Microplastics and Misinformation: What Science Really Says
November 12, 2025
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Brand Name :
Aldactazide
Synonyms :
spironolactone and hydrochlorothiazide
Class :
Potassium sparing diuretics with thiazides
Brand Name :
Aldactazide
Synonyms :
spironolactone and hydrochlorothiazide
Class :
Potassium sparing diuretics with thiazides
Dosage Forms & Strengths
spironolactone/hydrochlorothiazide
Tablet
50mg/50mg
25mg/25mg
Congestive Heart Failure (CHF)Â
Ascites, Edema:
1-4 tablets/day orally (hydrochlorothiazide 50 mg/ spironolactone 50 mg)
1-8 tablets/day orally (hydrochlorothiazide 25 mg/ spironolactone 25 mg)
1-2 tablets/day orally (hydrochlorothiazide 50 mg/ spironolactone 50 mg)
2-4 tablets/day orally (hydrochlorothiazide 25 mg/ spironolactone 25 mg)
Dose Adjustments
Renal Impairment
hydrochlorothiazide efficacy decreased when CrCL <30 mL/min
Hepatic Impairment
Contraindicated in Acute or severe hepatic failure
Congestive Heart Failure (CHF)Â
(Ascites, Edema) :
1-4 tablets/day orally (hydrochlorothiazide 50 mg/ spironolactone 50 mg)
1-8 tablets/day orally (hydrochlorothiazide 25 mg/ spironolactone 25 mg)
Hypokalemia (Diuretic Induced):
1-2 tablets/day orally (hydrochlorothiazide 50 mg/ spironolactone 50 mg)
2-4 tablets/day orally (hydrochlorothiazide 25 mg/ spironolactone 25 mg)
Dose Adjustments
dosing modifications
Renal Impairment
hydrochlorothiazide efficacy decreased when CrCL <30 mL/min
Hepatic Impairment
Contraindicated in Acute or severe hepatic failure
Safety and efficacy are not established
spironolactone dose of >25 mg/day should be avoided in heart failure and in patients with CrCl< 30 mL/min.
in older patients taking doses > 25 mg/day may have an increased risk of heart failure and hyperkalemia.
may increase the hyperkalemic effect of potassium salts
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may diminish the excretion when combined with lithium
may diminish the excretion when combined with lithium
may enhance the potassium levels in the blood when combined with sparsentan.
may have an increased hyperkalemic effect when combined with potassium-sparing diuretics
May enhance the toxic effects of the other by pharmacodynamic synergism
may decrease the absorption when combined with thiazide diuretics
may increase the sensitivity to pressor effects
may enhance the therapeutic efficacy of each other when used in combination
may enhance the therapeutic efficacy of each other when used in combination
may enhance the therapeutic efficacy of each other when used in combination
may enhance the therapeutic efficacy of each other when used in combination
may enhance the therapeutic efficacy of each other when used in combination
may diminish the therapeutic efficacy of each other when used in combination
may diminish the therapeutic efficacy of each other when used in combination
may diminish the therapeutic efficacy of each other when used in combination
may diminish the therapeutic efficacy of each other when used in combination
may diminish the therapeutic efficacy of each other when used in combination
may increase the hyperkalemic effect of ACE Inhibitors
may increase the hyperkalemic effect of ACE Inhibitors
may increase the hyperkalemic effect of ACE Inhibitors
may increase the hyperkalemic effect of ACE Inhibitors
may increase the hyperkalemic effect of ACE Inhibitors
it may enhance the risk of nephrotoxicity when combined with Diuretics
it may enhance the risk of nephrotoxicity when combined with Diuretics
it may enhance the risk of nephrotoxicity when combined with Diuretics
it may enhance the risk of nephrotoxicity when combined with Diuretics
it may enhance the risk of nephrotoxicity when combined with Diuretics
it may enhance the risk of nephrotoxicity when combined with Diuretics
it may enhance the risk of nephrotoxicity when combined with Diuretics
acetaminophen/dextromethorphan/pseudoephedrine/guaifenesin
it may enhance the risk of nephrotoxicity when combined with Diuretics
brompheniramine, dextromethorphan and phenylephrine
it may enhance the risk of nephrotoxicity when combined with Diuretics
it may enhance the risk of nephrotoxicity when combined with Diuretics
it may enhance the risk of nephrotoxicity when combined with Diuretics
it may enhance the risk of nephrotoxicity when combined with Diuretics
it may enhance the risk of nephrotoxicity when combined with Diuretics
it may enhance the risk of nephrotoxicity when combined with Diuretics
it may enhance the risk of nephrotoxicity when combined with Diuretics
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
antihypertensive actions of potassium-sparing diuretics can be reduced with combined NSAIDs
antihypertensive actions of potassium-sparing diuretics can be reduced with combined NSAIDs
antihypertensive actions of potassium-sparing diuretics can be reduced with combined NSAIDs
antihypertensive actions of potassium-sparing diuretics can be reduced with combined NSAIDs
antihypertensive actions of potassium-sparing diuretics can be reduced with combined NSAIDs
may have an increased nephrotoxic effect when combined with sodium phosphates
may have an increased nephrotoxic effect when combined with sodium phosphates
may have an increased nephrotoxic effect when combined with sodium phosphates
