Metoprolol/ hydrochlorothiazide extended-release tablets
Generic Name: metoprolol/hydrochlorothiazide (MET-oh-PROE-lol/HYE-droe-KLOR-oh-THYE-a-zide)
Brand Name: Dutoprol
Do not suddenly stop taking metoprolol/hydrochlorothiazide extended-release tablets. Sharp chest pain, irregular heartbeat, and sometimes heart attack may occur if you suddenly stop taking metoprolol/hydrochlorothiazide extended-release tablets. The risk may be greater if you have certain types of heart disease. Your doctor should slowly lower your dose over several weeks if you need to stop taking it. This should be done even if you only take metoprolol/hydrochlorothiazide extended-release tablets 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 metoprolol/hydrochlorothiazide extended-release tablets again.
Metoprolol/ hydrochlorothiazide extended-release tablets are used for:
Treating high blood pressure.
Metoprolol/hydrochlorothiazide extended-release tablets are a beta-adrenergic blocking agent (beta-blocker) and diuretic combination. The beta-blocker works by slowing down the heartbeat, helping the heart beat more regularly, and reducing the amount of work the heart has to do. The diuretic increases the elimination of excess fluid, which helps to decrease blood pressure.
Do NOT use metoprolol/ hydrochlorothiazide extended-release tablets if:
- you are allergic to any ingredient in metoprolol/hydrochlorothiazide extended-release tablets, to another beta-blocker (eg, propranolol), or to a sulfonamide medicine (eg, sulfamethoxazole)
- you have shock caused by serious heart problems or uncontrolled heart failure
- you have a very slow heartbeat, a certain type of irregular heartbeat (sick sinus syndrome), or second- or third-degree heart block and you do not have a pacemaker
- you are unable to urinate
- you are taking dofetilide
Contact your doctor or health care provider right away if any of these apply to you.
Before using metoprolol/ hydrochlorothiazide extended-release tablets:
Some medical conditions may interact with metoprolol/hydrochlorothiazide extended-release tablets. 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 asthma, bronchitis, or other lung or breathing problems (eg, chronic obstructive pulmonary disease [COPD]); diabetes; glaucoma or increased pressure in the eye; gout; an overactive thyroid; low blood sugar; an adrenal gland tumor (pheochromocytoma); lupus; liver problems; high blood cholesterol or triglycerides; low blood volume; or kidney problems
- if you have high or low blood electrolyte levels (eg, sodium, potassium, magnesium, calcium)
- if you will be having surgery or receiving anesthesia
- if you have low blood pressure or a history of heart attack, slow or irregular heartbeat, heart failure, or other heart problems; chest pain or angina; or blood vessel or circulation problems
- 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 metoprolol/hydrochlorothiazide extended-release tablets. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Clonidine, digoxin, diltiazem, or verapamil because the risk of slow heartbeat may be increased
- Monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), reserpine, or other medicines for blood pressure because side effects, such as slow or irregular heartbeat, unusual tiredness or weakness, low blood pressure, fainting, or severe dizziness or light-headedness, may occur
- Adrenocorticotropic hormone (ACTH), other beta-blockers (eg, propranolol), corticosteroids (eg, prednisone), fluoxetine, paroxetine, propafenone, or quinidine because they may increase the risk of metoprolol/hydrochlorothiazide extended-release tablets's side effects
- Cholestyramine, colestipol, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because they may decrease metoprolol/hydrochlorothiazide extended-release tablets's effectiveness
- Dofetilide, insulin or other medicines for diabetes (eg, glyburide), or lithium because the risk of their side effects may be increased by metoprolol/hydrochlorothiazide extended-release tablets
- Barbiturates (eg, phenobarbital) or narcotics (eg, codeine) because the risk of their side effects may be increased by metoprolol/hydrochlorothiazide extended-release tablets
This may not be a complete list of all interactions that may occur. Ask your health care provider if metoprolol/hydrochlorothiazide extended-release tablets 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 metoprolol/ hydrochlorothiazide extended-release tablets:
Use metoprolol/hydrochlorothiazide extended-release tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take metoprolol/hydrochlorothiazide extended-release tablets by mouth with or without food.
- Swallow metoprolol/hydrochlorothiazide extended-release tablets whole. Do not crush or chew before swallowing. Some strengths of metoprolol/hydrochlorothiazide extended-release tablets may be broken in half if your doctor tells you to do so.
- If you also take cholestyramine or colestipol, ask your doctor or pharmacist how to take it with metoprolol/hydrochlorothiazide extended-release tablets.
- Metoprolol/hydrochlorothiazide extended-release tablets 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.
- Take metoprolol/hydrochlorothiazide extended-release tablets on a regular schedule to get the most benefit from it.
- Continue to take metoprolol/hydrochlorothiazide extended-release tablets even if you feel well. Do not miss any doses.
