Pronunciation:

(hye droe klor oh THYE a zide & speer on oh LAK tone)

U.S. Brand Names:

Synonyms:

Generic Available:

Canadian Brand Names:

Use:

Pregnancy Risk Factor:

Pregnancy Implications:

Lactation:

Contraindications:

Warnings/Precautions:

Based on hydrochlorothiazide component: Avoid in severe renal disease (ineffective). Electrolyte disturbances (hypokalemia, hypochloremic alkalosis, hyponatremia) can occur. Use with caution in severe hepatic dysfunction; hepatic encephalopathy can be caused by electrolyte disturbances. Gout can be precipitate in certain patients with a history of gout, a familial predisposition to gout, or chronic renal failure. Cautious use in diabetics; may see a change in glucose control. Hypersensitivity reactions can occur. Can cause SLE exacerbation or activation. Use with caution in patients with moderate or high cholesterol concentrations. Photosensitization may occur. Correct hypokalemia before initiating therapy.

Chemical similarities are present among sulfonamides, sulfonylureas, carbonic anhydrase inhibitors, thiazides, and loop diuretics (except ethacrynic acid). Use in patients with sulfonamide allergy is specifically contraindicated in product labeling, however, a risk of cross-reaction exists in patients with allergy to any of these compounds; avoid use when previous reaction has been severe.

Based on spironolactone component: Avoid potassium supplements, potassium-containing salt substitutes, a diet rich in potassium, or other drugs that can cause hyperkalemia. Monitor for fluid and electrolyte imbalances. Gynecomastia is related to dose and duration of therapy. Diuretic therapy should be carefully used in severe hepatic dysfunction; electrolyte and fluid shifts can cause or exacerbate encephalopathy.

Adverse Reactions:

Drug Interactions:

Ethanol/Nutrition/Herb Interactions:

Food: Avoid food with high potassium content and potassium-containing salt substitutes.

Herb/Nutraceutical: Avoid natural licorice (causes sodium and water retention and increases potassium loss).

Pharmacodynamics/Kinetics:

Dosage:

Children: 1.66-3.3 mg/kg/day (of spironolactone) in 2-4 divided doses

Adults:

Hydrochlorothiazide 25 mg and spironolactone 25 mg: ¹/2-8 tablets daily

Hydrochlorothiazide 50 mg and spironolactone 50 mg: ¹/2-4 tablets daily in 1-2 doses

Patient Education:

Nursing Implications:

Cardiovascular Considerations:

Dental Health: Effects on Dental Treatment:

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

Mental Health: Effects on Mental Status:

Mental Health: Effects on Psychiatric Treatment:

Dosage Forms:

Aldactazide®:

25/25: Hydrochlorothiazide 25 mg and spironolactone 25 mg

50/50: Hydrochlorothiazide 50 mg and spironolactone 50 mg

International Brand Names: