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Hydrochlorothiazide 5 mg/ml/Spironolactone 5 mg/ml Oral Liquid

Hydrochlorothiazide 5 mg/mL and Spironolactone 5 mg/mL Oral Liquid, expertly compounded at Bayview Pharmacy, may help manage heart failure, hypertension, and edema.
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Compounded preparations are prepared by Bayview pursuant to a prescription for an individual patient. They are not FDA-approved and have not been evaluated by FDA for safety or effectiveness.
Hydrochlorothiazide
Spironolactone
Oral Liquid
65addaf8551a2c20b29bbac3

Formula Information

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Our specially compounded Hydrochlorothiazide 5 mg/ml/Spironolactone 5 mg/ml Oral Liquid is a bespoke medication designed for ease of administration, particularly beneficial for patients who have difficulty swallowing pills, such as children and the elderly. This oral liquid formulation ensures precise dosing of both hydrochlorothiazide, a thiazide diuretic, and spironolactone, a potassium-sparing diuretic. Together, these medications work synergistically to manage conditions such as hypertension, congestive heart failure, and edema associated with liver cirrhosis or renal dysfunction.

Hydrochlorothiazide functions by reducing the volume of fluid in the blood vessels through increased urination, which in turn lowers blood pressure and reduces edema. Spironolactone complements this action by conserving potassium levels and preventing excessive water retention, which is particularly useful in conditions where avoiding potassium loss is crucial. The combination of these two agents in a single oral liquid formulation simplifies the treatment regimen, enhancing patient compliance and therapeutic outcomes.

For patients, this formulation offers a convenient and palatable alternative to traditional tablets or capsules, with the added benefit of customizable dosing to meet individual therapeutic needs. For prescribers, it provides a versatile option for managing complex fluid and electrolyte imbalances with the assurance of high-quality compounding practices at Bayview Pharmacy.

It is important to note that this medication should be used under the guidance of a healthcare professional, with regular monitoring of blood pressure, electrolyte levels, and kidney function to optimize treatment and minimize potential side effects. If you have any questions or require further information about this formulation, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of expert compounding pharmacists is dedicated to providing support and guidance to both patients and healthcare providers.

Drug Interactions

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The combination of hydrochlorothiazide and spironolactone in an oral liquid formulation is used to treat conditions such as hypertension, congestive heart failure, and edema associated with various medical conditions. Hydrochlorothiazide is a thiazide diuretic that helps prevent your body from absorbing too much salt, which can cause fluid retention. Spironolactone is a potassium-sparing diuretic that also prevents the body from absorbing too much salt and keeps potassium levels from getting too low. When combined, these medications work synergistically to enhance diuretic and antihypertensive effects.

However, this combination also has the potential for significant drug interactions. Concurrent use with other medications that affect electrolyte balance, such as ACE inhibitors, angiotensin receptor blockers (ARBs), or other potassium-sparing diuretics, can lead to hyperkalemia, a condition characterized by high potassium levels in the blood. This can cause cardiac arrhythmias or other serious heart problems. Patients should have their potassium levels monitored regularly, and the use of potassium supplements or potassium-rich foods may need to be adjusted.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the diuretic, natriuretic, and antihypertensive effects of hydrochlorothiazide and spironolactone. They may also increase the risk of renal impairment, especially in volume-depleted or elderly patients. Caution is advised when NSAIDs and this combination are prescribed concurrently.

Concomitant use with digoxin may lead to increased digoxin levels and an increased risk of digitalis toxicity due to the potassium-depleting effect of hydrochlorothiazide. Patients taking digoxin should be monitored for signs of digitalis toxicity.

Alcohol, barbiturates, or narcotics can potentiate orthostatic hypotension, which may occur with this combination therapy. Patients should be counseled on the signs and symptoms of orthostatic hypotension and advised to rise slowly from a sitting or lying position.

Diabetes medications may require dosage adjustments since hydrochlorothiazide can affect glucose tolerance. Regular monitoring of blood glucose levels is recommended for patients on antidiabetic medications.

