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Aldactazide

Aldactazide is a fixed-dose combination of spironolactone and hydrochlorothiazide, paired in a single oral preparation for the management of hypertension and a range of conditions where fluid balance plays a clinical role. Combinations of this kind formalise a long-established co-prescribing pattern, putting two diuretic ingredients with complementary mechanisms into one tablet rather than two.

Spironolactone belongs to the potassium-sparing diuretic category, while hydrochlorothiazide is a thiazide diuretic — both fall within the broader diuretic class listed in the structured data on this page. The pairing is widely recognised in cardiovascular and renal practice, where the two mechanisms can offset some of each other's effects on electrolyte balance. Aldactazide's registered indications, as captured on this page, span hypertension, cirrhosis, diabetic kidney disease, and several related cardiovascular and metabolic conditions.

Aldactazide is registered in six countries — a relatively concentrated footprint that includes the United States, Italy, Egypt, Pakistan, and Turkey, alongside Canada. Travellers familiar with the brand from one of these markets may not encounter the same name elsewhere, although the two underlying molecules are individually available in essentially every regulated pharmaceutical market in the world, and other spironolactone-plus-thiazide combinations exist under different brand names regionally.

Combination diuretic products vary between countries more than single-ingredient drugs, both in their dosage ratios and in regulatory positioning. A pharmacist in the destination country can confirm whether a comparable fixed-dose combination, or the two ingredients prescribed separately, is the appropriate match locally. Any decision to start, stop, switch, or substitute Aldactazide should be made together with a healthcare provider familiar with the patient's full clinical picture.

Overdose

The oral LD50 of spironolactone is greater than 1000 mg/kg in mice, rats, and rabbits. The oral LD50 of hydrochlorothiazide is greater than 10 g/kg in both mice and rats.

Acute overdosage of spironolactone may be manifested by drowsiness, mental confusion, maculopapular or erythematous rash, nausea, vomiting, dizziness, or diarrhea. Rarely, instances of hyponatremia, hyperkalemia (less commonly seen with ALDACTAZIDE because the hydrochlorothiazide component tends to produce hypokalemia), or hepatic coma may occur in patients with severe liver disease, but these are unlikely due to acute overdosage.

However, because ALDACTAZIDE contains both spironolactone and hydrochlorothiazide, the toxic effects may be intensified, and signs of thiazide overdosage may be present. These include electrolyte imbalance such as hypokalemia and/or hyponatremia. The potassium-sparing action of spironolactone may predominate and hyperkalemia may occur, especially in patients with impaired renal function. BUN determinations have been reported to rise transiently with hydrochlorothiazide. There may be CNS depression with lethargy or even coma.

Treatment

 Induce vomiting or evacuate the stomach by lavage. There is no specific antidote. Treatment is supportive to maintain hydration, electrolyte balance, and vital functions.

Patients who have renal impairment may develop spironolactone-induced hyperkalemia. In such cases, ALDACTAZIDE should be discontinued immediately. With severe hyperkalemia, the clinical situation dictates the procedures to be employed. These include the intravenous administration of calcium chloride solution, sodium bicarbonate solution, and/or the oral or parenteral administration of glucose with a rapid-acting insulin preparation. These are temporary measures to be repeated as required. Cationic exchange resins such as sodium polystyrene sulfonate may be orally or rectally administered. Persistent hyperkalemia may require dialysis.

Undesirable effects

The following adverse reactions have been reported and, within each category (body system), are listed in order of decreasing severity.

Hydrochlorothiazide

Body as a whole: Weakness.

Cardiovascular: Hypotension including orthostatic hypotension (may be aggravated by alcohol, barbiturates, narcotics, or antihypertensive drugs).

Digestive: Pancreatitis, jaundice (intrahepatic cholestatic jaundice), diarrhea, vomiting, sialoadenitis, cramping, constipation, gastric irritation, nausea, anorexia.

Eye Disorders: acute myopia and acute angle closure glaucoma (see WARNINGS). Hematologic: Aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia.

Hypersensitivity: Anaphylactic reactions, necrotizing angitis (vasculitis and cutaneous vasculitis), respiratory distress including pneumonitis and pulmonary edema, photosensitivity, fever, urticaria, rash, purpura.

Metabolic: Electrolyte imbalance (see PRECAUTIONS), hyperglycemia, glycosuria, hyperuricemia.

Musculoskeletal: Muscle spasm.

Nervous system/psychiatric: Vertigo, paresthesias, dizziness, headache, restlessness.

Renal: Renal failure, renal dysfunction, interstitial nephritis (see WARNINGS).

Skin: Erythema multiforme, pruritus.

Special senses: Transient blurred vision, xanthopsia.

Spironolactone

Digestive: Gastric bleeding, ulceration, gastritis, diarrhea and cramping, nausea, vomiting.

Reproductive: Gynecomastia (see PRECAUTIONS), inability to achieve or maintain erection, irregular menses or amenorrhea, postmenopausal bleeding, breast pain. Carcinoma of the breast has been reported in patients taking spironolactone but a cause and effect relationship has not been established.

