Propranolol/ hydrochlorothiazide

Generic Name: propranolol/hydrochlorothiazide (proe-PRAN-oh-lol/HYE-droe-KLOR-oh-THYE-a-zide)
Brand Name: Inderide

Do not suddenly stop taking propranolol/hydrochlorothiazide without talking with your doctor. Sharp chest pain, irregular heartbeat, and sometimes a heart attack may occur if you suddenly stop propranolol/hydrochlorothiazide. The risk may be greater if you have certain types of heart disease. Your doctor should lower your dose over several weeks if you need to stop taking it. This should be done even if you only take propranolol/hydrochlorothiazide for high blood pressure. Heart disease is common and you may not know you have it. Limit physical activity while you are lowering your dose. If new or worsened chest pain or other heart problems occur, contact your doctor right away. You may need to start taking propranolol/hydrochlorothiazide again.


Propranolol/ hydrochlorothiazide is used for:

Treating high blood pressure. It may also be used for other conditions as determined by your doctor.

Propranolol/hydrochlorothiazide is a beta-blocker and thiazide diuretic combination. The beta-blocker works by decreasing the force and slowing down the heartbeat, helping the heart beat more regularly, and reducing the amount of work the heart has to do. The thiazide diuretic works by removing excess fluid from the body, which helps to decrease blood pressure.

Do NOT use propranolol/ hydrochlorothiazide if:

  • you are allergic to any ingredient in propranolol/hydrochlorothiazide or to another sulfonamide medicine (eg, glyburide, probenecid, sulfamethoxazole)
  • you have moderate to severe heart block, sick sinus syndrome, or a very slow heartbeat and you do not have a permanent pacemaker
  • you have uncontrolled heart failure, shock caused by serious heart problems, or very low blood pressure after a heart attack
  • you have asthma or you are unable to urinate
  • you are taking another beta-blocker (eg, metoprolol), dofetilide, or mibefradil

Contact your doctor or health care provider right away if any of these apply to you.

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Before using propranolol/ hydrochlorothiazide:

Some medical conditions may interact with propranolol/hydrochlorothiazide. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of lung or breathing problems (eg, asthma, chronic bronchitis, chronic obstructive pulmonary disease [COPD], emphysema), diabetes, gout, an overactive thyroid, low potassium or sodium blood levels, heart problems (eg, angina, congestive heart failure), blood vessel problems, glaucoma or increased eye pressure, an adrenal gland tumor (pheochromocytoma), lupus, liver disease, or kidney problems
  • if you have Wolff-Parkinson-White syndrome or Raynaud syndrome
  • if you are scheduled to have surgery or receive anesthesia
  • if you have recently had a certain type of nerve surgery (sympathectomy)
  • if you have never taken another medicine for high blood pressure

Some MEDICINES MAY INTERACT with propranolol/hydrochlorothiazide. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Digoxin, dofetilide, or mibefradil because the risk of irregular heartbeat may be increased
  • Other beta-blockers because they may increase the risk of propranolol/hydrochlorothiazide's side effects
  • Many prescription and nonprescription medicines (eg, used for infections, inflammation, aches and pains, high blood pressure, heart problems, irregular heartbeat, diabetes, prostate problems, blood thinning, thyroid problems, depression, mental or mood problems, immune system suppression, allergic reactions, asthma, high cholesterol, seizures, local anesthesia), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John's wort) may interact with propranolol/hydrochlorothiazide, increasing the risk of side effects

This may not be a complete list of all interactions that may occur. Ask your health care provider if propranolol/hydrochlorothiazide may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use propranolol/ hydrochlorothiazide:

Use propranolol/hydrochlorothiazide as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take propranolol/hydrochlorothiazide by mouth with or without food.
  • If you also take cholestyramine or colestipol, ask your doctor or pharmacist how to take it with propranolol/hydrochlorothiazide.
  • Propranolol/hydrochlorothiazide may increase the amount of urine or cause you to urinate more often when you first start taking it. To keep this from disturbing your sleep, try to take your dose before 6 pm.
  • If you miss a dose of propranolol/hydrochlorothiazide, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use propranolol/hydrochlorothiazide.

