hydrochlorothiazide-metoprolol

Do not take hydrochlorothiazide and metoprolol if you have an allergy to sulfa-based drugs such as sulfa antibiotics. You may have an allergic reaction to hydrochlorothiazide.

Before taking this medication, tell your doctor if you have

• asthma;

• a heart condition such as low blood pressure, heart block, a pacemaker, or heart failure, or any other heart problem;

• diabetes;

• gout;

• a collagen vascular disease such as systemic lupus erythematosus;

• pancreatitis;

• kidney disease;

• liver disease;

• any type of circulatory disease; or

• thyroid disease.

If you experience any of the following serious side effects, stop taking hydrochlorothiazide and metoprolol and seek emergency medical attention:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

• yellow skin or eyes;

• confusion;

• abnormal bleeding or bruising;

• unusual fatigue;

• a slow or irregular heartbeat, chest pain;

• swelling of feet and lower legs or sudden weight gain;

• cold or blue feet and hands; or

• skin rash.

Other, less serious side effects may be more likely to occur. Continue to take hydrochlorothiazide and metoprolol and talk to your doctor if you experience

• dizziness—especially upon changing position (e.g., sitting or standing from lying down);

• unusual headache, fatigue, or confusion;

• tingling or numbness in your arms, legs, hands, or feet;

• excessive urination or increased hunger or thirst;

• nausea or decreased appetite;

• diarrhea, constipation, gas, nausea, or vomiting;

• a weak pulse;

• muscle weakness or cramps;

• depression or nightmares; or

• sensitivity to sunlight.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

To reduce nighttime urination, take hydrochlorothiazide and metoprolol before 6 p.m. and preferably in the morning.

Do not stop taking this medication unless your doctor approves. If you stop taking your medication, your condition could become much worse.

Avoid a diet high in salt. Too much salt will cause your body to retain water and will decrease the effects of hydrochlorothiazide.

Avoid prolonged exposure to sunlight. Hydrochlorothiazide and metoprolol may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

Avoid becoming overheated in hot weather. It is easy to become dangerously dehydrated while taking hydrochlorothiazide.

Use caution when driving, operating machinery, or performing other hazardous activities. Hydrochlorothiazide and metoprolol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Also use caution when rising from a sitting or lying postion.

Use alcohol cautiously. Alcohol may further lower blood pressure and may increase drowsiness and dizziness while you are taking hydrochlorothiazide and metoprolol.

Before having surgery, tell your doctor and dentist that you are taking this medication.

The following medicines may decrease the effectiveness of hydrochlorothiazide and metoprolol:

• cholestyramine (Questran) and colestipol (Colestid);

• nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil), ketoprofen (Orudis, Orudis KT, Oruvail), and naproxen (Naprosyn, Anaprox, Aleve); and

• other commonly used NSAIDs, including diclofenac (Cataflam, Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), mefenamic acid (Ponstel), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin).

Larger doses of hydrochlorothiazide and metoprolol may be needed if you are taking any of the medicines listed above.

Before taking hydrochlorothiazide and metoprolol, tell your doctor if you are taking any of the medicines listed below:

• Oral diabetes medications such as glipizide (Glucotrol), glyburide (Micronase, Glynase, Diabeta), chlorpropamide (Diabinese), tolazamide (Tolinase), and tolbutamide (Orinase) may not be as effective in lowering your blood sugar when you are taking hydrochlorothiazide and metoprolol. Your diabetes therapy may have to be adjusted.

• Lithium (Lithobid, Eskalith, others) generally should not be taken with hydrochlorothiazide and metoprolol because dangerous side effects may result.

• Other drugs that lower blood pressure must be used very cautiously. Very low blood pressure can result. Some drugs commonly used to lower blood pressure include acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), carteolol (Cartrol), labetalol (Trandate, Normodyne), propranolol (Inderal), pindolol (Visken), timolol (Blocadren), benazepril (Lotensin), enalapril (Vasotec), captopril (Capoten), fosinopril (Monopril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), amlodipine (Norvasc), bepridil (Vascor), diltiazem (Cardizem, Dilacor), felodipine (Plendil), isradipine (Dynacirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), and verapamil (Calan, Veralan, Isoptin).

Drugs other than those listed here may also interact with hydrochlorothiazide and metoprolol or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Seek emergency medical attention.

Symptoms of a hydrochlorothiazide and metoprolol overdose include an irregular heartbeat, seizures, confusion, fainting, coma, shortness of breath, and wheezing.