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Compare Hydrochlorothiazide vs. Spironolactone

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Hydrochlorothiazide (Microzide) and spironolactone (Aldactone) are both diuretics, but they work differently and have different uses. Hydrochlorothiazide is a thiazide diuretic that helps you get rid of extra fluid by making you urinate more, which lowers blood pressure and reduces swelling. Spironolactone, on the other hand, is a potassium-sparing diuretic that also blocks aldosterone, a hormone that affects sodium and potassium levels. This means spironolactone helps you lose extra fluid without lowering your potassium levels. Hydrochlorothiazide is typically used for high blood pressure and swelling, while spironolactone is used for heart failure, high blood pressure, and swelling due to liver or kidney problems. Spironolactone can also treat conditions with too much aldosterone. Both medications can cause you to urinate more often, but spironolactone has additional side effects like breast tenderness and lower sex drive in males. Hydrochlorothiazide can cause dizziness and make your skin more sensitive to sunlight. Both medications are available in generic forms, making them more affordable.

  • Hydrochlorothiazide
    Spironolactone (Aldactone)
  • Hydrochlorothiazide
    Spironolactone (Aldactone)

  • Summary of Hydrochlorothiazide vs. Spironolactone

    Summary for Diuretic (water pill)
    Prescription only

    Hydrochlorothiazide is a diuretic or water pill. It helps lower blood pressure. It also helps with swelling from fluid buildup (edema) caused by some health conditions, like heart failure and kidney problems. People of all ages can take hydrochlorothiazide tablets and capsules. But children typically take much smaller, weight-based doses. You typically take your dose by mouth once (sometimes twice) daily, but avoid nighttime dosing so you won't wake up to urinate. Some common side effects are dizziness and urinating more often.

    Summary for Potassium sparing diuretic
    Prescription only

    Spironolactone (Aldactone) is a type of potassium-sparing diuretic (water pill). It's used to treat heart failure, high blood pressure, and swelling from kidney or liver problems in adults. Because it blocks aldosterone (a hormone that affects sodium and potassium levels), spironolactone (Aldactone) can also treat conditions where there's too much aldosterone. Spironolactone (Aldactone) is taken by mouth, generally once or a few times a day, depending on your condition. Some common side effects of this medication include breast tenderness (males and females) and loss of libido (in males).

  • Indications of Hydrochlorothiazide vs. Spironolactone

    Indications for
    •High blood pressure
    •Swelling in the body from fluid buildup (edema)
    Indications for
    •Heart failure
    •High blood pressure
    •Swelling due to liver damage (cirrhosis)
    •Swelling due to nephrotic syndrome (a rare kidney condition) - tablets only
    •Primary aldosteronism (a hormone imbalance) - tablets only

  • Pros and Cons of Hydrochlorothiazide vs. Spironolactone

    Pros and Const for Diuretic (water pill)
    Pros
    •Helps getting rid of extra fluid in your body
    •A first-choice treatment option if you have high blood pressure or heart failure
    •Dose can be adjusted based on how well it's working for you
    Cons
    •Can make you urinate more often
    •Can cause electrolytes and fluid levels to be out of balance, which can be dangerous
    •Might not be a good option for people with a sulfa allergy
    Pros and Const for Potassium sparing diuretic
    Pros
    •Taken by mouth
    •Oral suspension available for adults who've difficulty swallowing tablets
    •Lower-cost generics available
    Cons
    •Can make you urinate more often
    •Need to get blood tests regularly to check your electrolytes and kidney health
    •Can cause breast growth and lower sex drive in males

  • Common Side Effects of Hydrochlorothiazide vs. Spironolactone

    Common Side Effects for
    •Dizziness
    •Weakness
    •Headache
    •Blurry vision
    •Low blood pressure
    •Change in electrolyte levels
    Common Side Effects for
    •Dizziness
    •Headache
    •Sleepiness
    •Nausea
    •Vomiting
    •Diarrhea
    •Stomach cramps
    •Enlargement of male breasts
    •Breast pain
    •Lower sex drive
    •Sexual dysfunction
    •Irregular or lack of menstrual periods
    •Leg cramps
    •Higher potassium levels
    •Lower sodium levels

  • Warnings of Hydrochlorothiazide vs. Spironolactone

    Common Side Effects for
    •Low fluid and electrolyte levels in the body
    •Possibly higher calcium levels
    •Higher blood sugar
    •Risk of gout
    •Risk of vision problems and glaucoma
    •Use with caution in people with kidney problems
    Common Side Effects for
    •High blood potassium levels
    •Low blood pressure and kidney problems
    •Abnormal electrolyte levels
    •Breast pain or swelling

  • Prices with our coupons for Hydrochlorothiazide vs. Spironolactone

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