Aldactazide (spironolactone / hydrochlorothiazide)

Aldactazide (spironolactone / hydrochlorothiazide)

Basics, Side Effects, Reviews & More

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Aldactazide (spironolactone / hydrochlorothiazide) is a 2-in-1 diuretic (water pill) used to treat a number of different problems including heart failure, high blood pressure, and swelling due to certain liver or kidney problems. It combines two diuretics into a single pill for convenience.




Aldosterone receptor antagonists / Diuretic (water pill) combo


Not a controlled medication


Lower-cost generic available


Prescription only

Reviewed by:

Dalga Surofchy, PharmD, APh

Christina Aungst, PharmD

Last reviewed on:

August 4, 2020

What is Aldactazide (spironolactone / hydrochlorothiazide) used for?

How Aldactazide (spironolactone / hydrochlorothiazide) works

Aldactazide (spironolactone / hydrochlorothiazide) is a combination medicine. Spironolactone, the first medication in the combination pill, is a potassium-sparing diuretic (water pill) that makes you urinate more without lowering the amount of potassium in your body. It works in your kidneys to remove extra water and sodium, which helps lower the amount of fluid in your blood vessels and other areas of your body.

The second medication in the combination pill, hydrochlorothiazide, is a thiazide diuretic (water pill) that makes you urinate more. It works in your kidneys to remove extra water and certain electrolytes (like sodium and potassium), which helps lower your blood pressure and decrease swelling throughout your body.

What is Aldactazide (spironolactone / hydrochlorothiazide) used for?

  • High blood pressure (not first choice)
  • Swelling due to liver damage (cirrhosis), nephrotic syndrome (a rare kidney condition), or congestive heart failure

Dosage forms

Typical dosing

For swelling due to liver damage (cirrhosis), nephrotic syndrome (a rare kidney condition), or congestive heart failure: The typical dose is 100 mg/100 mg (spironolactone/hydrochlorothiazide) by mouth per day. This can be given as a single dose once a day or split into smaller doses and be given twice a day.

For high blood pressure: The typical dose is 50 mg/50 mg to 100 mg/100 mg (spironolactone/hydrochlorothiazide) by mouth per day. This can be given as a single dose once a day or split into smaller doses and be given twice a day.

Frequently asked questions about Aldactazide (spironolactone / hydrochlorothiazide)

Pros and cons of Aldactazide (spironolactone / hydrochlorothiazide)


Thumbs UpEasier to take one combination pill instead of two separate pills

Thumbs UpGood choice if you have both high blood pressure and heart or liver failure

Thumbs UpReduces the risk of death in people with heart failure

Thumbs UpHelpful for people who tend to accumulate fluid in their arms, legs, or stomach

Thumbs UpCan be taken with or without food


Thumbs DownA bit pricey without insurance - cheaper to get spironolactone and hydrochlorothiazide as separate prescriptions

Thumbs DownHas many possible side effects, especially at higher doses

Thumbs DownCan make you urinate more often

Thumbs DownRequires regular blood tests to check your electrolytes and kidney health

Thumbs DownBreast growth in men is a common side effect, especially at higher doses.

Thumbs DownHas multiple drug interactions with both prescription and over-the-counter medications

Thumbs DownCannot be taken if you have severe kidney problems, liver failure, electrolyte imbalances, or Addison's disease

Thumbs DownNot safe to use if you're pregnant or breastfeeding

Thumbs DownIf you have lupus, the hydrochlorothiazide in this medication can worsen your lupus or cause flares.

Pharmacist tips for Aldactazide (spironolactone / hydrochlorothiazide)

Capsule IconAldactazide (spironolactone / hydrochlorothiazide) can make you urinate more often, so try to take the medication in the morning or afternoon.

Capsule IconLike many blood pressure medications, Aldactazide (spironolactone / hydrochlorothiazide) can cause dizziness the first few days you are taking it because your body is not used to having lower blood pressure. Be careful when getting up from a lying down or seated position so you don't get too dizzy or fall.

