When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to spironolactone, hydrochlorothiazide, or sulfa drugs, or if you have Addison disease.

How to Use This Medicine:
Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some foods and medicines can affect how spironolactone/hydrochlorothiazide works. Tell your doctor if you are also using the following:
  
  • Cholestyramine, digoxin, eplerenone, lithium
  • A blood thinner (such as dalteparin, enoxaparin, heparin)
  • Insulin or diabetes medicine
  • NSAID pain or arthritis medicine (such as aspirin, diclofenac, indomethacin, naproxen)
  • Steroid medicine (such as hydrocortisone, methylprednisolone, prednisolone, prednisone)
• Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium. You could have high levels of potassium in your blood that would cause serious health problems.
• Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, diabetes, glaucoma, gout, high cholesterol, lupus, trouble urinating, or a history of asthma or allergies.
• This medicine may cause you to feel dizzy or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you are dizzy or lightheaded.
• Do not stop using the medicine without asking your doctor, even if you feel well. This medicine will not cure your high blood pressure, but it will help keep it in normal range. You may have to take blood pressure medicine for the rest of your life.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash
• Confusion, weakness, uneven heartbeat, trouble breathing, numbness or tingling in your hands, feet, or lips
• Dry mouth, increased thirst, muscle cramps, nausea, vomiting
• Eye pain, vision changes, seeing halos around lights
• Lightheadedness, dizziness, or fainting
• Problems urinating, pain in your side or lower back
• Stomach pain, vomiting blood or material that looks like coffee grounds, blood in your stools or dark stools
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Breast swelling, enlargement, pain, or tenderness

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088