spironolactone/hydrochlorothiazide

Spironolactone/hydrochlorothiazide is a combination medication used to treat high blood pressure (hypertension), heart failure, or extra fluid in the body (edema).

Spironolactone/hydrochlorothiazide is available under various brand names: Percodan, Endodan, Oxycodan

• 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
  • Hydrochlorothiazide can cause acute angle-closure glaucoma and elevated intraocular pressure with or without noticeable acute myopic shift and/or choroidal effusions
  • May occur within hours of initiating therapy; discontinue therapy immediately in patients with acute decreases in visual acuity or ocular pain
  • Additional medical or surgical treatments may be needed if intraocular pressure remains uncontrolled
  • Untreated angle-closure glaucoma may result in permanent visual field loss
  • Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy

Common side effects of spironolactone/hydrochlorothiazide include:

• drowsiness,
• dizziness,
• lack of energy,
• leg cramps,
• itching, and
• hair loss

Serious side effects of spironolactone/hydrochlorothiazide include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• fever,
• sore throat,
• burning in the eyes,
• skin pain,
• red or purple skin rash that spreads and causes blistering and peeling,
• skin rash,
• swollen glands,
• flu-like symptoms,
• muscle aches,
• severe weakness,
• unusual bruising,
• yellowing of the skin or eyes (jaundice),
• lightheadedness,
• sudden weakness,
• ill feeling,
• fever,
• chills,
• sore throat,
• mouth sores,
• easy bruising,
• unusual bleeding,
• purple or red pinpoint spots under the skin,
• eye pain,
• vision problems,
• breast swelling and tenderness,
• slow heart rate,
• weak pulse,
• muscle weakness,
• tingly feeling,
• confusion,
• uneven heart rate,
• extreme thirst,
• increased urination,
• leg discomfort,
• muscle weakness,
• limp feeling,
• headache,
• confusion,
• slurred speech,
• severe weakness,
• vomiting,
• loss of coordination, and
• feeling unsteady

Rare side effects of spironolactone/hydrochlorothiazide include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug.

Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Tablet

• 25 mg/25 mg
• 50 mg/50 mg

Edema, Ascites, Congestive Heart Failure

Adult dosage

• 1-8 tablets/day orally (spironolactone 25 mg/hydrochlorothiazide 25 mg)
• 1-4 tablets/day orally (spironolactone 50 mg/hydrochlorothiazide 50 mg)

Hypertension, Hypokalemia (Diuretic Induced)

Adult dosage

• 2-4 tablets/day orally (spironolactone 25 mg/hydrochlorothiazide 25 mg)
• 1-2 tablets/day orally (spironolactone 50 mg/hydrochlorothiazide 50 mg)

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first

• Spironolactone/hydrochlorothiazide has severe interactions with no other drugs.
• Spironolactone/hydrochlorothiazide has serious interactions with the following drugs:
  • amiloride
  • aminolevulinic acid oral
  • aminolevulinic acid topical
  • carbamazepine
  • cyclophosphamide
  • cyclosporine
  • dofetilide
  • drospirenone
  • eplerenone
  • isocarboxazid
  • lofexidine
  • methyl aminolevulinate
  • potassium acid phosphate
  • potassium chloride
  • potassium citrate
  • potassium phosphates, IV
  • squill
  • tretinoin
  • tretinoin topical
  • triamterene
• Spironolactone/hydrochlorothiazide has moderate interactions with at least 208 other drugs.
• Spironolactone/hydrochlorothiazide has minor interactions with at least 162 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. 

Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

Pregnancy & Lactation

• Use with caution if benefits outweigh risks during pregnancy

Lactation

• Discontinue drug or do not nurse