Comments on spironolactone with hydrochlorothiazide
(Aldactazide)
Spironolactone and hydrochlorothiazide are a combination of diuretics. The
combination seeks to improve the efficacy of the two while decreasing the adverse effects.
See hydrochlorothiazide and spironolactone. See urine for comparisons of the effects
and complications of the different diuretics. Engelhardt (J Pediatr 1989;
114:619) studied 21 infants with BPD. Twelve infants on oxygen but not on mechanical
ventilation received a dose of Aldactazide of 3 mg/kg/day and nine infants received
placebo over 6 to 8 days. Although urine output was significantly increased in the
treatment group, neither lung mechanics or oxygenation improved. Albersheim (J Pediatr
1989; 115:615) studied 34 infants with BPD who were still on a ventilator were treated
with diuretics for 8 weeks. Hydrochlorothiazide 2 mg/kg every 12 hours and spironolactone
1.5 mg/kg every 12 hours was given to 19 infants and 15 infants received a placebo. The
survival in the treated group was 84% compared to 47% in infants receiving placebo.
Respiratory mechanics were improved in the treatment group after 4 weeks of therapy.
Length of stay and length of time on the ventilator did not differ between the groups.