HYDROCHLOROTHIAZIDE AND METOPROLOL

(HYE droe klor oh THYE a zide and me TOE proe lole) Brand: Dutoprol, Lopressor HCT

What is the most significant information I must know about hydrochlorothiazide and metoprolol?

• You must not use this medicine if you have severe or uncontrolled heart failure, a heart condition called "sick sinus syndrome" or "AV block," severe blood circulation problems, an adrenal gland tumor, an allergy to beta-blockers, or if you are unable to urinate.

• Till using this medicine, speak your doctor if you have congestive heart failure, kidney or liver malady, cirrhosis, glaucoma, asthma or bronchitis, gout, lupus, diabetes, a thyroid mess, or if you are allergic to sulfa drugs or penicillin.

• If you are diabetic, check your blood sugar carefully. Using metoprolol can create it harder for you to speak when you have low blood sugar. Your insulin or diabetic medicine needs may change while you are taking hydrochlorothiazide and metoprolol. Conversation with your doctor till changing any doses.

• Drinking alcohol can further lower your blood pressure and may magnify determined side effects of hydrochlorothiazide and metoprolol.

• Avoid becoming overheated or dehydrated during exercice and in hot weather. Follow your doctor's instructions about the type and amount of liquids you must drink. In some cases, drinking too many liquid can be as unsafe as not drinking enough.

• Hold taking this medicine even if you feel beautiful. Tall blood pressure often has no symptoms.

• There are much another medicines that can interact with hydrochlorothiazide and metoprolol. Speak your doctor about all the prescription and over-the-counter medications you use.

What is hydrochlorothiazide and metoprolol?

• Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too many salt, which can reason fluid retention.

• Metoprolol is a beta-blocker. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).

• The combination of hydrochlorothiazide and metoprolol is used to treat tall blood pressure (hypertension).

• Hydrochlorothiazide and metoprolol may also be used for purposes not listed in this medicine guide.

What must I discuss with my doctor till taking hydrochlorothiazide and metoprolol?

• You must not use this medicine if you are allergic to hydrochlorothiazide or metoprolol, or if you have:

· severe or uncontrolled heart failure;

· a heart condition called "sick sinus syndrome" or "AV block" (2nd or 3rd degree);

· severe blood circulation problems;

· an adrenal gland tumor (pheochromocytoma);

· if you are unable to urinate; or

· if you are allergic to any beta-blocker medicine, such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Dutoprol, Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others.

• To create certain you can safely take hydrochlorothiazide and metoprolol, speak your doctor if you have any of these another conditions:

· congestive heart failure;

· kidney disease;

· liver malady (or cirrhosis);

· glaucoma;

· asthma or bronchitis;

· a thyroid disorder;

· lupus;

· gout;

· diabetes; or

· if you are allergic to sulfa drugs or penicillin.

• FDA pregnancy category C. It is not known whether this medicine will harm an unborn child. Speak your doctor if you are pregnant or plan to become pregnant while using this medication.

• Hydrochlorothiazide and metoprolol can pass into breast milk and may harm a nursing child. You must not breast-feed while you are using this medication.

How must I take hydrochlorothiazide and metoprolol?

• Take exactly as predesigned by your doctor. Do not take in larger or less amounts or for longer than recommended. Follow the directions on your prescription label.

• Take the medication with a meal or right after you eat.

• Your doctor may occasionally change your doze to create certain you get the excellent results.

• Do not stop using hydrochlorothiazide and metoprolol suddenly, or you could have a serious or life-threatening heart problem. Conversation to your doctor about how to avoid withdrawal symptoms when stopping the medication.

• Your blood pressure will need to be checked often. Your blood and urine may both be tested if you have been vomiting or are dehydrated. Visit your doctor regularly.

• If you need surgery or medical trials, speak the doctor onward of time that you are taking medicine that contains hydrochlorothiazide. You may need to stop using the medication for a short time.

• Hold taking this medicine even if you feel beautiful. Tall blood pressure often has no symptoms.

• Store this medicine in a tightly closed container at room temperature, away from heat, moisture, and light.

What happens if I miss a dose?

• Take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222.

• Overdose symptoms may include quick or slow heart course, feeling like you might pass out, trouble breathing, or heighten urination.

What must I avoid while taking hydrochlorothiazide and metoprolol?

• Drinking alcohol can further lower your blood pressure and may magnify determined side effects of hydrochlorothiazide and metoprolol.

• Avoid getting up too quick from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

• This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What are the possible side effects of hydrochlorothiazide and metoprolol?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your person, lips, tongue, or throat.

• Stop using this medicine and call your doctor at once if you have any of these serious side effects:

· eye pain, vision problems;

· swelling, rapid weight gain, feeling short of breath, even with mild exertion;

· quick, slow, or uneven heartbeat;

· light bruising or bleeding;

· numbness or tingly feeling in your hands or feet;

· feeling weak, drowsy, restless, or light-headed;

· nausea, vomiting, dry mouth, extreme thirst, headache, confusion, hallucinations, seizure (convulsions);

· heighten urination, leg discomfort, muscle pain or weakness or limp feeling;

· urinating smaller than normal or not at all;

· fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or

· upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

• Smaller serious side effects may include:

· diarrhea, constipation, upset stomach;

· dizziness, spinning sensation;

· sore throat, body aches;

· blurred vision; or

· ringing in your ears.

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect hydrochlorothiazide and metoprolol?

• Speak your doctor if you regularly use another medicines that create you light-headed (especially narcotic pain medicine or barbiturates). They can add to the side effects of hydrochlorothiazide and metoprolol.

• Much drugs can interact with hydrochlorothiazide and metoprolol. Adown is just a partial list. Speak your doctor if you are using:

· insulin or oral diabetes medication;

· colestipol (Colestid) or cholestyramine (Prevalite, Questran);

· theophylline (Elixophyllin, Respbid, Slo-Bid, Theo-Dur, Uniphyl, and others);

· steroids (prednisone and others);

· HIV or AIDS medication such as ritonavir (Norvir, Kaletra);

· an antidepressant such as bupropion (Wellbutrin, Zyban), fluoxetine (Prozac), or paroxetine (Paxil);

· an antibiotic such as rifampin (Rifadin, Rifamate, Rimactane) or terbinafine (Lamisil);

· anti-malaria medicine such as hydroxychloroquine (Plaquenil);

· medication to treat psychiatric or mood disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), lithium (Lithobid), or thioridazine (Mellaril);

· NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others; or

· another heart or blood pressure medications such as clonidine (Catapres), propafenone (Rythmol), quinidine (Quin-G) reserpine, or verapamil (Calan, Covera, Isoptin, Verelan).

• This list is not complete and another drugs may interact with hydrochlorothiazide and metoprolol. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about hydrochlorothiazide and metoprolol.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

(52)