Drug interactions
Hydrochlorothiazide + Spironolactone
Severity: Moderate
Hydrochlorothiazide and Spironolactone: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
The combination is commonly used for additive diuresis and potassium balance. Hyperkalemia or, less often, hyponatremia and volume depletion can occur, especially with renal impairment or other potassium-raising drugs.
What this interaction means in plain words
Hydrochlorothiazide and Spironolactone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Hydrochlorothiazide belongs to Cardiovascular; Spironolactone belongs to Cardiovascular.
Why it happens
Spironolactone antagonizes aldosterone and reduces potassium loss, while hydrochlorothiazide inhibits sodium reabsorption in the distal tubule; effects on sodium and volume are additive.
What to do
Monitor potassium, sodium and creatinine at the start and periodically. Avoid concurrent potassium supplements and review ACE inhibitor or ARB use.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Hydrochlorothiazide
Other interactions of Spironolactone
- Amiloride + Spironolactone Contraindicated
- Eplerenone + Spironolactone Contraindicated
- Spironolactone + Triamterene Contraindicated
- Abiraterone + Spironolactone Major
- Aceclofenac + Spironolactone Major
- Acemetacin + Spironolactone Major
Frequently asked questions
Can I take Hydrochlorothiazide with Spironolactone?
MediHelp rates the interaction as moderate. Hydrochlorothiazide and Spironolactone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. The combination is commonly used for additive diuresis and potassium balance. Hyperkalemia or, less often, hyponatremia and volume depletion can occur, especially with renal impairment or other potassium-raising drugs.
How serious is the interaction between Hydrochlorothiazide and Spironolactone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor potassium, sodium and creatinine at the start and periodically. Avoid concurrent potassium supplements and review ACE inhibitor or ARB use.
What other medicines interact with Hydrochlorothiazide?
MediHelp also lists interactions of Hydrochlorothiazide with, for example, Dofetilide, Amifostine, Amiodarone. The full list is on the Hydrochlorothiazide page.
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