SPIRONOLACTONE & HYDROCHLOROTHIAZIDE

Brand & Generic Names

Aldactazide
Novospirozine
Spirozide

Basic Information

• Habit forming? Yes
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Antihypertensive, diuretic (thiazide)

Uses

• Controls, but doesn't cure, high blood pressure.
• Reduces fluid retention (edema).

Dosage & Usage Information

How to take:
Tablet--Swallow with liquid. If you can't swallow whole, crumble tablet and take with liquid or food.

When to take:
1 dose a day--Take after breakfast.
More than 1 dose a day--Take last dose no later than 6 p.m.

If you forget a dose:
1 dose a day--Take as soon as you remember up to 12 hours late. If more than 12 hours, wait for next scheduled dose (don't double this dose).
More than 1 dose a day--Take as soon as you remember. Wait 6 hours for next dose.

What drug does:
Increases sodium and water excretion through increased urine production.
Retains potassium.
Relaxes muscle cells of small arteries.
Reduced body fluid and relaxed arteries lower blood pressure.

Time lapse before drug works:
4 to 6 hours. May require several weeks to lower blood pressure.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Thirst, drowsiness, confusion, fatigue, weakness, nausea, vomiting, cramps, irregular heartbeat, weak pulse, excessive blood pressure drop, coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Irregular heartbeat, Discontinue. Seek weak pulse, shortness emergency treatment. of breath.

Common:

Drowsiness, headache, thirst, abdominal cramping, muscle cramps.

Infrequent:

• Blurred vision, abdominal pain, nausea, vomiting, constipation, breast tenderness.
• Dizziness, mood change, headache, dry mouth, menstrual irregularities, diminished sex drive, increased sweating, weakness, tiredness, weight gain or loss, confusion, numbness or tingling in hands or feet, diarrhea.

Rare:

• Sore throat, fever, rash, jaundice.
• Excess growth of hair, deep voice in women, enlarged clitoris in women.

Warnings & Precautions

Don't take if:
You are allergic to any thiazide diuretic drug.

Before you start, consult your doctor:

• If you are allergic to any sulfa* drug.
• If you have gout, liver, pancreas or kidney disorder.
• If you have had kidney or liver disease.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:

• Adverse reactions and side effects may be more frequent and severe than in younger persons, especially dizziness and excessive potassium loss.
• Limit use to 2 to 3 weeks if possible.
• Heat or fever can reduce blood pressure. May require dose adjustment.
• Overdose and extended use may cause blood clots.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine.

Infants & children:
Use only under medical supervision.

Prolonged use:

• You may need medicine to treat high blood pressure for the rest of your life.
• Potassium retention with irregular heartbeat, unusual weakness and confusion.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check blood pressure, kidney function, ECG* and serum electrolytes.

Skin & sunlight:
May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes.

Discontinuing:

• Don't discontinue without medical advice.
• Consult doctor about adjusting doses of other drugs.

Others:

• Hot weather and fever may cause dehydration and drop in blood pressure. Dose may require temporary adjustment. Weigh daily and report any unexpected weight decreases to your doctor.
• May cause rise in uric acid, leading to gout.
• May cause blood sugar rise in diabetics.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
ACE inhibitors*:	Possible excessive
captopril, enalapril,	potassium in blood.
Allopurinol	Decreased allopurinol effect.
Anticoagulants*,	Decreased anticoagulant effect.
Antidepressants,	Dangerous drop in blood pressure.
tricyclic (TCA)*	Avoid combination unless under
	medical supervision.
Antidiabetics*,	Increased blood sugar.
Antihypertensives*,	Increased antihypertensive effect.
Aspirin	Decreased spironolactone effect.
Barbiturates*	Increased hydrochlorothiazide
	effect.
Carteolol	Increased antihypertensive effect.
Cholestyramine	Decreased hydrochlorothiazide
	effect.
Cortisone drugs*	Excessive potassium loss that
	causes dangerous heart rhythms.
Cyclosporine	Possible excessive potassium in
	blood.
Diuretics*, other	Increased effect of both drugs.
	Beneficial if needed and dose is
	correct.
Indapamide	Increased diuretic effect.
Indomethacin	Decreased hydrochlorothiazide
	effect.
Laxatives*	Reduced potassium levels.
Lithium	Increased effect of lithium. Likely
	lithium toxicity.
MAO inhibitors*	Increased hydrochlorothiazide
	effect.
Nicardipine	Blood pressure drop. Dosages may
	require adjustment.
Nimodipine	Dangerous blood pressure drop.
Nitrates*	Excessive blood pressure drop.
Opiates*	Weakness and faintness when arising
	from bed or chair.
Potassium	Decreased potassium effect. Dangerous
supplements*	potassium retention, causing
	possible heartbeat irregularity.
Potassium iodide	May raise potassium level in blood
	to toxic levels.
Probenecid	Decreased probenecid effect.
Salicylates*	May decrease spironolactone effect.
Sodium bicarbonate	Reduces high potassium levels.
Sotalol	Decreased antihypertensive effect.
Terazosin	Decreases effectiveness of
	terazosin.
Triamterene	Dangerous potassium retention.
Zinc supplements	Increased need for zinc.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Dangerous blood pressure drop.
Low-salt milk.	Possible potassium toxicity.
Cocaine:	Decreased spironolactone effect.
Salt.	Don't restrict unless directed by
	doctor.
Salt substitutes.	Possible potassium toxicity.
Marijuana:	May increase blood pressure.
	Increased thirst, fainting.
Tobacco:	None expected.