Hydrochlorothiazide Spironolactone

Hydrochlorothiazide Spironolactone Brand Name– Aldactazide

What is Hydrochlorothiazide Spironolactone

Hydrochlorothiazide Spironolactone are diuretics used together to treat hypertension or edema associated with congestive heart failure, cirrhosis, or the nephrotic syndrome.

The two diuretics have complementary mechanisms of action; hydrochlorothiazide promotes sodium and water excretion primarily by inhibiting their reabsorption in the renal cortical diluting segment, whereas spironolactone is an aldosterone antagonist at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted renal tubule.

The drug combination is not indicated for the initial treatment of hypertension or edematous conditions.

Hydrochlorothiazide spironolactone may be appropriate for some patients, such as those with hyperaldosteronism or hypokalemia, if the titrated dose of each drug component represents the combination product doses.

The risk of primary cardiac arrest after adjustment for potential confounding factors was lower for patients with hypertension that received a thiazide and a potassium-sparing diuretic than for patients that received only a thiazide diuretic. In contrast, addition of potassium supplements to a thiazide diuretic was not associated with a lower risk.

The National Council on Potassium in Clinical Practice recommends the use of a low-dose diuretic combined with a drug with potential for sparing potassium, such as a potassium-sparing diuretic for patients that need diuretic therapy.

The Joint National Committee for Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) recommends increased potassium intake and drugs to increase potassium for the treatment of hypertension.

Diuretics have been shown to reduce hypertension-related morbidity and mortality. The combination tablets contain hydrochlorothiazide and spironolactone in the recommended dose range for hypertension of 12.5—50 mg daily and 25—50 mg daily, respectively.

Hydrochlorothiazide, spironolactone (Aldactazide®) was approved by the FDA in December 1982.

Indications

1. chronic lung disease (CLD)
2. edema
3. hypertension

For the treatment of edema associated with cirrhosis of the liver, congestive heart failure, or the nephrotic syndrome

Side Effects

1. abdominal pain
2. agranulocytosis
3. alopecia
4. amenorrhea
5. anaphylactoid reactions
6. anorexia
7. aplastic anemia
8. ataxia
9. azotemia
10. blurred vision
11. cholestasis
12. confusion
13. constipation
14. diarrhea
15. dizziness
16. drowsiness
17. erythema
18. erythema multiforme
19. fever
20. gastritis
21. glycosuria
22. gout
23. gynecomastia
24. headache
25. hemolysis
26. hemolytic anemia
27. hepatic failure
28. hypercalcemia
29. hypercholesterolemia
30. hyperglycemia
31. hyperkalemia
32. hypertriglyceridemia
33. hyperuricemia
34. hypomagnesemia
35. hyponatremia
36. hypovolemia
37. impotence (erectile dysfunction)
38. infertility
39. interstitial nephritis
40. jaundice
41. lethargy
42. leukopenia
43. libido decrease
44. lupus-like symptoms
45. maculopapular rash
46. mastalgia
47. menstrual irregularity
48. muscle cramps
49. myopia
50. nausea
51. new primary malignancy
52. ocular hypertension
53. pancreatitis
54. paresthesias
55. photosensitivity
56. polyuria
57. postmenopausal bleeding
58. pruritus
59. rash
60. renal failure (unspecified)
61. restlessness
62. sialadenitis
63. Stevens-Johnson syndrome
64. thrombocytopenia
65. toxic epidermal necrolysis
66. tumorigenicity
67. urticaria
68. vasculitis
69. vertigo
70. vomiting
71. weakness
72. xanthopsia

Monitoring Parameters

• blood glucose
• blood pressure
• ECG
• serum calcium
• serum creatinine/BUN
• serum electrolytes
• serum magnesium
• serum uric acid

Contraindications

• adrenal insufficiency
• anuria
• asthma
• breast-feeding
• children
• diabetes mellitus
• driving or operating machinery
• electrolyte imbalance
• geriatric
• gout
• hepatic disease
• hypercalcemia
• hypercholesterolemia
• hyperkalemia
• hyperparathyroidism
• hypertriglyceridemia
• hyperuricemia
• hypomagnesemia
• hyponatremia
• hypotension
• hypovolemia
• infertility
• menstrual irregularity
• new primary malignancy
• orthostatic hypotension
• penicillin hypersensitivity
• preeclampsia
• pregnancy
• prostate cancer
• renal failure
• renal impairment
• sulfonamide hypersensitivity
• sunlight (UV) exposure
• sympathectomy
• syncope
• systemic lupus erythematosus (SLE)
• thiazide diuretic hypersensitivity
• tumorigenicity
• water intoxication

Interactions

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