose in your urine.

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Spironolactone is a potassium-sparing diuretic (water pill). It is used to reduce the amount of fluid in the body without causing the loss of potassium.

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Hydrochlorothiazide and spironolactone is used to treat edema (swelling) and hypertension (high blood pressure).

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Hydrochlorothiazide and spironolactone may also be used for purposes other than those listed in this medication guide.

Who should not take hydrochlorothiazide and spironolactone?

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Do not take hydrochlorothiazide and spironolactone if you

have an allergy to sulfa-based drugs such as sulfa antibiotics,

have severe kidney disease,

have high levels of potassium in your blood (hyperkalemia); or

are taking another diuretic that helps you retain potassium such as triamterene (Dyrenium, Dyazide, Maxzide) or spironolactone (Midamor).

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Before taking this medication, tell your doctor if you have

liver disease,

high levels of triglycerides or cholesterol (types of fat) in your blood,

kidney stones,

gout, or

diabetes.

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You may not be able to take hydrochlorothiazide and spironolactone, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

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Hydrochlorothiazide and spironolactone can harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant.

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Hydrochlorothiazide and spironolactone passes into breast milk and may harm a nursing infant. Do not take hydrochlorothiazide and spironolactone without first talking to your doctor if you are breast-feeding a baby.

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If you are over 60 years of age, you may be more likely to experience side effects from hydrochlorothiazide and spironolactone. You may require a lower dose of this medication.

How should I take hydrochlorothiazide and spironolactone?

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Take hydrochlorothiazide and spironolactone exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

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Take each dose with a full glass of water.

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Take hydrochlorothiazide and spironolactone with food or milk to lessen stomach upset.

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To reduce nighttime urination, take hydrochlorothiazide-spironolactone before 6 p.m. and preferably in the morning.

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Hydrochlorothiazide and spironolactone should begin working about 4 to 6 hours after you take it, but it may be a few weeks before you see an improvement in your condition.

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Do not stop taking hydrochlorothiazide and spironolactone suddenly even if you feel better. Stopping suddenly could make your condition much worse.

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Store hydrochlorothiazide and spironolactone at room temperature away from moisture and heat.

What happens if I miss a dose?

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Take the missed dose as soon as you remember. If it is almost time for your next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication.

What happens if I overdose?

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Seek emergency medical attention.

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Symptoms of a hydrochlorothiazide and spironolactone overdose include dizziness, fainting, nausea, and vomiting.

What should I avoid while taking hydrochlorothiazide and spironolactone?

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Avoid a diet high in salt. Too much salt will cause your body to retain water and will decrease the effects of hydrochlorothiazide and spironolactone.

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Avoid prolonged exposure to sunlight. Hydrochlorothiazide may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

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Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking hydrochlorothiazide and spironolactone.

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Avoid becoming overheated during exercise and in hot weather. Overheating can lead to dehydration while taking hydrochlorothiazide and spironolactone.

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Tell your doctor and dentist that you are taking this medication before having surgery.

What are the possible side effects of hydrochlorothiazide and spironolactone?

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If you experience any of the following serious side effects, stop taking hydrochlorothiazide and spironolactone and seek emergency medical treatment:

an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

an irregular heartbeat, shortness of breath, fatigue, confusion, weakness, numbness, or tingling (caused by high levels of potassium in your blood);

severe mood changes;

muscle cramping;

black, bloody, or tarry stools;

easy bruising or bleeding;

blood in your urine;

little or no urine;

yellowing of your skin or eyes; or

confusion.

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Other, less serious side effects may be more likely to occur. Continue to take hydrochlorothiazide and spironolactone and talk to your doctor if you experience

dizziness;

tingling or numbness in your hands or feet;

headache or tiredness;

excessive urination;

muscle weakness or cramps;

increased hunger or thirst;

a dry mouth;

nausea, vomiting, diarrhea, or constipation;

changes in weight;

increased swelling;

sensitivity of the skin to sunlight; or

decreased sex drive.

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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?

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

Angiotensin-converting-enzyme inhibitors (ACE inhibitors) such as benazepril (Lotensin) or captopril (Capoten) may increase potassium in your blood, which could be dangerous when you are taking hydrochlorothiazide and spironolactone.

Other commonly used ACE inhibitors include enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), and ramipril (Altace).

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil, Rufen, others), ketoprofen (Orudis, Orudis KT, Oruvail), and naproxen (Naprosyn, Aleve, Anaprox) may decrease the effects of hydrochlorothiazide and spironolactone and may increase the risk of damage to your kidneys.

Other commonly used NSAIDs include diclofenac (Voltaren, Cataflam), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin).

Diabetes medications such as chlorpropamide (Diabinese), tolbutamide (Orinase), tolazamide (Tolinase), glipizide (Glucotrol), and glyburide (Diabeta, Glynase, Micronase) may not be as effective in lowering your blood sugar levels when you are taking hydrochlorothiazide and spironolactone. Your diabetes therapy may have to be adjusted.

Lithium (Lithobid, Lithane, Eskalith, others) may have increased effects when taken with hydrochlorothiazide and spironolactone and may cause side effects.

Steroid medications such as hydrocortisone (Cortef, Hydrocortone, Solu-Cortef), prednisone (Orasone, Deltasone, Meticorten), methylprednisolone (Medrol, Depo-Medrol, A-MetaPred, Solu-Medrol, others), prednisolone (Prelone, Delta Cortef, Pediapred, others), dexamethasone (Decadron, Hexadrol), betamethasone (Celestone), corticotropin (Acthar, ACTH), and others may affect potassium levels in your blood.

Warfarin (Coumadin) may have decreased effects when it is taken with hydrochlorothiazide and spironolactone.

Allopurinol (Zyloprim), probenecid (Benemid), and sulfinpyrazone (Anturane) may have reduced effects because hydrochlorothiazide and spiranolactone increases levels of uric acid in your body.

Cholestyramine (Questran) and colestipol (Colestid) may decrease the effects of hydrochlorothiazide and spironolactone. Hydrochlorothiazide and spironolactone should be taken at least 1 hour before or 4 hours after any dose of cholestyramine or colestipol.

Laxatives may affect potassium levels in your body. This could interfere with hydrochlorothiazide and spironolactone therapy.

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Drugs other than those listed here may also interact with hydrochlorothiazide and spironolactone. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

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

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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.

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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.