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Beta-Adrenergic Blocking Agents

Brand & Generic Names

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

BASIC INFORMATION

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

USES

  • 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:

  • Tablet, liquid or extended-release capsule — Swallow with liquid.
  • If you can’t swallow whole, crumble tablet or open capsule and take with liquid or food. Don’t crush capsule.

When to take:
With meals or immediately after.

If you forget a dose:
Take as soon as you remember. Return to regular schedule, but allow 3 hours between doses.

What drug does:

  • Blocks certain 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.
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: Weakness, slow or weak pulse, blood-pressure drop, fainting, difficulty breathing, convulsions, cold and sweaty skin.
  • 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: Congestive heart Discontinue. Seek failure. emergency treatment.

Common:

  • Pulse slower than Discontinue. Call 50 beats per minute. doctor right away.
  • Drowsiness, fatigue, Continue. Call doctor numbness or tingling when convenient. of fingers or toes, dizziness, diarrhea, nausea, weakness.
  • Cold hands or feet; Continue. Tell doctor dry mouth, eyes and at next visit. skin. Infrequent:
  • Hallucinations, Discontinue. Call nightmares, insomnia, doctor right away. headache, difficult breathing, joint pain, anxiety.
  • Confusion, reduced Continue. Call doctor alertness, depression, when convenient. impotence.
  • Constipation. Continue. Tell doctor at next visit. Rare:
  • Rash, sore throat, Discontinue. Call fever. doctor right away.
  • Unusual bleeding and Continue. Call doctor bruising; dry, burning when convenient. eyes; impotence.

WARNINGS & PRECAUTIONS

Don’t take if:

  • You are allergic to any beta-adrenergic blocker.
  • You have asthma.
  • You have hay fever symptoms.
  • You have taken MAO inhibitors in past 2 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.
  • If you have overactive thyroid function.
  • If you have impaired liver or kidney function.
  • If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.
  • If you have diabetes or hypoglycemia. 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. Skin & sunlight: No age-related problems expected.

Driving or hazardous activities:
Don’t drive or pilot aircraft until you learn how medicine 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.
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.

Possible Interaction with Other Drugs

GENERIC NAME COMBINED EFFECT
———————— ———————–
Allopurinol Decreased allopurinol effect.
Aminophylline Decreased effectiveness of both.
Antidepressants, Dangerous drop in blood pressure.
tricyclic (TCA) Avoid combination unless under
medical supervision.
Antidiabetics Increased antidiabetic effect.
Antihistamines Decreased antihistamine effect.
Antihypertensives Increased antihypertensive effect.
Barbiturates Increased barbiturate effect.
Dangerous sedation.
Bumetanide Increased diuretic effect.
Calcium channel Increased antihypertensive
blockers effect. Dosages of both drugs may
require adjustments.
Cholestyramine Decreased hydrochlorthiazide
effect.
Cortisone drugs Excessive potassium loss that
causes dangerous heart rhythms.
Diclofenac Decreased antihypetensive effect.
Digitalis Excessive potassium loss that causes
preparations dangerous heart rhythms. Can either
increase or decrease heart rate.
Improves irregular heartbeat.
Diuretics, thiazide 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
oral lower blood glucose.
Indapamide Increased diuretic effect.
Insulin Decreased ability to lower blood
glucose.
Lisinopril Increased antihypertensive effect.
Dosage of each may require
adjustment.
MAO inhibitors Increased hydrochlorothiazide
effect.
Metolazone Increased diuretic effect.
Narcotics Increased narcotic effect.
Dangerous sedation.
Nicardipine Possible irregular heartbeat and
congestive heart failure.
Nicotine Increased beta blocker effect.
Nitrates Excessive blood pressure drop.
Non-steroidal Decreased anti-
anti-inflammatory inflammatory effect.
Phenytoin Increased betaadrenergic effect.
Potassium Decreased potassium
supplements effect.
Probenecid Decreased probenecid effect.
Propafenone Increased effect of both drugs and
increased risk of toxicity.
Quinidine Slows heart excessively.
Reserpine Increased reserpine effect.
Excessive sedation and depression.
Sympathomimetics Decreased effectiveness of both.
Theophylline Decreased effectiveness of both.
Tocainide May worsen congestive heart
failure.
Zinc supplements Increased need for zinc.

Possible Interaction with Other Substances

INTERACTS WITH COMBINED EFFECT
————— —————
Alcohol: Dangerous blood pressure drop.
Avoid.
Beverages: None expected.
Cocaine: Irregular heartbeat, decreased
beta-blocker effect. Avoid.
Licorice. Excessive potassium loss that
causes dangerous heart rhythms.
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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