Metoprolol/hydrochlorothiazide (By mouth)

How to Use This Medicine

Tablet, Long Acting Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• This medicine should not be the first medicine you use to treat your condition. It is meant to be used only after you have tried other medicines that have not worked or have caused unwanted side effects.
• Take this medicine with a meal or just after a meal.
• Carefully follow your doctor's instructions about any special diet.

If a dose is missed:

• If you miss a dose or forget to use your medicine, skip the missed dose. Never take extra medicine to make up for a missed dose.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blurred vision or changes in vision
• Change in how much or how often you urinate
• Chest pain
• Confusion, body weakness, and muscle twitching
• Dry mouth, increased thirst, or muscle cramps
• Lightheadedness, dizziness, or fainting
• Seizures
• Shortness of breath, cold sweats, and bluish-colored skin, palms, or fingernails
• Slow, fast, pounding, or uneven heartbeat
• Sudden and severe stomach pain, nausea, or vomiting
• Swelling in your hands, feet, ankles, or legs
• Unusual tiredness or weakness
• Wheezing or trouble breathing

If you notice these less serious side effects, talk with your doctor:

• Constipation, diarrhea, loss of appetite, or stomach upset
• Depression
• Stuffy nose

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Introduction

Hydrochlorothiazide (hye-droe-klor-oh-THYE-a-zide), Metoprolol (met-oh-PROE-lol)

Treats high blood pressure. A lower blood pressure will reduce the risk of stroke and heart attack. This medicine is a combination of a beta-blocker and a diuretic (water pill).

Brand Name(s)

Lopressor HCT, Dutoprol

When This Medicine Should Not Be Used

How to Store and Dispose of This Medicine

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you use diet pills, amiodarone (Cordarone®), chlordiazepoxide (Limbitrol®), cholestyramine (Questran®), colestipol (Colestid®), digoxin (Lanoxin®), lithium (Eskalith®, Lithobid®), mirtazapine (Remeron®), norepinephrine, reserpine (Ser-ap-es®), theophylline (Slo-Bid®, Theo-Dur®), medicine to treat depression (such as bupropion, fluoxetine, paroxetine, Paxil®, or Prozac®), medicine for seizures (such as phenobarbital, primidone, or Mysoline®), pain medicine (such as Percocet®, Percodan®, or Vicodin®), medicine for heart rhythm problems (such as disopyramide, quinidine, propafenone, Norpace®, or Rythmol®), or a monoamine oxidase (MAO) inhibitor (such as Eldepryl®, Marplan®, Nardil®, or Parnate®).
• Make sure your doctor knows if you are also using a diabetes medicine (insulin or oral medicine such as glipizide, glyburide, metformin, Avandia®, Glucophage®, or Glucotrol®), diuretics or water pills (such as furosemide, Hyzaar®, Lasix®, or Moduretic®), pain or arthritis medicine (such as aspirin, celecoxib, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Ecotrin®, Motrin®, or Orudis®), steroid medicine (such as cortisone, dexamethasone, prednisolone, prednisone, Azmacort®, Flonase®, or Medrol®), or other blood pressure medicines (such as atenolol, clonidine, diltiazem, lisinopril, metoprolol, verapamil, propranolol, Accupril®, Adalat®, Altace®, Calan®, Cardizem®, Catapres®, Combipres®, Dilacor® XR, Inderal®, Ismelin®, Lotensin®, Lotrel®, Plendil®, Procardia®, Tenormin®, Tiazac®, Toprol®, Vasotec®, or Zestril®).
• Tell your doctor if you are use diphenhydramine (Benadryl®), halothane (Fluothane®), methyldopa (Aldomet®), terbinafine (Lamisil®), tubocurarine, medicine for HIV infection (such as ritonavir, Norvir®), medicine for mental illness (such as thioridazine, Mellaril®), medicine for malaria (such as hydroxychloroquine, Plaquenil®, or Quinora®), or a stomach medicine (such as cimetidine, Tagamet®).
• Ask your doctor before you use medicines, supplements, or salt substitutes that contain potassium.
• Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine.

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart or blood vessel disease, chest pain, or a history of mineral imbalance (such as high or low calcium, magnesium, potassium, or sodium in the blood). Tell your doctor if you have gout, lung disease, lupus, an overactive thyroid, pheochromocytoma (an adrenal gland tumor), or a history of asthma. Also tell your doctor if you will be having any surgery.
• Do not stop using this medicine suddenly without asking your doctor, or you could develop life-threatening heart problems. You may need to slowly decrease your dose before stopping it completely.
• This medicine may make you dizzy, lightheaded, or drowsy, especially when you first begin to use it. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you are dizzy.
• This medicine could cause dehydration. Symptoms include dry mouth, thirst, unusual tiredness, and less urine than usual. Dehydration is more likely to occur if you have diarrhea or vomiting, sweat heavily, or do not drink enough water.
• Check with your doctor right away if you have confusion, muscle pain or cramps, nausea and vomiting, trouble breathing, weakness, or an uneven heartbeat. These could be symptoms of electrolyte imbalances (loss of sodium, potassium, or magnesium).
• Stop using this medicine and check with your doctor immediately if blurred vision, difficulty reading, eye pain, or any other change in vision occurs. Your doctor will want an eye doctor to check your eyes.
• Call your doctor right away if you have rapid weight gain, chest pain, or trouble breathing. These may be signs of a serious heart problem.
• Tell your doctor if you have diabetes. This medicine may raise or lower your blood sugar, or it may cover up symptoms of very low blood sugar.
• Make sure any doctor or dentist who treats you knows that you are using this medicine.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood and urine tests may be needed to check for unwanted effects.
• Even if you feel well, do not stop using this medicine without asking your doctor. This medicine will not cure your high blood pressure, but it will help lower it and keep it down. You may have to take blood pressure medicine for the rest of your life.