Congestive Heart Failure Home > Aldactazide Warnings and Precautions

There are many Aldactazide warnings and precautions to be aware of before starting treatment, including side effects that may occur and information on who should not take the drug. Aldactazide may cause low potassium levels, lupus, or gout in some people. Aldactazide warnings and precautions also apply to people who have severe kidney disease, are allergic to sulfonamides, or cannot produce urine.

Aldactazide: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Aldactazide® (spironolactone-HCTZ) if you have:
  • Liver disease, including cirrhosis
  • Kidney disease or kidney failure
  • Diabetes
  • Systemic lupus erythematosus (lupus or SLE)
  • Gout
  • Addison's disease
  • Fluid or electrolyte problems
  • Any allergies, including allergies to sulfa drugs, foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or trying to become pregnant
  • Breastfeeding.
Tell your healthcare provider about all other medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Aldactazide Warnings and Precautions

Warnings and precautions to be aware of prior to taking Aldactazide include the following:
  • Aldactazide can cause low potassium levels (hypokalemia), high potassium levels (hyperkalemia), or other electrolyte imbalances. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider. These symptoms may include:
    • Dry mouth
    • Thirst
    • Weakness
    • Lethargy
    • Drowsiness
    • Restlessness
    • Muscle pain or muscle cramps
    • Low blood pressure (hypotension)
    • Decreased urination
    • Rapid heart rate (tachycardia), slow heart rate (bradycardia), or irregular heart rhythm (arrhythmia)
    • Nausea or vomiting.
Changes in potassium levels can be very dangerous. Because there are sometimes no symptoms, your healthcare provider should measure your potassium levels regularly while you are taking the drug using a blood test.
  • Do not use salt substitutes while taking Aldactazide. Salt substitutes usually contain potassium, and combining them with Aldactazide can increase your risk of high potassium levels in your blood (hyperkalemia). Herb-type salt substitutes that do not contain potassium are okay to use.
  • Aldactazide should be started cautiously in people with liver disease, as a fluid or electrolyte imbalance can be especially dangerous in people with liver disease.
  • If kidney problems seem to be getting worse (especially for those with very severe kidney disease), Aldactazide should be stopped, since the medication can sometimes make kidney problems worse.
  • Breast enlargement in males (known medically as gynecomastia) has occurred in men taking Aldactazide. This is most likely due to the spironolactone component of the drug, which can affect male hormones. Usually, the breast enlargement goes away once Aldactazide is stopped.
  • Spironolactone (one of the components of Aldactazide) has been shown to cause tumors in rats. It is not known if spironolactone causes tumors in humans.


  • Drugs that contain hydrochlorothiazide (including this medication) can sometimes cause a potentially dangerous eye reaction (a particularly dangerous type of glaucoma). This reaction usually occurs within days to weeks of starting the drug. 
Because this reaction can permanently damage vision, let your healthcare provider know right away if you develop vision changes and/or eye pain. The main treatment for this reaction is to stop taking this medication, although other treatment (including surgery) may sometimes be necessary. 
  • Aldactazide can cause systemic lupus erythematosus (lupus or SLE) or may make lupus worse.
  • The medication may cause or worsen gout. Make sure to tell your healthcare provider if you have gout or if your gout is becoming worse while taking the drug.
  • There are a number of medicines that Aldactazide can interact with (see Aldactazide Drug Interactions).
  • Aldactazide is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy, although the full risks are not known. Talk to your healthcare provider about the risks and benefits of using the drug while pregnant (see Aldactazide and Pregnancy).
  • Aldactazide passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Aldactazide and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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