Two medicines, side by side
Chlorthalidone vs spironolactone
Chlorthalidone and spironolactone are both labeled for high blood pressure, heart failure and edema (fluid retention). Drugs@FDA records approvals of chlorthalidone since 1960 and of spironolactone since 1960. Pharmacies paid $0.0743 per chlorthalidone 25 mg tablet and $0.0426 per spironolactone 25 mg tablet (NADAC, October 7, 2026). Chlorthalidone's other strengths are brand-only: $0.957 per Hemiclor 12.5 mg tablet. In FDA's classes, chlorthalidone is a thiazide-like diuretic and spironolactone an aldosterone antagonist.
Check it at the source: the chlorthalidone FDA label on DailyMed (effective August 5, 2026); the spironolactone FDA label on DailyMed (effective November 28, 2025).
Highlights of the chlorthalidone record
Chlorthalidone (Hygroton) · label of August 5, 2026
Used for
From the label: indicationsDiuretics such as chlorthalidone are indicated in the management of hypertension either as the sole therapeutic agent or to enhance the effect of other antihypertensive drugs in the more severe forms of hypertension. Chlorthalidone is indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. […]
On the market
- Earliest approval on file
- April 7, 1960
- Generic labelers
- 36 labelers
- Pharmacy cost
- $0.0743 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Highlights of the spironolactone record
Spironolactone (Aldactone) · label of November 28, 2025
Used for
From the label: indicationsALDACTONE 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. […]
On the market
- Earliest approval on file
- January 21, 1960
- Generic labelers
- 38 labelers
- Pharmacy cost
- $0.0426 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 6
Source: FDA drug labels via openFDA (Chlorthalidone label of August 5, 2026, Spironolactone label of November 28, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do chlorthalidone and spironolactone differ on the record?
In FDA's classes, chlorthalidone is a thiazide-like diuretic and spironolactone an aldosterone antagonist.
Half-life, in each label's words: Chlorthalidone, “The mean half-life following a 50 to 200 mg dose is 40 hours.”; Spironolactone, “The mean half-life values of its metabolites including canrenone, 7-α-(thiomethyl) spirolactone (TMS), and …”
Generics: chlorthalidone since 1981; spironolactone since 1980 (Drugs@FDA).
| Chlorthalidone | Spironolactone | |
|---|---|---|
| Labeled for | High blood pressure, Heart failure, Edema (fluid retention) | Heart failure, Edema (fluid retention), High blood pressure |
| Pharmacologic class | Thiazide-like Diuretic | Aldosterone Antagonist |
| How it works (label) | n/a | 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 … |
| Half-life (label) | The mean half-life following a 50 to 200 mg dose is 40 hours. | The mean half-life values of its metabolites including canrenone, 7-α-(thiomethyl) spirolactone (TMS), and 6-β-hydroxy-7-α-(thiomethyl) spirolactone (HTMS) are 16.5, 13.8, and 15 hours, respectively. |
| Earliest approval on file (Drugs@FDA) | April 7, 1960 | January 21, 1960 |
| First generic approved | February 26, 1981 | May 7, 1980 |
| Generic labelers (NDC) | 36 labelers | 38 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0743 per tablet (Chlorthalidone 25 mg tablet) | $0.0426 per tablet (Spironolactone 25 mg tablet) |
| 12-month price change | -12% | -14% |
| Boxed warning | No | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 5 | 6 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 11,545 | 139,757 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to chlorthalidone
- every medicine labeled for the same conditions