Classes
DEA Class; Rx
Common Brand Names; Aldactazide
- Thiazide Combos
Description
Combination oral diuretic product; potassium-sparing diuretic (aldosterone antagonist) and thiazide diuretic
For treatment of hypertension or edema (not initial treatment)
Useful for patients with hyperaldosteronism or hypokalemia
Indications
Indicated for the treatment of edema associated with cirrhosis of the liver, congestive heart failure, or the nephrotic syndrome.
For the treatment of essential hypertension.
For the treatment of chronic lung disease (CLD).
Contraindications
Hypersensitivity to spironolactone, hydrochlorothiazide, or sulfonamides
Acute renal failure
Acute/severe hepatic failure
Anuria
Hyperkalemia
Addison’s disease or other conditions associated with hyperkalemia
Coadministration with eplerenone
Adverse Effects
Spironolactone
- Drowsiness
- Lethargy
- Headache
- Stevens-Johnson Syndrome
- Rash
- Urticaria
- Gynecomastia
- Impotence
- Menstrual disorders
- Abdominal cramping
- Diarrhea
- Gastritis
- Nausea/vomiting
- Drug rash with eosinophilia and systemic symptoms (DRESS)
- Toxic epidermal necrolysis
Hydrochlorothiazide
- Anorexia
- Epigastric distress
- Hypotension
- Orthostatic hypotension
- Photosensitivity
- Anaphylaxis
- Anemia
- Confusion
- Erythema multiforme
- Stevens-Johnson syndrome
- Exfoliative dermatitis including toxic epidermal necrolysis
- Hypomagnesemia
- Dizziness
- Headache
- Hyperuricemia
Warnings
Somnolence and dizziness reported
Caution with hepatic impairment
Spironolactone
- May cause hyperkalemia; risk may be increased in patients with renal insufficiency, diabetes mellitus, or if coadministered with other drugs/diet that raise serum potassium levels
- Gynecomastia reported
Hydrochlorothiazide
- May cause hypokalemia and hyponatremia; risk of hypokalemia may be increased in patients with cirrhosis, brisk diuresis, or if coadministered with other drugs that lower serum potassium
- May cause hypomagnesemia, which can then result in hypokalemia which appears difficult to treat despite potassium repletion
- May alter glucose tolerance and increase risk for hyperglycemia
- May increase serum levels of calcium and uric acid by decreasing urinary excretion; may also increase cholesterol and triglycerides
- Thiazides diuretics may add to or potentiate the action of other antihypertensive drugs
- Sensitivity reactions to thiazides may occur in patients with or without a history of allergy or bronchial asthma
- Sulfonamide derivatives, including thiazides, have been reported to exacerbate or activate systemic lupus erythematosus
- Instruct patients to protect skin from sun and undergo regular skin cancer screening
Angle-closure glaucoma
Pregnancy and Lactation
Pregnancy Category: C
Lactation: discontinue drug or do not nurse
Maximum Dosage
200 mg/day PO spironolactone and 200 mg/day PO hydrochlorothiazide.
200 mg/day PO spironolactone and 200 mg/day PO hydrochlorothiazide.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Spironolactone/hydrochlorothiazide
tablet
- 25mg/25mg
- 50mg/50mg