Compare hydrochlorothiazide vs. spironolactone

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

Microzide (hydrochlorothiazide)

Prescription only
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.

4.5/ 7 average rating with 139 reviewsforhydrochlorothiazide
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.

Upsides
  • 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
  • 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.
Used for
Dosage forms
  • Pill
  • Pill
Price
Lowest price near you
$4
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Lowest price near you
$4
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Reviews
139 
47%
think this treatment is worth it
31%
think this treatment works well
16%
think this treatment is a hassle

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Side effects
The Microzide (hydrochlorothiazide (HCTZ)) FDA package insert doesn’t have numbers about how common side effects are.
The Aldactone (spironolactone) FDA package insert doesn’t have numbers about how common side effects are.
Risks and warnings
  • Dehydration and electrolyte imbalance

    Current electrolyte imbalance

    ...and 2 more risk factors

  • Severe allergic reactions

    History of sulfa allergies

  • Gout

    History of gout

    ...and 1 more risk factors

  • Vision problems

    History of sulfa or penicillin allergies

  • Higher blood sugars

    Diabetes

See more detailed risks and warnings
  • Low blood pressure

    Taking with alcohol

    ...and 1 more risk factors

  • Heart problems from high potassium

    Current kidney problems

    ...and 2 more risk factors

See more detailed risks and warnings