Lithium generally should not be given with diuretics like hydrochlorothiazide and spironolactone because they reduce the renal clearance of lithium, increasing the risk of lithium toxicity. If the use of lithium is necessary, serum lithium levels should be closely monitored.

Cholestyramine and colestipol resins can decrease the absorption of hydrochlorothiazide. If these medications must be used, they should be taken at least one hour before or four to six hours after the administration of the hydrochlorothiazide/spironolactone oral liquid to minimize the potential interaction.

Patients and prescribers should be aware that this is not an exhaustive list of all potential drug interactions. It is important to disclose all medications, supplements, and over-the-counter drugs being taken to the healthcare provider or pharmacist to avoid possible interactions. If you have any questions or concerns regarding this formulation or its interactions with other medications, please reach out to us at Bayview Pharmacy for further assistance.

How Does it Work

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The Hydrochlorothiazide 5 mg/ml/Spironolactone 5 mg/ml Oral Liquid is a specially compounded medication designed for ease of administration and precise dosing. Hydrochlorothiazide is a thiazide diuretic, often referred to as a water pill, which helps prevent your body from absorbing too much salt, leading to fluid retention. It works by blocking the sodium-chloride symporter in the distal convoluted tubule of the kidneys, which inhibits sodium reabsorption. This action increases the excretion of sodium and chloride ions, along with water, into the urine, thereby reducing fluid accumulation in the body and lowering blood pressure.

Spironolactone, on the other hand, is a potassium-sparing diuretic that prevents your body from absorbing too much salt and keeps your potassium levels from getting too low. It works by antagonizing the aldosterone receptor in the distal nephron of the kidney. Aldosterone is a hormone that promotes sodium and water retention; by blocking its effect, spironolactone causes more sodium and water to be excreted, while conserving potassium. This dual action of spironolactone not only helps to reduce fluid retention but also helps to manage conditions where the body has excess aldosterone levels.

Together, hydrochlorothiazide and spironolactone in this oral liquid formulation work synergistically to treat edema (swelling) associated with congestive heart failure, cirrhosis of the liver, and kidney disorders. The liquid form is particularly beneficial for patients who have difficulty swallowing pills, such as children and the elderly, or for those who require precise dosage adjustments.

Additionally, patients should be counseled on potential side effects, such as dehydration, dizziness, and electrolyte disturbances, and advised on the importance of adherence to prescribed dosages.

If you have any questions about this formulation or its appropriate use, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to provide you with the information and support you need to ensure appropriate treatment.

Other Uses

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The hydrochlorothiazide 5 mg/ml and spironolactone 5 mg/ml oral liquid formulation is primarily indicated for the treatment of conditions like hypertension and heart failure, where the combination of a thiazide diuretic and a potassium-sparing diuretic can be particularly beneficial. This synergistic formulation aids in managing fluid retention (edema) associated with various diseases, including liver cirrhosis, nephrotic syndrome, and congestive heart failure by promoting the excretion of water and sodium from the kidneys while conserving potassium.

In addition to its primary uses, this specifically formulated liquid medication might be considered for adjunctive therapy in patients with resistant hypertension, where multiple medications are required to control blood pressure. Furthermore, given the antihypertensive and diuretic properties of the combination, it may be beneficial in treating certain cases of calcium-containing kidney stones, as hydrochlorothiazide can decrease urinary calcium excretion. Moreover, the combination can be used in the management of certain cases of primary hyperaldosteronism, where spironolactone acts as an aldosterone antagonist, and hydrochlorothiazide aids in achieving additional diuretic and blood pressure control.

It is important to consider the individual components of the formulation when evaluating other potential uses. Spironolactone has antiandrogenic effects and may be useful in addressing conditions like hirsutism or acne, secondary to its ability to block the effects of certain hormones in the body. In terms of availability, this liquid dosage form is particularly suitable for patients who have difficulties swallowing solid dosage forms, such as tablets or capsules, including pediatric and geriatric patients, or those with disorders affecting their ability to swallow.