Hematologic: Leukopenia (including agranulocytosis), thrombocytopenia.

Hypersensitivity: Fever, urticaria, maculopapular or erythematous cutaneous eruptions, anaphylactic reactions, vasculitis.

Metabolism: Hyperkalemia, electrolyte disturbances (see WARNINGS and PRECAUTIONS).

Musculoskeletal: Leg cramps.

Nervous system/psychiatric: Lethargy, mental confusion, ataxia, dizziness, headache, drowsiness.

Liver/biliary: A very few cases of mixed cholestatic/hepatocellular toxicity, with one reported fatality, have been reported with spironolactone administration.

Renal: Renal dysfunction (including renal failure).

Skin: Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN), drug rash with eosinophilia and systemic symptoms (DRESS), alopecia, pruritus.

Fertility, pregnancy and lactation

Teratogenic effects

Pregnancy Category C. Hydrochlorothiazide: Studies in which hydrochlorothiazide was orally administered to pregnant mice and rats during their respective periods of major organogenesis at doses up to 3000 and 1000 mg hydrochlorothiazide/kg, respectively, provided no evidence of harm to the fetus. There are, however, no adequate and well-controlled studies in pregnant women.

Spironolactone

Teratology studies with spironolactone have been carried out in mice and rabbits at doses of up to 20 mg/kg/day. On a body surface area basis, this dose in the mouse is substantially below the maximum recommended human dose and, in the rabbit, approximates the maximum recommended human dose. No teratogenic or other embryo-toxic effects were observed in mice, but the 20 mg/kg dose caused an increased rate of resorption and a lower number of live fetuses in rabbits. Because of its antiandrogenic activity and the requirement of testosterone for male morphogenesis, spironolactone may have the potential for adversely affecting sex differentiation of the male during embryogenesis. When administered to rats at 200 mg/kg/day between gestation days 13 and 21 (late embryogenesis and fetal development), feminization of male fetuses was observed. Offspring exposed during late pregnancy to 50 and 100 mg/kg/day doses of spironolactone exhibited changes in the reproductive tract including dose-dependent decreases in weights of the ventral prostate and seminal vesicle in males, ovaries and uteri that were enlarged in females, and other indications of endocrine dysfunction, that persisted into adulthood. There are no adequate and well-controlled studies with ALDACTAZIDE in pregnant women. Spironolactone has known endocrine effects in animals including progestational and antiandrogenic effects. The antiandrogenic effects can result in apparent estrogenic side effects in humans, such as gynecomastia. Therefore, the use of ALDACTAZIDE in pregnant women requires that the anticipated benefit be weighed against the possible hazards to the fetus.

Non-teratogenic effects

Spironolactone or its metabolites may, and hydrochlorothiazide does, cross the placental barrier and appear in cord blood. Therefore, the use of ALDACTAZIDE in pregnant women requires that the anticipated benefit be weighed against possible hazards to the fetus. The hazards include fetal or neonatal jaundice, thrombocytopenia, and possibly other adverse reactions that have occurred in adults.

Frequently asked questions

What conditions does Aldactazide treat?

Aldactazide is prescribed in the management of hypertension and as part of fluid-related management in conditions including cirrhosis and diabetic kidney disease. As a combination diuretic, it brings together two molecules that act through complementary mechanisms on fluid and electrolyte balance. The structured indication block further down this page lists the registered uses recognised by the regulators in each market where Aldactazide is sold.

What is Aldactazide made of?

Aldactazide contains two active ingredients: spironolactone, a potassium-sparing diuretic, and hydrochlorothiazide, a thiazide diuretic. Both molecules are individually available worldwide under a wide range of brand names, and the combination of a potassium-sparing agent with a thiazide is a long-established pairing in cardiovascular and fluid-management practice formalised here in a single oral preparation.

In how many countries is Aldactazide available?

Aldactazide is registered in six countries, spanning North America, Europe, North Africa, and parts of Asia. Examples include the United States, Italy, Egypt, Pakistan, Turkey, and Canada. If your country is not represented on this list, a local pharmacist can usually confirm whether a comparable spironolactone-and-hydrochlorothiazide combination, or the two ingredients separately, is available in that market.

Are there other medications with the same active ingredients as Aldactazide?

Spironolactone and hydrochlorothiazide are each sold under numerous brand names worldwide as single-ingredient products, and combination products pairing the two also exist under other brand names in various regional markets. Other diuretics — including other thiazides and other potassium-sparing agents — are also widely available, though they are not freely interchangeable. A pharmacist or a search by active ingredient on Pill2Trip can help identify regional equivalents.

Should I consult a doctor before taking Aldactazide?

Yes. Aldactazide is a prescription medication, and combination diuretic therapy is calibrated to an individual's blood pressure, kidney function, electrolyte status, and concurrent medications. Combination products also vary between countries in their dosage ratios and regulatory status more than single-ingredient drugs do. Travellers and people relocating internationally should treat any substitution or change as a clinical decision led by a healthcare provider familiar with their history.

Aldactazide

Available in 6 countries