Compare Hydrochlorothiazide vs. Aldactone

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

Microzide
(Hydrochlorothiazide )

Aldactone
(Spironolactone)

Lowers blood pressure. Removes extra water from your body. Microzide (Hydrochlorothiazide (Hctz)) is a well-tolerated water pill that's often the first-choice treatment for mild high blood pressure.Removes extra water from your body. Aldactone (Spironolactone) is helpful when added to another diuretic to get rid of excess fluid in your body. Doesn't work well on its own.
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Reviews & ratings
Button Group. All currently active
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4.467153284671533Hydrochlorothiazide
Reviews for Microzide (Hydrochlorothiazide (Hctz))
47%
of people say Microzide (Hydrochlorothiazide (Hctz)) is worth it
31%
say it works well
15%
say it's a big hassle

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Side effects
HydrochlorothiazideAldactone

The Hydrochlorothiazide FDA package insert doesn’t have numbers about how common side effects are.

More about Hydrochlorothiazide side effects »

We haven’t found good data for Aldactone side effects.

FDA side effect reports for Aldactone »
How it works
HydrochlorothiazideAldactone
Microzide (Hydrochlorothiazide (Hctz)) is a thiazide diuretic (water pill). It works in the kidneys to make you urinate more, which removes extra water and certain electrolytes. This lowers blood pressure and swelling.Aldactone (Spironolactone) is a potassium-sparing diuretic that blocks aldosterone (a hormone) and helps the kidney get rid of excess fluids in your body.
Type of medication
HydrochlorothiazideAldactone
Antihypertensive
Diuretic
Prescription only
Antihypertensive
Diuretic
Prescription only
Available as
HydrochlorothiazideAldactone
  • Pill
  • Pill
Used for (click to learn more)
HydrochlorothiazideAldactone
Risk factors for serious side effects
HydrochlorothiazideAldactone
  • Current electrolyte imbalance
  • History of sulfa allergies
  • History of gout
  • Current kidney problems
    Detailed Microzide (Hydrochlorothiazide (Hctz)) risks & warnings »
      • Taking with alcohol
      • Taking other medicines that make you less alert
      • Current kidney problems
      • Medicine that increase potassium
      • Use of salt substitute
        Detailed Aldactone (Spironolactone) risks & warnings »
        Pregnancy category
        HydrochlorothiazideAldactone
        Alcohol
        No specific alcohol-related info.No specific alcohol-related info.
        Food
        No specific food-related info.No specific food-related info.
        Kidneys and liver
        • Doesn't work well in people with severe kidney problems.
        • Requires routine blood tests to check kidney function.
        • Needs to have blood tests done to monitor electrolyte levels and kidney function.
        • Aldactone (Spironolactone) can increase the amount of potassium in your body. High potassium can cause heart problems. Baseline and routine blood tests are needed to monitor your potassium and kidney function.
        Sex
        No specific sex-related info.
        • You can have breast pain/swelling, irregular periods (women), or trouble with sexual performance.
        Sleep
        No specific sleep-related info.No specific sleep-related info.
        Weight
        No specific weight-related info.No specific weight-related info.
        Upsides and benefits
        HydrochlorothiazideAldactone
        • Works well to get rid of extra fluids in your body through urination.
        • A first-choice blood pressure treatment for many people. Works especially well for African Americans.
        • Lowers the risk of heart attack and stroke.
        • Good option if you have both high blood pressure and heart failure.
        • Raises calcium levels in the body, so it can be good for people with osteoporosis to slow down bone loss and even help with new bone formation.
        • Most people have very few side effects.
        • Has a low risk of causing muscle problems due to low potassium levels in your blood.
        • More useful when taken with another diuretic that'll also help your body get rid of extra fluids.
        • Can lower blood pressure.
        • Reduces the risk of death in people with heart failure.
        Downsides and risks
        HydrochlorothiazideAldactone
        • Makes you urinate more often.
        • Doesn't work well in people with severe kidney problems.
        • Not very good at getting rid of excess fluids on its own. Should be used with another drug to help get rid of excess fluids.
        • Has many possible side effects, especially when higher doses are used.
        • Can increase the risk of tumor growth.
        • Needs to have blood tests done to monitor electrolyte levels and kidney function.
        Tips from our pharmacists for people taking the medication
        HydrochlorothiazideAldactone
        • Starts working in about 2 hours.
        • Makes you urinate more often, so avoid taking it at bedtime.
        • Can cause dizziness in the first few days.
        • Check your blood pressure 1 week after starting this medicine, and tell your doctor if it hasn't improved.
        • Tell your doctor about any dizziness, fatigue, or muscle weakness that doesn't go away.
        • Requires routine blood tests to check kidney function.
        • Can make you dizzy or cause trouble concentrating, so be careful using it until you know how the medicine affects you.
        • Don't use supplements or salt substitutes that are high in potassium.
        • You can have breast pain/swelling, irregular periods (women), or trouble with sexual performance.
        • Tell your doctor about any muscle weakness, skin changes, red or black tarry stool.
        • Can take 2 to 3 days to see full diuretic effects and 2 to 3 weeks to see blood pressure lowering effects.
        Learn more
        More about HydrochlorothiazideSide effectsReviews & ratingsAlternativesFDA package insert
        More about AldactoneSide effectsReviews & ratingsAlternativesFDA package insert