hydrochlorothiazide/lisinopril vs spironolactone
Side-by-side comparison of hydrochlorothiazide/lisinopril and spironolactone. 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.
Recommendation: Your doctor will need to perform regular blood tests to check your potassium levels while you take these drugs.
Zestoretic
Aldactone
Zestoretic is a drug that combines lisinopril and hydrochlorothiazide. It is used to treat high blood pressure.
Spironolactone is a medicine that helps remove extra fluid from your body and lower blood pressure. It also helps your heart work better if you have heart failure.
Zestoretic is used to treat high blood pressure. Lowering blood pressure reduces the risk of heart problems and strokes. Controlling high blood pressure should also include managing cholesterol, diabetes, and quitting smoking. Many people need more than one medicine to control their blood pressure.
Spironolactone is used to treat heart failure by reducing fluid build-up and helping you live longer. It also treats high blood pressure, which can lower your chance of having a stroke or heart attack. This medicine can also manage fluid build-up caused by liver problems or a kidney problem called nephrotic syndrome. It can also treat a condition where your body makes too much of a hormone called aldosterone.
Zestoretic contains two medicines. Lisinopril is an ACE inhibitor that widens blood vessels. Hydrochlorothiazide is a diuretic that helps your body get rid of extra salt and water, which also lowers blood pressure.
Spironolactone belongs to a class of drugs called aldosterone antagonists. It works by blocking the effects of aldosterone, a hormone that causes your body to hold onto salt and water. By blocking aldosterone, spironolactone helps your body get rid of extra fluid and salt, which lowers blood pressure and reduces strain on the heart.
- • Dizziness
- • Headache
- • Cough
- • Feeling tired
- • Breast enlargement in men
- • Dizziness
- • Headache
- Feeling tired 10,013
- Feeling sick to your stomach 9,706
- Loose stools 8,311
- Discomfort 7,665
- Difficulty breathing 7,584
- Difficulty breathing 10,389
- Tiredness 8,179
- Feeling sick to your stomach 7,818
- Loose stools 7,416
- Sudden kidney damage 6,785
This drug can cause serious harm or death to an unborn baby. Stop taking Zestoretic as soon as you find out you are pregnant.
Spironolactone can cause your potassium levels to get too high, which can be dangerous. Your doctor will check your potassium levels regularly, especially if you have kidney problems or are taking other medicines that can raise potassium. This medicine can also cause low blood pressure or make kidney problems worse. Tell your doctor if you have side effects.
Do not take Zestoretic if you are pregnant. It can harm your unborn baby. Talk to your doctor about other blood pressure medicines if you are breastfeeding.
Spironolactone may affect the sex organs of a baby boy if taken during pregnancy. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if spironolactone passes into breast milk, so talk to your doctor about the best way to feed your baby if you are taking this medicine.
How to Read This hydrochlorothiazide/lisinopril vs spironolactone Comparison
hydrochlorothiazide/lisinopril is classified in the Thiazide Diuretic / ACE Inhibitor Combination drug class, while spironolactone sits within the Potassium-Sparing Diuretic / Aldosterone Antagonist 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, hydrochlorothiazide/lisinopril has 43,279 submissions while spironolactone has 40,587. 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 both of these medicines can cause your body to keep too much potassium, which can lead to dangerously high levels in your blood.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between hydrochlorothiazide/lisinopril and spironolactone - always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.