hydrochlorothiazide and metoprolol

What is the most important information I should know about hydrochlorothiazide and metoprolol?

You should not use this medicine if you are unable to urinate.

Do not stop using this medicine suddenly, even if you feel fine. Stopping suddenly may cause serious or life-threatening heart problems. Follow your doctor's instructions about tapering your dose.

What is hydrochlorothiazide and metoprolol?

Hydrochlorothiazide is a thiazide diuretic (water pill). Metoprolol is a beta-blocker.

Hydrochlorothiazide and metoprolol is a combination medicine used to treat high blood pressure (hypertension).

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

What should I discuss with my healthcare provider before taking hydrochlorothiazide and metoprolol?

• a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker), or if your heart cannot pump blood properly;
• slow heartbeats that have caused you to faint;
• severe or uncontrolled heart failure;
• an allergy to sulfa drugs; or
• if you are unable to urinate.

Tell your doctor if you have ever had:

• congestive heart failure;
• slow heartbeats;
• blood circulation problems;
• asthma or other breathing disorder;
• peripheral vascular disease such as Raynaud's syndrome;
• diabetes;
• a thyroid disorder;
• kidney disease (or if you are on dialysis);
• pheochromocytoma (tumor of the adrenal gland);
• glaucoma;
• lupus;
• gout; or
• high cholesterol or triglycerides.

Tell your doctor if you are pregnant or breastfeeding.

How should I take hydrochlorothiazide and metoprolol?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take hydrochlorothiazide and metoprolol with (or immediately after food) or without food.

Your blood pressure will need to be checked often. You may also need frequent blood tests.

If you are diabetic, check your blood sugar carefully. Taking hydrochlorothiazide and metoprolol can make it harder for you to tell when you have low blood sugar. Do not change your medication dose or schedule without your doctor's advice.

If you need surgery, tell the surgeon ahead of time that you are using hydrochlorothiazide and metoprolol.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Do not stop using hydrochlorothiazide and metoprolol suddenly, even if you feel fine. Stopping suddenly may cause serious or life-threatening heart problems. Follow your doctor's instructions about tapering your dose.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Overdose symptoms may include fast or slow heart rate, trouble breathing, or fainting.

What should I avoid while taking hydrochlorothiazide and metoprolol?

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

What are the possible side effects of hydrochlorothiazide and metoprolol?

• bronchospasm (wheezing, chest tightness, trouble breathing);
• slow heart rate, weak pulse, fainting, slow breathing (breathing may stop);
• blurred vision, tunnel vision, eye pain, or seeing halos around lights;
• low potassium level --leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling; or
• low sodium level --headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.

Common side effects may include:

• tired feeling; or
• stuffy nose, sore throat.

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

What other drugs will affect hydrochlorothiazide and metoprolol?

Tell your doctor about all your other medicines, especially:

• cholestyramine, colestipol;
• clonidine;
• digoxin;
• diltiazem, verapamil;
• epinephrine (Epi-Pen);
• lithium;
• an MAO inhibitor --isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others; or
• an NSAID (nonsteroidal anti-inflammatory drug) --aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect hydrochlorothiazide and metoprolol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about hydrochlorothiazide and metoprolol.