What side effects are associated with combining hydrochlorothiazide and spironolactone?

Combining hydrochlorothiazide, a thiazide diuretic, with spironolactone, a potassium-sparing diuretic, can lead to specific electrolyte imbalances, particularly hyponatremia and hypochloremic metabolic acidosis.

Hyponatremia occurs because hydrochlorothiazide promotes the excretion of sodium in the urine, which can lower serum sodium levels, especially when fluid intake is maintained or increased. The body’s ongoing response to hydration and the effects of both diuretics can further exacerbate this condition.

Hypochloremic metabolic acidosis is also a concern because thiazide diuretics can cause a loss of bicarbonate and chloride. When chloride levels drop, it can lead to a compensatory metabolic acidosis as the body attempts to maintain acid-base balance.

In summary, the combination of these two medications can create a situation where both sodium and chloride levels are adversely affected, leading to the specified side effects of hyponatremia and hypochloremic metabolic acidosis.