Capsule IconAvoid any task (eg. driving or operating other machinery) that requires you to be alert until you know how you will respond to Aldactazide (spironolactone / hydrochlorothiazide). Side effects like dizziness and fainting are more common when you first start this medication or right after your dose is changed. Most people find these side effects get better or go away within 1 to 2 weeks after starting Aldactazide (spironolactone / hydrochlorothiazide).

Capsule IconAldactazide (spironolactone / hydrochlorothiazide) makes your skin more sensitive to the sun and can cause you to sunburn more easily. This is also possible on overcast days and during the winter, so be sure to wear a hat and use a sunscreen with an SPF of at least 30 when you go outside.

Capsule IconAvoid using potassium supplements or salt substitutes that contain potassium while taking Aldactazide (spironolactone / hydrochlorothiazide) unless your healthcare provider or dietitian tell you to do so. This can cause high levels of potassium in your blood which can cause heart problems.

Capsule IconIf any side effects (such as leg cramps, diarrhea, breast growth in men) become excessive or bothersome, please let your healthcare provider know. Together, you and your provider can decide if staying on Aldactazide (spironolactone / hydrochlorothiazide) is the best option to treat your condition.

Capsule IconIt is very important to keep up with any regular blood tests your healthcare provider asks you to have done. This helps to makes sure Aldactazide (spironolactone / hydrochlorothiazide) isn't causing problems with your electrolytes or kidneys.

Prices for Aldactazide (spironolactone / hydrochlorothiazide) start at just $39.98 with a GoodRx coupon. They’re fast, easy-to-use and free!

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What are the side effects of Aldactazide (spironolactone / hydrochlorothiazide)?

With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.

Warning Small Contact your doctor immediately if you experience any of the following:

  • Stevens-Johnson Syndrome and toxic epidermal necrolysis (rare, but life-threatening skin disorders)
  • High levels of potassium in the blood
  • Kidney failure
  • Severe allergic reactions

Caution Small The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time.

Common side effects

  • Enlargement of a man's breasts
  • Dizziness
  • Low blood pressure
  • Sensitivity to the sun

Other side effects

  • Difficulty getting or maintaining an erection
  • Low sex drive
  • Irregular or no menstrual periods
  • Leg cramps
  • Tiredness
  • Changes to electrolytes (sodium, magnesium, calcium)
  • Headache
  • Diarrhea
  • Nausea/vomiting

Source: DailyMed

The following side effects have also been reported:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

Abdominal or stomach cramping, burning, or tenderness

back or leg pains

blistering, peeling, or loosening of the skin

bloody or black, tarry stools

bloody or cloudy urine

blue lips and fingernails

blurred vision

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

chest pain

clay-colored stools

clear or bloody discharge from the nipple


cough or hoarseness

dark urine

decreased appetite


difficult, fast, or noisy breathing

difficulty with swallowing

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

fast or irregular heartbeat

fever with or without chills

flushed, dry skin

fruit-like breath odor

general body swelling

general feeling of discomfort or illness

greatly decreased frequency of urination or amount of urine

hives or welts, skin rash

increased hunger

increased thirst

inverted nipple

joint pain, stiffness, or swelling

lower back or side pain

lump in the breast or under the arm

muscle cramps or pain

nausea and vomiting

numbness, tingling, pain, or weakness in the hands, feet, or lips

painful or difficult urination

pains in the stomach, side, or abdomen, possibly radiating to the back

pinpoint red or purple spots on the skin

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

red, irritated eyes

redness or swelling of the breast

redness, soreness, or itching skin


sore on the skin of the breast that does not heal

sores, ulcers, or white spots on the lips or in the mouth

swelling of the face, hands, fingers, feet, or lower legs

swollen, painful, or tender lymph glands in the neck, armpit, or groin

tightness in the chest


troubled breathing

unusual bleeding or bruising

unusual tiredness or weakness

yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Difficulty with sleeping


drowsiness to profound coma




mood or other mental changes

rash with flat lesions or small raised lesions on the skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Absent, missed, or irregular menstrual periods

bleeding after menopause

burning feeling in the chest or stomach

discoloration of the skin

feeling of constant movement of self or surroundings

inability to have or keep an erection

increased sensitivity of the skin to sunlight

muscle spasm


sensation of spinning

severe sunburn

stomach upset

stopping of menstrual bleeding

swelling of the breasts or breast soreness in both females and males

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

What are the risks and warnings for Aldactazide (spironolactone / hydrochlorothiazide)?

