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Beta-Adrenergic Blocking Agents & Thiazide Diuretics

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BRAND & GENERIC NAMES

ATENOLOL & CHLORTHALIDONE

  • Co-Betaloc
  • Corzide
  • Inderide
  • Inderide LA
  • Lopressor HCT
  • METOPROLOL & HYDROCHLOROTHIAZIDE
  • NADOLOL & BENDROFLUMETHIAZIDE
  • Normozide
  • PINDOLOL & HYDROCHLOROTHIAZIDE
  • PROPRANOLOL & HYDROCHLOROTHIAZIDE
  • Tenoretic
  • Timolide
  • TIMOLOL & HYDROCHLOROTHIAZIDE
  • Trandate HCT
  • Viskazide

BASIC INFORMATION

  • Habit forming? No
  • Prescription needed? Yes
  • Available as generic? Yes
  • Drug class: Beta-adrenergic blocker, thiazide diuretic

USES

  • Controls, but doesn’t cure, high blood pressure.
  • Reduces fluid retention (edema).
  • Reduces angina attacks.
  • Stabilizes irregular heartbeat.
  • Lowers blood pressure.
  • Reduces frequency of migraine headaches. (Does not relieve headache pain.)
  • Other uses prescribed by your doctor.

DOSAGE & USAGE INFORMATION

How to take: Extended-release capsules — Swallow with liquid. If you can’t swallow whole, crumble tablet and take with liquid or food.
When to take: At the same time each day.
If you forget a dose: Take as soon as you remember up to 4 hours late. If more than 4 hours, wait for next scheduled dose (don’t double this dose).
What drug does:

  • Forces sodium and water excretion, reducing body fluid.
  • Relaxes muscle cells of small arteries.
  • Reduced body fluid and relaxed arteries lower blood pressure.
  • Blocks some of the actions of sympathetic nervous system.
  • Lowers heart’s oxygen requirements.
  • Slows nerve impulses through heart.
  • Reduces blood vessel contraction in heart, scalp and other body parts.

Time lapse before drug works:

  • 1 to 4 hours for beta-blocker effect.
  • May require several weeks to lower blood pressure. Don’t take with: Any other medicines, even over-the-counter drugs such as cough and cold medicines, nose drops, diet pills, laxatives or caffeine, without consulting your doctor.

OVERDOSE SYMPTOMS: Irregular heartbeat (usually too slow), confusion, fainting, convulsions, coma.
WHAT TO DO: Dial 0 (operator) or 911 (emergency) for an ambulance or medical help. Then give first aid immediately.

POSSIBLE ADVERSE REACTIONS OR SIDE EFFECTS

SYMPTOMS WHAT TO DO

Life-threatening: Wheezing, chest pain, Seek emergency irregular heartbeat. treatment immediately.
Common:
Dry mouth, weak Discontinue. Call pulse, vomiting, doctor right away. muscle cramps, increased thirst, mood changes.
Weakness, tiredness, Continue. Call doctor dizziness, mental when convenient. depression, diminished sex drive, constipation, nightmares, insomnia. Infrequent: Cold feet and hands, Discontinue. Call chest pain, breathing doctor right away. difficulty, anxiety, nervousness, headache, appetite loss, abdominal pain, numbness and tingling in fingers and toes. Rare:
Hives, skin rash; Discontinue. Call joint pain; jaundice; doctor right away. fever, sore throat, mouth ulcers.
Impotence. Continue. Call doctor when convenient.

WARNINGS & PRECAUTIONS

Don’t take if:

  • You are allergic to any beta-adrenergic blocker or any thiazide diuretic drug.
  • You have asthma or hay fever symptoms.
  • You have taken MAO inhibitors in past two weeks.

Before you start, consult your doctor:

  • If you have heart disease or poor circulation to the extremities.
  • If you have hay fever, asthma, chronic bronchitis, emphysema, overactive thyroid function, impaired liver or kidney function, gout, diabetes, hypoglycemia, pancreas disorder, systemic lupus erythematosus.
  • If you are allergic to any sulfa drug or tartrazine dye.
  • If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia. Pregnancy: Risk to unborn child outweighs drug benefits. Don’t use. Infants & children: Don’t give to infants or young children unless prescribed and monitored by your physician.

Prolonged use:

  • Weakens heart muscle contractions.
  • You may need medicine to treat high blood pressure for the rest of your life. Skin & sunlight: May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

Driving or hazardous activities: Don’t drive or pilot aircraft until you learn how med-icine affects you. Don’t work around dangerous machinery. Don’t climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.
Discontinuing: Don’t discontinue without consulting doctor. Dose may require gradual reduction if you have taken drug for a long time. Doses of other drugs may also require adjustment.
Others:

  • May mask hypoglycemia symptoms.
  • Hot weather and fever may cause dehydration and drop in blood pressure. Dose may require temporary adjustment. Weigh daily and report any unexpected weight decreases to your doctor.
  • May cause rise in uric acid, leading to gout.
  • May cause blood-sugar rise in diabetics.

POSSIBLE INTERACTION WITH OTHER DRUGS

Allopurinol Decreased allopurinol effect.
Antidepressants, Dangerous drop in tricyclic combination unless under medical supervision.
Antidiabetics Increased antidiabetic effect.
Antihistamines Decreased antihistamine effect.
Antihypertensives Increased antihypertensive effect.
Barbiturates Increased barbiturate effect. Dangerous sedation.
Beta-adrenergic Increased blockers antihypertensive effect.
Dosages of both drugs may require adjustments.
Bumetanide Increased diuretic effect.
Cholestyramine Decreased hydrochlorothiazide effect.
Cortisone drugs Excessive potassium loss that causes dangerous heart rhythms.
Digitalis Excessive potassium preparations loss that causes dangerous heart rhythms. Can either increase or decrease heart rate.
Improves irregular heartbeat.
Diuretics Increased effect of other thiazide diuretics.
Ethacrynic acid Increased diuretic effect.
Furosemide Increased diuretic effect.
Guanfacine Increased effect of both drugs.
Hypoglycemics Decreased ability to lower blood glucose.
Indapamide Increased diuretic effect.
Insulin Decreased ability to lower blood glucose.
MAO inhibitors Increased hydrochlorothiazide effect.
Metolazone Increased diuretic effect.
Narcotics Increased narcotic effect. Dangerous sedation.
Nitrates Excessive blood-pressure drop.
Non-steroidal Decreased anti-inflammatory effect.
Phenytoin Increased beta-adrenergic effect.
Potassium Decreased potassium supplements effect.
Probenecid Decreased probenecid effect.
Quinidine Slows heart excessively.
Reserpine Increased reserpine effect.
Excessive sedation and depression.
Tocainide May worsen congestive heart failure.

POSSIBLE INTERACTION WITH OTHER SUBSTANCES

  • Marijuana: May increase blood pressure.
  • Tobacco: May increase blood pressure and make heart work harder. Avoid.

From the Complete Guide to Pediatric Symptoms, Illness & Medications by H. Winter Griffith, M.D. © 1989 The Putnam Berkley Group, Inc.; electronic rights by Medical Data Exchange.

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