Compare hydrochlorothiazide vs. Inspra

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

Microzide
(hydrochlorothiazide )

Inspra
(eplerenone)

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.Helps lower blood pressure and protect the heart in people with heart failure. Inspra (eplerenone) lowers blood pressure and can help remove fluid when it's used with other drugs. It reduces the risk of death in people with heart failure and is usually used when people can't take spironolactone.
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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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Side effects
hydrochlorothiazideInspra

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

More about hydrochlorothiazide side effects »
  • High potassium 1%
  • Abnormal renal function 1%
  • Dizziness 1%
  • Diarrhea 1%
  • Coughing 1%
  • Fatigue 1%
  • Flu-like symptoms 1%
More Inspra side effects »
How it works
hydrochlorothiazideInspra
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.Inspra (eplerenone) is an aldosterone antagonist. It blocks aldosterone (a hormone) and helps your kidneys get rid of excess fluid in your body, which helps lower blood pressure.
Type of medication
hydrochlorothiazideInspra
Prescription only
Prescription only
Available as
hydrochlorothiazideInspra
  • Pill
  • Pill
Used for
hydrochlorothiazideInspra
Risk factors for serious side effects
hydrochlorothiazideInspra
  • 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
  • Medicines that increase potassium
  • Use of salt substitutes
  • Diabetes with proteinuria
    • Current kidney problems
    • Liver damage
    Detailed Inspra (eplerenone) 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 haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

    Kidneys and liver
    hydrochlorothiazideInspra
    • Requires routine blood tests to check kidney function.
    • You'll need to have blood tests done regularly since Inspra (eplerenone) can affect your potassium levels and kidney function.
    • Shouldn't be used by people with kidney or liver damage.
    • Inspra (eplerenone) shouldn't be used by people with bad kidneys since it can hurt your kidneys or cause worse side effects, such as high potassium levels. Your doctor will do frequent blood tests to monitor your kidney function and electrolytes while you're on this drug.
    Upsides and benefits
    hydrochlorothiazideInspra
    • 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.
    • Lowers your blood pressure.
    • It can help remove fluid from your body when it's used with other drugs.
    • Reduces the risk of death in people with heart failure.
    • It can have fewer side effects than spironolactone.
    Downsides and risks
    hydrochlorothiazideInspra
    • 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)).
    • Inspra (eplerenone) isn't a first choice medicine for lowering blood pressure or getting rid of fluid in the body. It's usually used in combination with other medicines.
    • It can make you feel dizzy for the first few days. Be careful driving until you know how it affects you.
    • You'll need to have blood tests done regularly since Inspra (eplerenone) can affect your potassium levels and kidney function.
    • It can be very expensive compared to spironolactone.
    Tips from our pharmacists for people taking the medication
    hydrochlorothiazideInspra
    • 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.
    • Inspra (eplerenone) can make you feel dizzy the first few days you're taking it.
    • It can increase your potassium to dangerous levels, so don't use salt substitutes or other products that contain potassium.
    • Women may notice breast tenderness or swelling and irregular periods.
    • Shouldn't be used by people with kidney or liver damage.
    • Your doctor will check the amount of potassium in your blood while you're on this drug.
    Learn more
    More about hydrochlorothiazideSide effectsReviews & ratingsAlternativesFDA package insert
    Have you used Microzide (hydrochlorothiazide )?
    Worth itNot sureNot worth it
    More about InspraSide effectsReviews & ratingsAlternativesFDA package insert
    Have you used Inspra (eplerenone)?
    Worth itNot sureNot worth it