Compare hydrochlorothiazide vs. spironolactone

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

Microzide
(hydrochlorothiazide )

Aldactone
(spironolactone)

Removes water from the body, which lowers blood pressure. 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) should be used with other medicines to get rid of excess fluid in your body, especially if you have heart failure.
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Reviews & ratings
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4.48hydrochlorothiazide
Reviews for Microzide (hydrochlorothiazide )
47%
of people (All ages) say Microzide (hydrochlorothiazide ) is worth it
31%
say it works well
16%
say it's a big hassle
139 reviews
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Have you used Aldactone (spironolactone)?
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Side effects
hydrochlorothiazidespironolactone

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

More about hydrochlorothiazide side effects »

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

More about spironolactone side effects »
How it works
hydrochlorothiazidespironolactone
Microzide (hydrochlorothiazide (HCTZ)) is a thiazide diuretic (water pill) that makes you urinate more. It works in the kidneys to remove extra water and certain electrolytes, while lowering blood pressure and reducing 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
hydrochlorothiazidespironolactone
Prescription only
Prescription only
Available as
hydrochlorothiazidespironolactone
  • Pill
  • Pill
Used for
hydrochlorothiazidespironolactone
Risk factors for serious side effects
hydrochlorothiazidespironolactone
  • Current electrolyte imbalance
  • Lower kidney function
  • Dehydration
  • History of sulfa allergies
  • History of gout
  • Current kidney problems
  • History of sulfa or penicillin allergies
  • Diabetes
Detailed Microzide (hydrochlorothiazide ) risks & warnings »
    • Taking with alcohol
    • Taking other medicines that lower your blood pressure
    • Current kidney problems
    • Taking other medicines that increase potassium
    • Use of salt substitutes
      Detailed Aldactone (spironolactone) risks & warnings »
      Pregnancy

      Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

      Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

      Kidneys and liver
      hydrochlorothiazidespironolactone
      • Requires routine blood tests to check kidney function.
      • You'll need to have blood tests done regularly since Aldactone (spironolactone) can affect your potassium levels and kidneys.
      Pain
      hydrochlorothiazidespironolactone
      No pain related info.
      • It can cause breast pain/swelling, irregular periods (women), or trouble with sexual performance.
      Upsides and benefits
      hydrochlorothiazidespironolactone
      • Does a good job getting rid of extra fluids in your body by making you urinate more.
      • A first-choice blood pressure treatment. Works especially well for people of African descent.
      • Lowers the risk of heart attack and stroke.
      • Good option if you have high blood pressure and heart failure.
      • Most people have very few side effects from Microzide (hydrochlorothiazide (HCTZ)).
      • Can be good for patients with osteoporosis since it raises the body's level of calcium.
      • Has a low risk of causing muscle problems from 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
      hydrochlorothiazidespironolactone
      • Makes you urinate more often.
      • Microzide (hydrochlorothiazide (HCTZ)) doesn't work well in people with severe kidney problems.
      • It can increase the risk of gout attacks in people with poor kidney function or a history of gout.
      • People with a sulfa allergy may be allergic to Microzide (hydrochlorothiazide (HCTZ)).
      • Aldactone (spironolactone) doesn't work well on its own. It 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.
      • You'll need to have blood tests done regularly since Aldactone (spironolactone) can affect your potassium levels and kidneys.
      Tips from our pharmacists for people taking the medication
      hydrochlorothiazidespironolactone
      • Microzide (hydrochlorothiazide (HCTZ)) starts working in about 2 hours.
      • It makes you urinate more often, so don't take 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 tiredness 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.
      • It can cause breast pain/swelling, irregular periods (women), or trouble with sexual performance.
      • Tell your doctor about any muscle weakness, skin changes, and red or black tarry stool.
      • You will urinate more often within 2 to 3 days, and will have lower blood pressure in 2 to 3 weeks.
      Learn more
      More about hydrochlorothiazideSide effectsReviews & ratingsAlternativesFDA package insert
      Have you used Microzide (hydrochlorothiazide )?
      Worth itNot sureNot worth it
      More about spironolactoneSide effectsAlternativesFDA package insert
      Have you used Aldactone (spironolactone)?
      Worth itNot sureNot worth it