may have an increased nephrotoxic effect when combined with sodium phosphates
may have an increased nephrotoxic effect when combined with sodium phosphates
may increase the adverse/toxic effect of diuretics
may increase the adverse/toxic effect of diuretics
may increase the adverse/toxic effect of diuretics
may increase the adverse/toxic effect of diuretics
may increase the toxicity of the drug by decreasing the renal clearance
may increase the toxicity of the drug by decreasing the renal clearance
may increase the toxicity of the drug by decreasing the renal clearance
may increase the toxicity of the drug by decreasing the renal clearance
may increase the toxicity of the drug by decreasing the renal clearance
may have an increased hypercalcemic effect when combined with vitamin D analogs
may decrease the anti-hypertensive effect of nonsteroidal anti-inflammatory agents
may increase the hyperkalemic effect when combined with potassium-sparing diuretics
may have an increased hyperkalemic effect when combined with potassium-sparing diuretics
may increase the adverse/toxic effect of Opioid Agonists
drospirenone/ethinyl estradiol/levomefolateÂ
may increase the hyperkalemic effect of Drospirenone-Containing Products
buprenorphine,long-acting injectionÂ
may increase the adverse/toxic effect of Opioid Agonists
polyethylene glycol and electrolytesÂ
They may increase the nephrotoxic effect when combined with polyethylene Glycol-electrolyte Solution
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
it increases the concentration of thiazide and its diuretics in the serum
it increases the concentration of thiazide and its diuretics in the serum
it increases the concentration of thiazide and its diuretics in the serum
it increases the concentration of thiazide and its diuretics in the serum
it increases the concentration of thiazide and its diuretics in the serum
diacerein: they may increase the therapeutic effect when combined with diuretics
Angiotensin II Receptor Blockers: they may increase the hyperkalemic effect of potassium-sparing diuretics
Angiotensin II Receptor Blockers: they may increase the hyperkalemic effect of potassium-sparing diuretics
Angiotensin II Receptor Blockers: they may increase the hyperkalemic effect of potassium-sparing diuretics
Angiotensin II Receptor Blockers: they may increase the hyperkalemic effect of potassium-sparing diuretics
Angiotensin II Receptor Blockers: they may increase the hyperkalemic effect of potassium-sparing diuretics
may enhance the hyperkalemic effect
may enhance the hyperkalemic effect
may enhance the hyperkalemic effect
it may enhance the risk of nephrotoxicity when combined with Dopamine agonists
it may enhance the risk of nephrotoxicity when combined with Dopamine agonists
it may enhance the risk of nephrotoxicity when combined with Dopamine agonists
it may enhance the risk of nephrotoxicity when combined with Dopamine agonists
it may enhance the risk of nephrotoxicity when combined with Dopamine agonists
acetaminophen/dextromethorphan/pseudoephedrine/guaifenesin
It may enhance the risk of bleeding when combined with Decongestants
brompheniramine, dextromethorphan and phenylephrine
It may enhance the risk of bleeding when combined with Decongestants
It may enhance the risk of bleeding when combined with Decongestants
it increases the effect of hypokalemia of thiazide and other diuretics
mu-opioid receptor agonists: they may increase the toxic effect of diuretics
mu-opioid receptor agonists: they may increase the toxic effect of diuretics
It may enhance the risk of adverse reactions when combined with Potassium
may have an increased hyperkalemic effect when combined with potassium-sparing diuretics
may have an increased hyperkalemic effect when combined with potassium-sparing diuretics
may have an increased hyperkalemic effect when combined with potassium-sparing diuretics
may have an increased hyperkalemic effect when combined with potassium-sparing diuretics
may have an increased hyperkalemic effect when combined with potassium-sparing diuretics
may increase the hypokalemic effect when combined with diuretics
may increase the hypokalemic effect when combined with diuretics
may increase the hypokalemic effect when combined with diuretics
may increase the hypokalemic effect when combined with diuretics
may increase the hypokalemic effect when combined with diuretics
may diminish the excretion of thiazide diuretics
may diminish the excretion of thiazide diuretics
may diminish the excretion of thiazide diuretics
may diminish the excretion of thiazide diuretics
may diminish the excretion of thiazide diuretics
may increase the hypokalemic effect when combined with diuretics
may increase the hypokalemic effect when combined with diuretics
may increase the hypokalemic effect when combined with diuretics
may increase the hypokalemic effect when combined with diuretics
may have an increased orthostatic hypotensive effect when combined with thiazide diuretics
Actions and spectrum:
spironolactone and hydrochlorothiazide are both medications used to treat hypertension, but they work through different mechanisms of action. spironolactone is a potassium-sparing diuretic that acts by blocking the aldosterone receptor in the distal tubules of the kidney, resulting in increased excretion of sodium and water and decreased excretion of potassium.
