Skip to Content

Hydrochlorothiazide / metoprolol Side Effects

Not all side effects for hydrochlorothiazide / metoprolol may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to hydrochlorothiazide / metoprolol: oral tablet

In addition to its needed effects, some unwanted effects may be caused by hydrochlorothiazide / metoprolol. In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking hydrochlorothiazide / metoprolol:

More common
  • Chest pain or discomfort
  • convulsions
  • decreased urine
  • dry mouth
  • increased thirst
  • lightheadedness, dizziness, or fainting
  • loss of appetite
  • mood changes
  • muscle pain or cramps
  • nausea or vomiting
  • numbness or tingling in the hands, feet, or lips
  • slow or irregular heartbeat
  • unusual tiredness or weakness
Less common
  • Ankle, knee, or great toe joint pain
  • decreased ability to exercise
  • difficult or labored breathing
  • joint stiffness or swelling
  • lower back or side pain
  • swelling of the face, fingers, feet, or lower legs
  • tightness in the chest

If any of the following symptoms of overdose occur while taking hydrochlorothiazide / metoprolol, get emergency help immediately:

Symptoms of overdose
  • Blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chemical imbalance in the blood
  • cold, clammy skin
  • coma
  • confusion
  • cough
  • dilated neck veins
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drowsiness
  • extreme fatigue
  • fast or pounding heartbeat or pulse
  • frequent urination
  • headache
  • increased volume of pale, dilute urine
  • irregular breathing
  • irritability
  • noisy breathing
  • not able to pass urine
  • pain or aching in the lower legs
  • pain or weakness in the hands or feet
  • seizures
  • sweating
  • trembling
  • unconsciousness
  • very drowsy or sleepy
  • weak pulse
  • weakness and heaviness of the legs
  • weight gain

Some of the side effects that can occur with hydrochlorothiazide / metoprolol may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common
  • Chills
  • diarrhea
  • feeling of constant movement of self or surroundings
  • fever
  • general feeling of discomfort or illness
  • muscle aches
  • nightmares
  • runny nose
  • sensation of spinning
  • shivering
  • sleepiness
  • sore throat
  • trouble sleeping
  • unusual drowsiness, dullness, or feeling of sluggishness
Less common
  • Continuing ringing or buzzing or other unexplained noise in the ears
  • decreased interest in sexual intercourse
  • difficulty having a bowel movement (stool)
  • earache
  • hearing loss
  • inability to have or keep an erection
  • loss in sexual ability, desire, drive, or performance
  • pinpoint red or purple spots on the skin
  • weight loss

For Healthcare Professionals

Applies to hydrochlorothiazide / metoprolol: oral tablet, oral tablet extended release


The most common side effects were fatigue, lethargy, flu syndrome, dizziness, vertigo, drowsiness, somnolence, and headache.[Ref]


Common (1% to 10%): Diarrhea, digestive disorder, dry mouth, nausea, vomiting, constipation

Frequency not reported: Sialadenitis, vomiting, diarrhea, cramping, nausea, gastric irritation, constipation

Common (1% to 10%): Diarrhea, nausea, gastric pain, constipation, flatulence, heartburn
Frequency not reported: Vomiting, retroperitoneal fibrosis
Postmarketing reports: Dry mouth[Ref]

Nervous system

Common (1% to 10%): Lethargy, dizziness, drowsiness, somnolence, headache, tinnitus

Frequency not reported: Dizziness, headache, paresthesia

Common (1% to 10%): Tiredness, dizziness
Frequency not reported: Short-term memory loss, headache
Postmarketing reports: Somnolence, paresthesia, syncope, taste disturbance[Ref]


Common (1% to 10%): Fatigue, vertigo, exercise tolerance decreased, edema, earache

Frequency not reported: Vertigo, weakness
Postmarketing reports: Fever

Frequency not reported: Fatigue
Postmarketing reports: Lactic dehydrogenase elevation, alkaline phosphatase elevation, blood triglycerides increased, high-density lipoprotein decreased, tinnitus[Ref]


Common (1% to 10%): Hypokalemia, gout, anorexia

Frequency not reported: Anorexia, hyperglycemia, hyperuricemia, hypokalemia

Frequency not reported: Weight gain[Ref]


Common (1% to 10%): Sweating, purpura

Frequency not reported: Stevens-Johnson syndrome, purpura, urticaria, rash, photosensitivity
Postmarketing reports: Erythema multiforme, exfoliative dermatitis, toxic epidermal necrolysis

Uncommon (0.1% to 1%): Pruritus
Frequency not reported: Gangrene, rash, photosensitivity, worsening of psoriasis, alopecia
Postmarketing reports: Sweating[Ref]

Gangrene has been reported very rarely in patients with preexisting severe peripheral circulatory disorders who were taking metoprolol.[Ref]


Common (1% to 10%): Dyspnea, nasopharyngitis

Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema

Common (1% to 10%): Shortness of breath
Uncommon (0.1% to 1%): Wheezing
Frequency not reported: Rhinitis
Postmarketing reports: Dyspnea[Ref]


Common (1% to 10%): Bradycardia

Frequency not reported: Orthostatic hypotension, necrotizing angiitis

Common (1% to 10%): Bradycardia
Frequency not reported: Cold extremities, arterial insufficiency, palpitations, congestive heart failure
Postmarketing reports: Peripheral edema, chest pain[Ref]


Common (1% to 10%): Blurred vision

Frequency not reported: Transient blurred vision, xanthopsia

Postmarketing reports: Blurred vision, dry eyes[Ref]


Common (1% to 10%): Nightmare

Frequency not reported: Restlessness

Common (1% to 10%): Depression
Frequency not reported: Mental confusion, nightmare, insomnia
Postmarketing reports: Confusional state, anxiety/nervousness, hallucination, libido decreased[Ref]


Common (1% to 10%): Impotence

Frequency not reported: Glycosuria

Very rare (less than 0.01%): Peyronie's disease
Postmarketing reports: Male impotence[Ref]


Common (1% to 10%): Muscle pain

Frequency not reported: Muscle spasm

Frequency not reported: Arthritis
Postmarketing reports: Musculoskeletal pain, arthralgia[Ref]


Common (1% to 10%): Flu syndrome

Postmarketing reports: Anaphylactic reactions[Ref]


Frequency not reported: Liver enzymes increased, serum bilirubin increased

Frequency not reported: Pancreatitis, intrahepatic cholestatic jaundice

Postmarketing reports: Hepatitis, jaundice, non-specific hepatic dysfunction, transaminase elevation[Ref]


Frequency not reported: Aplastic anemia, agranulocytosis, leukopenia, thrombocytopenia, hemolytic anemia[Ref]


Postmarketing reports: Interstitial nephritis[Ref]


1. "Product Information. Lopressor HCT (metoprolol-hydrochlorothiazide)." Novartis Pharmaceuticals, East Hanover, NJ.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.