eplerenone vs hydrochlorothiazide/triamterene

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Side-by-side comparison of eplerenone and hydrochlorothiazide/triamterene. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

minor Known Drug Interaction

Use of lisinopril with potassium-sparing diuretics (e.g., spironolactone, eplerenone, triamterene, or amiloride), potassium supplements, or potassium-containing salt substitutes may lead to significant increases in serum potassium.

Drug Class
eplerenone Aldosterone Antagonist
hydrochlorothiazide/triamterene Thiazide / Potassium-Sparing Diuretic Combination
Type
eplerenone Prescription
hydrochlorothiazide/triamterene Prescription
Summary
eplerenone

Eplerenone (Inspra) helps you live longer if you have heart failure after a heart attack. It also lowers blood pressure if you have high blood pressure.

hydrochlorothiazide/triamterene

This medicine combines lisinopril and hydrochlorothiazide to lower high blood pressure. Lowering blood pressure reduces the risk of strokes and heart attacks.

What It Treats
eplerenone

Eplerenone is used to help people with heart failure who have had a heart attack live longer. It is also used to treat high blood pressure in adults. Lowering blood pressure helps reduce the risk of strokes and heart attacks.

hydrochlorothiazide/triamterene

This medicine is used to treat high blood pressure. High blood pressure can lead to serious problems like stroke and heart attack if it is not treated. Lowering your blood pressure can help prevent these problems. You may need more than one medicine to control your blood pressure.

How It Works
eplerenone

Eplerenone blocks a hormone called aldosterone in your body. Aldosterone can cause your body to hold onto too much salt and water, which can raise blood pressure and worsen heart failure. By blocking aldosterone, eplerenone helps lower blood pressure and reduce strain on the heart.

hydrochlorothiazide/triamterene

Lisinopril is an ACE inhibitor that widens blood vessels. Hydrochlorothiazide is a diuretic that helps your body get rid of extra salt and water. This combination helps to lower blood pressure.

Common Side Effects
eplerenone
  • High potassium levels in your blood
  • Increased creatinine levels
hydrochlorothiazide/triamterene
  • Dizziness
  • Headache
  • Cough
  • Feeling tired
  • Lightheadedness when standing up
FAERS Reports
eplerenone
  • Dyspnoea 1,083
  • Cardiac Failure 939
  • Acute Kidney Injury 905
  • Hypotension 859
  • Fatigue 659
hydrochlorothiazide/triamterene
  • Feeling tired 10,013
  • Feeling sick to your stomach 9,706
  • Loose stools 8,311
  • General pain 7,665
  • Difficulty breathing 7,584
Serious Warnings
eplerenone

Eplerenone can cause high potassium levels in your blood, which can be dangerous. Your doctor will check your potassium levels before you start taking eplerenone and regularly while you are taking it. People with kidney problems, diabetes, or who take certain other medicines are at higher risk.

hydrochlorothiazide/triamterene

This medicine can harm your unborn baby. If you become pregnant, stop taking this medicine and tell your doctor right away. You should not take this medicine if you have ever had a severe allergic reaction (angioedema) to an ACE inhibitor or if you cannot urinate.

Pregnancy
eplerenone

It is not known if eplerenone can harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is also not known if eplerenone passes into breast milk. Talk to your doctor about the best way to feed your baby if you are taking eplerenone.

hydrochlorothiazide/triamterene

This medicine can cause harm or death to an unborn baby. Do not take this medicine if you are pregnant. Talk to your doctor about other blood pressure medicines if you are breastfeeding.

How to Read This eplerenone vs hydrochlorothiazide/triamterene Comparison

eplerenone is classified in the Aldosterone Antagonist drug class, while hydrochlorothiazide/triamterene sits within the Thiazide / Potassium-Sparing Diuretic Combination class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, eplerenone has 4,445 submissions while hydrochlorothiazide/triamterene has 43,279. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known minor interaction flagged in FDA labeling, attributed to these drugs work in a similar way to keep potassium in the body instead of letting it leave through urine. this can cause potassium levels to rise too high, which can affect your heart rhythm.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for eplerenone or hydrochlorothiazide/triamterene.

Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.