Aldactazide (spironolactone / hydrochlorothiazide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options


  • Risk factors: Current kidney problems | Diabetes | Taking other medications that increase potassium | Use of potassium-based salt substitutes

Aldactazide (spironolactone / hydrochlorothiazide) can increase the amount of potassium in your body. Kidney problems, diabetes, certain medications, and the use of potassium-based salt sustitutes raise your risk of this happening. High potassium can cause heart problems, such as a heart attack. Your healthcare provider will be checking your potassium level before you start Aldactazide (spironolactone / hydrochlorothiazide) and regularly after starting to make sure it is safe to keep taking it.


  • Risk factors: History of kidney problems

In some rare cases, Aldactazide (spironolactone / hydrochlorothiazide) can cause or worsen kidney problems. You'll need blood tests done to check your kidney health before starting Aldactazide (spironolactone / hydrochlorothiazide) and regularly afterwards.


Aldactazide (spironolactone / hydrochlorothiazide) can lower sodium, calcium, and magnesium in your blood. These electrolytes are important for many bodily functions. When they are too low, you can experience muscle cramps, fainting, irregular heart beats, or even seizures. Your healthcare provider will be checking these electrolytes before you start Aldactazide (spironolactone / hydrochlorothiazide) and regularly after starting to make sure it is safe to keep taking it.


  • Risk factors: Taking high doses of Aldactazide (spironolactone / hydrochlorothiazide)

The spironolactone in Aldactazide (spironolactone / hydrochlorothiazide) can cause breast pain or swelling, especially with higher doses of the medication. This is more common and noticeable for males. Some people have this side effect it within 1 to 2 months of starting Aldactazide (spironolactone / hydrochlorothiazide), while others may not experience it until they've been on the medication for a year. It usually goes away when you stop taking Aldactazide (spironolactone / hydrochlorothiazide). If this side effect is excessive or bothers you, talk to your healthcare provider about other options to treat your condition.


  • Risk factors: History of sulfa or penicillin allergies

Vision changes and/or eye pain can occur within hours to weeks of starting Aldactazide (spironolactone / hydrochlorothiazide) because of the hydrochlorothiazide. Tell your healthcare provider if you experience any vision changes or eye pain and stop the medication right away. This can lead to permanent blindness if not treated immediately.


  • Risk factors: History of gout | Family history of gout | Existing kidney problems

Aldactazide (spironolactone / hydrochlorothiazide) can increase uric acid in your body and cause or worsen gout. If you've had gout attacks before or you have problems with your kidneys, your risk is higher. Talk to your healthcare provider right away is you notice any of your joints become swollen, red, and painful.

Interactions between Aldactazide (spironolactone / hydrochlorothiazide) and other medications

Aldactazide (spironolactone / hydrochlorothiazide) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Aldactazide (spironolactone / hydrochlorothiazide). Please note that only the generic name of each medication is listed below.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

How much does Aldactazide (spironolactone / hydrochlorothiazide) cost?

Aldactazide (spironolactone / hydrochlorothiazide) is available as a generic medication and may be significantly cheaper compared to the brand version. Unless there is a specific reason you need the brand, the generic medication will be a better value. For even more savings, use a GoodRx coupon and pay just a fraction of the retail price.

Lowest GoodRx Price
Aldactazide (brand)


Lowest GoodRx Price
spironolactone/hydrochlorothiazide (generic)


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Pricing based on most commonly-filled versions: 30 tablets of spironolactone / HCTZ 25mg/25mg

What are alternatives to Aldactazide (spironolactone / hydrochlorothiazide)?

There are a number of medications that your doctor can prescribe in place of Aldactazide (spironolactone / hydrochlorothiazide). Compare a few possible alternatives below.

Aldactazide (spironolactone / hydrochlorothiazide)
Drug Class:Aldosterone receptor antagonists / Diuretic (water pill) combo


lowest GoodRx price

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Dyazide (hydrochlorothiazide / triamterene)
Drug Class:Diuretic (water pill)


lowest GoodRx price

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lowest GoodRx price

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