$Unique_ID{BRK02135}
$Pretitle{}
$Title{SPIRONOLACTONE AND HYDROCHLOROTHIAZIDE COMBINATION}
$Subject{Alazide (Major)
Aldactazide (Searle)
Spironazide (Henry Schein)
spironolactone and hydrochlorothiazide (various manufacturers)
Spirozide (Rugby)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


SPIRONOLACTONE AND HYDROCHLOROTHIAZIDE COMBINATION
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BRAND NAMES (Manufacturers):
     Alazide (Major)
     Aldactazide (Searle)
     Spironazide (Henry Schein)
     spironolactone and hydrochlorothiazide (various manufacturers)
     Spirozide (Rugby)
TYPE OF DRUG:
     Diuretic and antihypertensive
INGREDIENTS:
     spironolactone and hydrochlorothiazide
DOSAGE FORM:
     Tablets (25 mg spironolactone and 25 mg hydrochlorothiazide; 50 mg
       spironolactone and 50 mg hydrochlorothiazide)
STORAGE:
     Store at room temperature in a tightly closed, light-resistant container.

USES

     Spironolactone and hydrochlorothiazide combination is prescribed to treat
high blood pressure.  It is also used to reduce fluid acccumulation in the
body caused by conditions such as heart failure, cirrhosis of the liver,
kidney disease, and the long-term use of some medications.  This medication
reduces fluid accumulation by increasing the elimination of salt and water
through the kidneys.  Spironolactone is combined with hydro chlorothiazide to
prevent potassium loss from the body.

TREATMENT

     To decrease stomach irritation, you can take this medication with a glass
of milk or with a meal (unless your doctor directs you to do otherwise).  Try
to take it at the same time every day.  Avoid taking a dose after 6:00 P.M.;
otherwise, you may have to get up during the night to urinate.
     This medication does not cure high blood pressure, but it will help to
control the condition as long as you continue to take it.
     If you miss a dose of this medication, take the missed dose as soon as
possible, unless it is almost time for the next dose.  In that case, do not
take the missed dose at all; just wait until the next scheduled dose.  Do not
double the dose.

SIDE EFFECTS

     Minor.

     Constipation, cramping, diarrhea, dizziness, headache, increased
urination, loss of appetite, lack of energy, light-headedness, restlessness,
or unusual sweating.  These side effects should disappear as your body adjusts
to this medication.
     This medication can increase your sensitivity to sunlight.  You should,
therefore, avoid prolonged exposure to sunlight and sunlamps.  Wear protective
clothing, and use an effective sunscreen.
     To relieve constipation, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads) and exercise more
(unless your doctor directs you to do otherwise).
     To avoid dizziness or light-headedness when you stand, contract and relax
the muscles of your legs for a few moments before rising.  Do this by pushing
one foot against the floor while raising the other foot slightly, alternating
feet so that you are "pumping" your legs in a pedaling motion.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
anxiety; blurred vision; breast tenderness or enlargement (in both sexes);
clumsiness; confusion; deepening of the voice (in women); drowsiness; dry
mouth; impotence; increased hair growth; irregular menstrual periods or
vaginal bleeding; joint pain; mood changes; muscle cramps; nausea; numbness or
tingling in the hands, feet, or lips; palpitations; rapid weight gain (three
to five pounds within a week); rash; sore throat and fever; swelling; thirst;
unusual bleeding or bruising; unusual tiredness or weakness; vomiting; or
yellowing of the eyes or skin.

INTERACTIONS

     Spironolactone and hydrochlorothiazide combination interacts with several
foods and medications:
     1. Concurrent use of it with triamterene, amiloride, potassium salts,
low-salt milk, salt substitutes, captopril, or laxatives can cause serious
side effects from hyperkalemia (high levels of potassium in the blood).
     2. This drug may decrease the effectiveness of oral anticoagulants,
antigout medications, insulin, oral antidiabetic medicines, and methenamine.
     3. Fenfluramine may increase the blood-pressure-lowering effects of this
drug.
     4. Indomethacin and aspirin may decrease the blood-pressure-lowering
effects of this medication.
     5. Cholestyramine and colestipol can decrease the absorption of this
medication from the gastrointestinal tract.  Therefore, spironolactone and
hydrochlorothiazide combination should be taken one hour before or four hours
after a dose of cholestyramine or colestipol if either of these medications
has also been prescribed for you.
     6. Spironolactone and hydrochlorothiazide may increase the side effects
of amphotericin B, ammonium chloride, calcium, cortisone and cortisone-like
steroids (such as dexamethasone, hydrocortisone, prednisone, and
prednisolone), digoxin, digitoxin, digitalis, lithium, quinidine, sulfonamide
antibiotics, and vitamin D.
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any listed above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to spironolactone or hydrochlorothiazide or to any
other sulfa drug, including other diuretics (water pills), oral antidiabetic
medications, or sulfonamide antibiotics.
     * Before you start taking this medication, tell your doctor if you now
have or if you have ever had kidney disease or problems with urination,
diabetes mellitus, gout, liver disease, asthma, pancreas disease, systemic
lupus erythematosus, hyperkalemia, menstrual abnormalities, breast
enlargement, acidosis, or hypercalcemia.
     * This drug can occasionally cause potassium loss from the body.  Signs
of potassium loss include dry mouth, muscle pain or cramps, nausea, thirst,
vomiting, and weakness.  If you experience any of these symptoms, call your
doctor.
     * Spironolactone can cause hyperkalemia.  Signs of hyperkalemia include
anxiety; confusion; numbness or tingling in the hands, feet, or lips;
palpitations; or unusual tiredness or weakness.  Do not alter your diet in an
attempt to avoid this problem unless you first consult your doctor.  Elderly
patients may be more susceptible to hyperkalemia.
     * There are several "generic brands" of this drug.  Consult your
pharmacist about these items.  Some of them are not equivalent to the
brand-name medications.
     * Limit your intake of alcoholic beverages to prevent dizziness and
lightheadedness while taking this drug.
     * Do not take any over-the-counter (nonprescription) medication for
weight control or for allergy, asthma, cough, cold, or sinus problems unless
you first check with your doctor.
     * To prevent severe water loss (dehydration), check with your doctor if
you develop any illness that causes severe or continuous nausea, vomiting, or
diarrhea.
     * This medication can raise blood sugar levels in diabetic patients.
Blood sugar should be monitored carefully with blood or urine tests when this
drug is being taken.
     * A doctor does not usually prescribe a "fixed-dose" drug like this as
the first choice in the treatment of high blood pressure.  Usually, the
patient first receives each ingredient singly.  If there is an adequate
response to the fixed dose contained in this product, it can then be
substituted.  The advantages of a combination product are increased
convenience and (often) decreased cost.
     * Be sure to tell your doctor if you are pregnant.  This drug crosses the
placenta, and its safety in human pregnancy has not been established.  Adverse
effects have been observed in the fetuses of animals that were given large
doses of this drug during pregnancy.  Also, tell your doctor if you are
breast-feeding an infant.  Small amounts of this medication pass into breast
milk.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
