Hydrochlorothiazide / Metoprolol Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Hypertension

Dosage should be determined by individual titration.

Immediate release dose form:
Initial dose: 2 tablets of hydrochlorothiazide-metoprolol 25 mg-50 mg per day in single or divided doses, or 1 to 2 tablets of hydrochlorothiazide-metoprolol 25 mg-100 mg per day in single or divided doses, or 1 tablet of hydrochlorothiazide-metoprolol 50 mg-100 mg per day in single or divided doses.

Extended release dose form:
Initial dose: 1 tablet of hydrochlorothiazide-metoprolol (12.5-25, 12.5-50, or 12.5-100) orally once daily.

Renal Dose Adjustments

Hydrochlorothiazide is generally not effective in patients with creatinine clearance less than 25 mL/min. Thiazide diuretics should be used with caution in patients with severe renal disease.

Liver Dose Adjustments

Thiazide diuretics should be used with caution in patients with impaired hepatic function.

Dose Adjustments

Dosing regimens that exceed 50 mg of hydrochlorothiazide per day are not recommended.

Precautions

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Metoprolol is not significantly removed by hemodialysis, although its major metabolites are. There are no data on the peritoneal dialysis clearance of metoprolol; however, little removal by peritoneal dialysis is expected.

Other Comments

When necessary, another antihypertensive agent may be added gradually, beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.

Hydrochlorothiazide-metoprolol in combination may be substituted for treatment with individual components.

Hydrochlorothiazide-metoprolol may be administered with or without food.

Hydrochlorothiazide-metoprolol extended release should be administered once daily.

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