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How Spironolactone-HCTZ Works for Water Retention

Why Is Spironolactone-HCTZ Used for Water Retention?

One common cause of water retention is congestive heart failure (CHF). This is a condition where the heart cannot pump enough blood throughout the body. It does not mean that your heart has stopped or is about to stop working. It means that your heart is not able to pump blood the way that it should. This can lead to symptoms of CHF that include shortness of breath; swelling of the feet, ankles, or lower legs; and rapid weight gain (see Symptoms of Congestive Heart Failure for more information). Spironolactone-HCTZ can help with water retention by helping the body to get rid of the extra fluid. However, the drug does not cure congestive heart failure.
Water retention can be caused by other conditions, such as cirrhosis of the liver or kidney disease. Spironolactone-HCTZ is effective for treating water retention due to these causes. It is also approved to treat a special kind of water retention called ascites. This is the accumulation of fluid in the abdominal cavity and is usually the result of liver disease.

How Does Spironolactone-HCTZ Work?

Spironolactone-HCTZ is a diuretic, which is commonly referred to as a "water pill." It contains two diuretics that work together to keep electrolytes in balance. Hydrochlorothiazide, while effective, often causes low potassium levels in the blood. On the other hand, spironolactone is a "potassium-sparing" diuretic, meaning that it can actually increase potassium levels in the blood. When taken together, these medications balance each other out.
The spironolactone component of spironolactone-HCTZ is known as an "aldosterone antagonist," which means it blocks aldosterone receptors. Aldosterone is a hormone in the body that causes water retention. By blocking aldosterone (and through the actions of hydrochlorothiazide, the other component), spironolactone-HCTZ increases the amount of salt and water that the kidneys remove from the blood. This extra salt and water is then passed out through the urine. By increasing the amount of water removed from the blood, the medication causes a decrease in blood volume. Because of this effect, it can lower blood pressure and also help with water retention.
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Spironolactone Hydrochlorothiazide

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