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Aldactone vs Microzide

Spironolactone  ·  Hydrochlorothiazide

Two diuretics that behave very differently — one conserves potassium, the other loses it, which drives the choice between them.

At a glance

AldactoneSpironolactone
MicrozideHydrochlorothiazide
Brand name
Aldactone
Microzide
Drug class
Aldosterone antagonist
Thiazide diuretic
Route
Oral
Not listed
Marketed by
Pfizer
Teva
First FDA approval
21 Jan 1960
27 Dec 1996
US shortage
Not in shortage
Not in shortage

Key differences

What each one treats

AldactoneSpironolactone

ALDACTONE is an aldosterone antagonist indicated for: • The treatment of NYHA Class III–IV heart failure and reduced ejection fraction to increase survival, manage edema, and to reduce the need for hospitalization for heart failure ( 1.1 ). • Use as an add-on therapy for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions ( 1.2 ). • The management of edema in adult patients who are cirrhotic when edema is not responsive to fluid and sodium restrictions and in the setting of nephrotic syndrome when treatment of the underlying disease, restriction of fluid and sodium intake, and the use of other diuretics produce an inadequate response ( 1.3 ). • Treatment of primary hyperaldosternism for: ( 1.4 ) o Short-term preoperative treatment o Long-term maintenance…

MicrozideHydrochlorothiazide

An oral daily water pill used to treat high blood pressure and fluid retention.

How each one works

AldactoneAldosterone antagonist

12.1 Mechanism of Action Spironolactone and its active metabolites are specific pharmacologic antagonists of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted renal tubule. Spironolactone causes increased amounts of sodium and water to be excreted, while potassium is retained. Spironolactone acts both as a diuretic and as an antihypertensive drug by this mechanism. It may be given alone or with other diuretic agents that act more proximally in the renal tubule.

MicrozideThiazide diuretic

An oral daily water pill used to treat high blood pressure and fluid retention.

Read more

Aldactone profile Microzide profile All comparisons
This is not medical advice, and not a recommendation of one drug over the other.

Which medicine is right for a given person depends on their diagnosis, other conditions, other medicines, kidney and liver function, pregnancy, and cost or reimbursement — none of which this page knows. Two drugs in the same class are not automatically interchangeable. Never start, stop or switch a prescription medicine on the basis of a web page; that decision belongs to you and your clinician or pharmacist.

Class and summary text is written by the Priya Life Science editorial team. Label, mechanism, route, manufacturer and approval data come from the U.S. FDA via the openFDA API; shortage status from the FDA Drug Shortage Database. Approvals, indications and brand names differ between the US, EU/Ireland (EMA/HPRA) and other regions — a drug approved in one may not be approved, or may carry a different name, in another.