It is also a weak anti-androgen and can be used to treat hirsutism and acne in women. hydrochlorothiazide is a thiazide diuretic that acts by inhibiting the reabsorption of chloride and sodium in the early distal tubules of the kidney, resulting in increased excretion of sodium, chloride, and water.
Frequency undefined:
Spironolactone
hydrochlorothiazide
Post marketing Reports
hydrochlorothiazide
Black Box Warning
There is no black box warning for spironolactone and hydrochlorothiazide combination therapy.
Contraindication/Caution
Contraindication
Caution
Comorbidities
spironolactone is a potassium-sparing diuretic that can increase serum potassium levels and should be used with caution in patients with renal impairment, hyperkalemia, Addison’s disease, and those taking medications that can also increase potassium levels, such as ACE inhibitors, angiotensin receptor blockers (ARBs), and potassium supplements. Spironolactone may also be contraindicated in patients with a history of hypersensitivity to the medication, anuria, and acute renal insufficiency.
hydrochlorothiazide is a thiazide diuretic that can cause electrolyte imbalances, including hyponatremia, hypokalemia, and hypomagnesemia, especially in patients with liver cirrhosis or heart failure. hydrochlorothiazide may be contraindicated in patients with a history of hypersensitivity to the medication, anuria, and severe renal impairment. In patients with a history of gout, it should be used with caution, with diabetes, hyperparathyroidism, and those taking medications that can increase serum potassium levels.
Pregnancy consideration: pregnancy category C
Lactation: do not use or discontinue drugÂ
Pregnancy category:
Pharmacology
spironolactone is a potassium-sparing diuretic that acts by antagonizing the aldosterone receptor in the distal convoluted tubule of the nephron, which leads to increased sodium and water excretion while retaining potassium. hydrochlorothiazide is a thiazide diuretic that acts on the proximal part of the distal convoluted tubule by inhibiting the sodium/chloride symporter, which leads to increased excretion of sodium, water, and potassium. The combination of spironolactone and hydrochlorothiazide results in an additive diuretic effect with minimal potassium loss to treat conditions such as hypertension and edema.
Pharmacodynamics
The combination of spironolactone and hydrochlorothiazide provides a dual mechanism of action that helps to treat hypertension and edema associated with congestive heart failure, cirrhosis of the liver, and nephrotic syndrome. The potassium-sparing effect of spironolactone helps to counteract the potassium-wasting effect of hydrochlorothiazide, which can lead to hypokalaemia.
pharmacokinetics
spironolactone and hydrochlorothiazide are both orally administered medications that are absorbed from the gastrointestinal tract. The absorption of spironolactone is slow, and it may take up to two hours to reach peak plasma concentrations. hydrochlorothiazide, on the other hand, is rapidly absorbed, with peak plasma concentrations occurring within one to two hours.
spironolactone undergoes extensive hepatic metabolism, with the primary metabolites being the active canrenone and its sulfate conjugate. The elimination half-life of spironolactone is approximately 1.4 hours, while that of canrenone is 16.5 hours. hydrochlorothiazide is eliminated primarily unchanged by the kidneys, with an elimination half-life of 6 to 15 hours.
Administration
spironolactone and hydrochlorothiazide are available in tablet form and are administered orally. The frequency and dosage of administration will depend on the condition being treated and individual patient factors.
It is important to take the medication as directed by a healthcare provider. The tablets should be taken whole with a glass of water with or without food.
Patient information leaflet
Generic Name: hydrochlorothiazide and spironolactone
Pronounced: (hye-dro-klor-oh-thy-a-zide-and-spir-on-oh-lak-tone)
Why do we use hydrochlorothiazide and spironolactone?
spironolactone and hydrochlorothiazide are a combination medication that is used to treat hypertension and edema (fluid retention) in patients who have liver cirrhosis, congestive heart failure, or nephrotic syndrome.
spironolactone works by blocking the hormone aldosterone, which is responsible for sodium and water retention in the body, while hydrochlorothiazide works by increasing urine output to eliminate excess fluid from the body. The combination of these medications can help to lower blood pressure and reduce edema.
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