spironolactone - hydrochlorothiazide

By GD Searle

What side effects are possible with this medication?

A side effect is an unwanted response to a medication when it is taken in normal doses. It can be mild or severe, temporary or permanent, but does not occur in everyone. The following side effects have been reported by at least 1% of people taking this medication. If you develop any of these side effects (or any other side effects not listed here) or they change in intensity, speak to your doctor or pharmacist for advice on managing them and on the risks and benefits of the medication.

  • bleeding after menopause
  • constipation
  • decreased sexual ability
  • dizziness or lightheadedness when getting up from a lying or sitting position
  • drowsiness
  • enlargement of breasts (men)
  • headache
  • increased sensitivity of skin to sunlight
  • irregular menstrual periods
  • loss of appetite
  • nausea and vomiting
  • signs and symptoms of high blood potassium levels (hyperkalemia)
    • confusion
    • irregular heartbeat
    • nervousness
    • numbness or tingling in hands, feet, or lips
    • shortness of breath or difficulty breathing
    • unusual tiredness or muscle weakness
    • weakness or heaviness of legs
  • stomach cramps and diarrhea
Click here to learn about serious side effects that can potentially occur with any medication. These examples are provided for information purposes only and are not meant to be exhaustive. Always consult your doctor for sound medical advice specific to your particular medication and treatment.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online or by phone at 1-800-332-1088.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Breast enlargement in men: Men may develop breast enlargement with the use of spironolactone. If this occurs, tell your doctor. In the great majority of cases, breast enlargement disappears once the medication is stopped.

Diabetes: Hydrochlorothiazide may make it more difficult for people with diabetes to control their blood sugar levels. If you have diabetes you should be cautious and monitor your blood sugar carefully while taking this medication. A dose adjustment of antidiabetic medications, including insulin, may be required.

Dizziness: Spironolactone - hydrochlorothiazide may cause dizziness or lightheadedness when moving from a lying or sitting to an upright position.

Gout: People with high levels of uric acid in their blood or a history of gout should use this medication with caution. Gout may be brought on by use of spironolactone - hydrochlorothiazide.

Kidney function impairment: If you have kidney function impairment you should be monitored closely by your doctor while taking this medication.

Liver function impairment: If you have liver function impairment you should be monitored closely by your doctor while taking this medication.

Possible association with cancer: There may be an increased risk of cancer with this medication. Unnecessary use of this medication should be avoided.

Potassium, magnesium, sodium, and chloride: This medication can cause potassium, magnesium, sodium, and chloride imbalances. You will need to have regular blood tests while you are taking this medication. Do not take potassium supplements (including dietary potassium) at the same time as spironolactone unless directed to do so by your doctor. Warning signs or symptoms of potassium, magnesium, sodium, or chloride imbalance include:

  • confusion
  • drowsiness
  • dry mouth
  • lethargy
  • low blood pressure
  • muscle pains or cramps
  • muscular fatigue
  • nausea and vomiting
  • racing heartbeat
  • restlessness
  • seizures
  • thirst
  • weakness

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking spironolactone, it may affect your baby. Talk to your doctor about whether you will need to stop taking spironolactone or stop breast-feeding.

Children: The safety and effectiveness of this medication have not been established for children.

What other drugs could interact with this medication?

There may be an interaction between spironolactone - hydrochlorothiazide and any of the following:

  • angiotensin-converting enzyme (ACE) inhibitors (e.g., captopril, enalapril, lisinopril, ramipril)
  • ACTH
  • alcohol
  • antidiabetes medications (e.g., insulin, glyburide)
  • barbiturates (e.g., phenobarbital)
  • cholestyramine
  • colestipol
  • corticosteroids (e.g., prednisone)
  • diazoxide
  • digoxin
  • furosemide
  • lithium
  • medications that increase potassium levels (such as potassium supplements, triamterene, amiloride, heparin, cyclosporine, and salt substitutes containing potassium)
  • muscle relaxants
  • narcotics (e.g., codeine, morphine)
  • nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, naproxen)
  • other medications that reduce blood pressure

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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The contents of this health site are for informational purposes only. Always seek the advice of your physician or other qualified healthcare provider regarding any questions you may have about a medical condition.

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