Spironolactone and hydrochlorothiazide (patient information)

IMPORTANT WARNING:
Spironolactone has caused tumors in laboratory animals. Talk to your doctor about the risks and benefits of using this medicine for your condition.

Why is this medication prescribed
The combination of spironolactone and hydrochlorothiazide, a 'water pill,' is used to treat high blood pressure and fluid retention caused by various conditions, including heart disease. It causes the kidneys to eliminate unneeded water and salt from the body into the urine.

This medicine is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used
The combination of spironolactone and hydrochlorothiazide comes as a tablet to take by mouth. It usually is taken once a day in the morning with food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take spironolactone and hydrochlorothiazide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

This medication controls high blood pressure but does not cure it. Continue to take spironolactone and hydrochlorothiazide even if you feel well. Do not stop taking spironolactone and hydrochlorothiazide without talking to your doctor.

What special precautions should I follow
Before taking spironolactone and hydrochlorothiazide:


 * tell your doctor and pharmacist if you are allergic to spironolactone, hydrochlorothiazide, sulfa drugs, or any other drugs.
 * tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially aspirin; captopril (Capoten); digoxin (Lanoxin); enalapril (Vasotec); lisinopril (Prinivil, Zestril); lithium (Eskalith, Lithobid); medications for arthritis, diabetes, or high blood pressure; potassium supplements; and vitamins. Do not take this medicine if you are taking amiloride or triamterene.
 * tell your doctor if you have or have ever had diabetes, gout, or kidney or liver disease.
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking spironolactone and hydrochlorothiazide, call your doctor.
 * if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking spironolactone and hydrochlorothiazide.
 * you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
 * remember that alcohol can add to the drowsiness caused by this drug.

What special dietary instructions should I follow
Follow your doctor's directions for a low-salt or low-sodium diet and daily exercise program. Avoid potassium-containing salt substitutes. Limit your intake of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice). Ask your doctor for advice on how much of these foods you may have.

What should I do if I forget a dose? Return to top Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Mild side effects
''Spironolactone and hydrochlorothiazide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:''


 * upset stomach
 * vomiting
 * diarrhea
 * loss of appetite
 * stomach pain
 * gas
 * frequent urination
 * dizziness
 * headache
 * enlarged or painful breasts
 * irregular menstrual periods
 * drowsiness

Severe side effects
If you experience any of the following symptoms, call your doctor immediately:


 * muscle weakness or cramps
 * rapid, excessive weight loss
 * fatigue
 * slow or irregular heartbeat
 * sore throat
 * unusual bruising or bleeding
 * yellowing of the skin or eyes
 * skin rash
 * vomiting blood
 * fever
 * confusion

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 [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine
Keep this medicine in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medicine that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medicine.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know
Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly, and blood tests should be done occasionally.

Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

 * Aldactazide®
 * Spironazide®
 * Spirozide®