Important safety information:

  • Propranolol/hydrochlorothiazide may cause drowsiness, dizziness, or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use propranolol/hydrochlorothiazide with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Propranolol/hydrochlorothiazide may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Check with your doctor before drinking alcohol while you are taking propranolol/hydrochlorothiazide.
  • Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
  • If you suddenly stop taking certain medicines, sharp chest pain, and in some cases a heart attack, may occur. When stopping treatment with propranolol/hydrochlorothiazide, your doctor will need to slowly decrease your dose over a period of 1 to 2 weeks and will watch you closely for side effects, particularly if you have certain kinds of heart disease. If chest pain becomes more severe, contact your doctor immediately. Because heart artery disease is common and you may no know you have it, it may be safer not to stop propranolol/hydrochlorothiazide quickly, even if you are only being treated for high blood pressure.
  • Propranolol/hydrochlorothiazide contains hydrochlorothiazide, a sulfonamide, which can cause certain eye problems (myopia, angle-closure glaucoma). Your risk may be increased if you are allergic to sulfonamide medicines (eg, sulfamethoxazole) or to penicillin antibiotics (eg, amoxicillin). Untreated angle-closure glaucoma can lead to permanent vision loss. If these eye problems occur, symptoms usually occur within hours to weeks of starting propranolol/hydrochlorothiazide. Contact your doctor immediately if you experience symptoms such as vision changes (eg, decreased vision clearness) or eye pain.
  • Propranolol/hydrochlorothiazide may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to propranolol/hydrochlorothiazide. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Tell your doctor or dentist that you take propranolol/hydrochlorothiazide before you receive any medical or dental care, emergency care, or surgery.
  • If you have high blood pressure, do not use nonprescription products that contain stimulants. These products may include diet pills or cold medicines. Contact your doctor if you have any questions or concerns.
  • If you have a history of any severe allergic reaction, talk with your doctor. You may be at a risk of an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are using propranolol/hydrochlorothiazide.
  • Propranolol/hydrochlorothiazide may cause low blood sugar levels. This is most likely to happen in infants and children, or in patients who have diabetes or kidney problems. It may also occur after prolonged physical activity or during fasting. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you hungrier. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If it is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens.
  • Diabetes patients - Propranolol/hydrochlorothiazide may hide signs of low blood sugar, such as a rapid heartbeat. Be sure to watch for other signs of low blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Propranolol/hydrochlorothiazide may interfere with certain lab tests, including glaucoma screening and thyroid function. Be sure your doctor and lab personnel know that you are taking propranolol/hydrochlorothiazide.
  • Lab tests, including blood pressure and blood electrolyte levels, may be performed while you use propranolol/hydrochlorothiazide. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use propranolol/hydrochlorothiazide with caution in the ELDERLY; they may be more sensitive to its effects.
  • Propranolol/hydrochlorothiazide should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking propranolol/hydrochlorothiazide while you are pregnant. Propranolol/hydrochlorothiazide is found in breast milk. Do not breast-feed while taking propranolol/hydrochlorothiazide.

Possible side effects of propranolol/ hydrochlorothiazide:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Dizziness; drowsiness; light-headedness; tiredness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; decreased urination; eye pain; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; muscle pain, weakness, or cramping; nausea; red, swollen, blistered, or peeling skin; restlessness; severe or persistent dizziness or drowsiness; severe or persistent dry mouth; shortness of breath or wheezing; sudden, unusual weight gain; swelling of the hands, ankles, or feet; symptoms of low blood sodium levels (eg, confusion, mental or mood changes, seizures, sluggishness); unusual bruising or bleeding; unusual fatigue, thirst, or weakness; vision changes (eg, decreased vision clearness); vomiting.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; loss of consciousness; nausea; severe or persistent dizziness, light-headedness, or drowsiness; slow heart rate; symptoms of blood electrolyte problems (eg, confusion; irregular heartbeat; mental or mood changes; muscle pain, weakness, or cramping; seizures; sluggishness; trouble breathing); symptoms of heart failure (eg, sudden, unusual weight gain; swelling of the hands, ankles, or feet); trouble breathing; unusual tiredness or weakness; upset stomach; vomiting.

Proper storage of propranolol/hydrochlorothiazide:

Store propranolol/hydrochlorothiazide between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep propranolol/hydrochlorothiazide out of the reach of children and away from pets.

General information:

  • If you have any questions about propranolol/hydrochlorothiazide, please talk with your doctor, pharmacist, or other health care provider.
  • Propranolol/hydrochlorothiazide is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take propranolol/hydrochlorothiazide or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about propranolol/hydrochlorothiazide. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to propranolol/hydrochlorothiazide. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using propranolol/hydrochlorothiazide.

Issue Date: April 2, 2014
Database Edition 14.2.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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