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

General

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

Gastrointestinal

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

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

Metoprolol:
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

Hydrochlorothiazide:
Frequency not reported: Dizziness, headache, paresthesia

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

Other

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

Hydrochlorothiazide:
Frequency not reported: Vertigo, weakness
Postmarketing reports: Fever

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

Metabolic

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

Hydrochlorothiazide:
Frequency not reported: Anorexia, hyperglycemia, hyperuricemia, hypokalemia

Metoprolol:
Frequency not reported: Weight gain[Ref]

Dermatologic

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

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

Metoprolol:
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]

Respiratory

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

Hydrochlorothiazide:
Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema

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

Cardiovascular

Common (1% to 10%): Bradycardia

Hydrochlorothiazide:
Frequency not reported: Orthostatic hypotension, necrotizing angiitis

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

Ocular

Common (1% to 10%): Blurred vision

Hydrochlorothiazide:
Frequency not reported: Transient blurred vision, xanthopsia

Metoprolol:
Postmarketing reports: Blurred vision, dry eyes[Ref]

Psychiatric

Common (1% to 10%): Nightmare

Hydrochlorothiazide:
Frequency not reported: Restlessness

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

Genitourinary

Common (1% to 10%): Impotence

Hydrochlorothiazide:
Frequency not reported: Glycosuria

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

Musculoskeletal

Common (1% to 10%): Muscle pain

Hydrochlorothiazide:
Frequency not reported: Muscle spasm

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

Immunologic

Common (1% to 10%): Flu syndrome

Hydrochlorothiazide:
Postmarketing reports: Anaphylactic reactions[Ref]

Hepatic

Frequency not reported: Liver enzymes increased, serum bilirubin increased

Hydrochlorothiazide:
Frequency not reported: Pancreatitis, intrahepatic cholestatic jaundice

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

Hematologic

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

Renal

Hydrochlorothiazide:
Postmarketing reports: Interstitial nephritis[Ref]

References

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. Drugs.com 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.

(web1)