It is essential for prescribers to understand that while these potential other uses exist, the primary indication for this specially tailored oral liquid is for the management of their specific medical condition where fluid balance and blood pressure control are of concern. The formulation's effectiveness and safety for off-label uses should be evaluated by healthcare providers based on individual patient needs, current clinical evidence, and medication tolerance. If you have any questions or would like to discuss the potential application of this compounded medication for other uses beyond its primary indications, please reach out to us at Bayview Pharmacy. Our team is dedicated to providing quality care and can offer guidance on the appropriateness of this medication for your patients.

Frequently Asked Questions

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What is this compounded Hydrochlorothiazide/Spironolactone Oral Liquid used for?

This oral liquid is used for treating conditions that require a diuretic such as fluid retention (edema) and high blood pressure. It combines two medications that help your body get rid of excess water and salt. It's particularly beneficial for patients who need the effects of both hydrochlorothiazide and spironolactone.

How do I take this medication?

Take the medication as prescribed by your healthcare provider. The liquid should be measured with the provided measuring device and taken orally, with or without food. Do not use a household spoon as it may not give the correct dosage.

Who can take this Hydrochlorothiazide/Spironolactone Oral Liquid?

This medication is suitable for patients who have difficulty swallowing pills, such as children or elderly patients, as well as any patient prescribed this combination by their healthcare provider.

What should I do if I miss a dose?

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Can I mix this medication with food or drinks?

Generally, it is best to take the medication on its own as per the instructions provided by your healthcare professional. However, if you struggle with the taste, consult your pharmacist or healthcare provider for advice on mixing it with food or drinks.

Are there any side effects of taking this liquid medication?

As with any medication, side effects are possible. Common side effects may include dizziness, headache, mild stomach pain, or dehydration. Contact your healthcare provider if you experience any of these symptoms persistently or in a severe manner. Severe side effects such as electrolyte imbalances are less common but require immediate medical attention.

How should I store this oral liquid and how long is it stable?

Store this medication at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications out of the reach of children and pets. The stability of the preparation varies, so consult with your pharmacist for specific storage requirements and expiration dates.

Is this formulation safe for use in pregnancy or breastfeeding?

This medication should be taken during pregnancy or while breastfeeding only if clearly needed and prescribed by a healthcare provider. Tell your doctor if you are pregnant or plan to become pregnant or if you are breastfeeding before starting this medication.

Can I stop taking the medication once my symptoms improve?

Do not stop taking this medication without consulting with your healthcare provider, even if your symptoms improve. Stopping suddenly can cause your condition to worsen or provoke unwanted side effects.

What should I do if I take too much of this medication?

If you suspect an overdose, seek immediate medical attention. Overdose symptoms may include severe dizziness, dehydration, or fainting. It is important to always take the medication exactly as prescribed to minimize the risk of an overdose.

About this compounded preparation

This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.

The conditions listed on this page are indications prescribers have ordered this preparation for. They are not FDA-approved indications, and listing them is not a statement that this preparation is effective for them.

A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice — discuss your situation with a licensed healthcare provider.

Related Formulas

Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.
For prescribers

How to e-prescribe this formula

Controlled substance: e-prescribe only (EPCS). Faxed, phoned, and handwritten prescriptions cannot be filled. Rhode Island law (R.I. Gen. Laws § 21-28-3.18) requires Schedule II to V prescriptions to be transmitted electronically.
1

Find Bayview in your EHR's pharmacy directory

Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.

NCPDP4106882NPI1750455143Address3844 Post Rd, Warwick, RI 02886Phone(401) 284-4505Fax(401) 284-4506
2

Enter the formula as a compound

Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.

Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.

3

Copy the prescription details

RxFormula name
Dose formDose form
Quantity________
SigAs directed by prescriber
Refills____
PharmacyBayview Pharmacy, Warwick RI, NCPDP 4106882
Copy prescription details

Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.

4

Send it

Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.

Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.

Do not use Notes to Pharmacy for the formula. Some EHRs keep that field internal and never transmit it. A prescription that arrives without the formula is delayed while we call your office.

Licensed to dispense in RI, MA, CT, NY, NJ, NH, FL, and ME. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.

Hydrochlorothiazide 5 mg/ml/Spironolactone 5 mg/ml Oral Liquid
Oral Liquid
controlled

Take orally