- If you miss a dose of metoprolol/hydrochlorothiazide extended-release tablets, 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 metoprolol/hydrochlorothiazide extended-release tablets.
Important safety information:
- Metoprolol/hydrochlorothiazide extended-release tablets may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use metoprolol/hydrochlorothiazide extended-release tablets with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Metoprolol/hydrochlorothiazide extended-release tablets 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.
- Drink plenty of fluids while taking metoprolol/hydrochlorothiazide extended-release tablets and avoid engaging in activities that cause excessive sweating. Dehydration, excessive sweating, vomiting, or diarrhea may lead to a fall in blood pressure. Contact your health care provider at once if any of these occur.
- Metoprolol/hydrochlorothiazide extended-release tablets may decrease the amount of potassium in your body. If your doctor has also prescribed a potassium supplement for you, follow the dosing directions carefully. Check with your doctor before taking additional potassium on your own or including foods high in potassium (eg, bananas, orange juice) in your diet.
- 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.
- Metoprolol/hydrochlorothiazide extended-release tablets may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to metoprolol/hydrochlorothiazide extended-release tablets. 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 metoprolol/hydrochlorothiazide extended-release tablets before you receive any medical or dental care, emergency care, or surgery.
- Do not suddenly stop taking metoprolol/hydrochlorothiazide extended-release tablets without first consulting your doctor. If your doctor decides you should no longer take metoprolol/hydrochlorothiazide extended-release tablets, you will need to stop metoprolol/hydrochlorothiazide extended-release tablets gradually according to your doctor's instructions.
- If your doctor has instructed you to check your blood pressure and heart rate regularly, be sure to do so.
- Metoprolol/hydrochlorothiazide extended-release tablets contains a sulfonamide called hydrochlorothiazide, 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 metoprolol/hydrochlorothiazide extended-release tablets. Contact your doctor immediately if you experience symptoms such as vision changes (eg, decreased vision clearness) or eye pain.
- 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.
- Diabetes patients - Metoprolol/hydrochlorothiazide extended-release tablets may affect your blood sugar. It may also hide signs of low blood sugar, such as a rapid heartbeat. Be sure to watch for other signs of low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your vision change; give you a headache, chills, or tremors; or make you more hungry. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- If you have a history of any severe allergic reaction, talk with your doctor. You may be at 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 taking metoprolol/hydrochlorothiazide extended-release tablets.
- Metoprolol/hydrochlorothiazide extended-release tablets may interfere with certain lab tests, including parathyroid function. Be sure your doctor and lab personnel know you are taking metoprolol/hydrochlorothiazide extended-release tablets.
- Lab tests may be performed while you use metoprolol/hydrochlorothiazide extended-release tablets. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use metoprolol/hydrochlorothiazide extended-release tablets with caution in the ELDERLY; they may be more sensitive to its effects.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking metoprolol/hydrochlorothiazide extended-release tablets while you are pregnant. Metoprolol/hydrochlorothiazide extended-release tablets are found in breast milk. If you are or will be breast-feeding while you use metoprolol/hydrochlorothiazide extended-release tablets, check with your doctor. Discuss any possible risks to your baby.
Possible side effects of metoprolol/ hydrochlorothiazide extended-release tablets:
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:
Seek medical attention right away if any of these SEVERE side effects occur:
Diarrhea; dizziness; drowsiness; headache; mild sore throat; runny or stuffy nose; tiredness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); burning, numbness, or tingling; chest pain; chills, fever, or sore throat; cold hands and feet; decreased urination; dry mouth or eyes; fainting; fast, slow, or irregular heartbeat; hallucinations; mood or mental changes (eg, depression); red, swollen, blistered, or peeling skin; restlessness; severe or persistent dizziness, drowsiness, or light-headedness; severe or persistent stomach pain; shortness of breath; sudden, unexplained weight gain; swelling of the hands, ankles, legs, or feet; symptoms of electrolyte problems (eg, mood changes, confusion, muscle pain or weakness, irregular heartbeat, seizures, loss of appetite, severe nausea or vomiting, sluggishness); unusual bruising or bleeding; unusual thirst, weakness, or fatigue; wheezing; yellowing of the skin or eyes.
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.Proper storage of metoprolol/hydrochlorothiazide extended-release tablets:
Store metoprolol/hydrochlorothiazide extended-release tablets at 77 degrees F (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 metoprolol/hydrochlorothiazide extended-release tablets out of the reach of children and away from pets.
- If you have any questions about metoprolol/hydrochlorothiazide extended-release tablets, please talk with your doctor, pharmacist, or other health care provider.
- Metoprolol/hydrochlorothiazide extended-release tablets are 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 metoprolol/hydrochlorothiazide extended-release tablets 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 metoprolol/hydrochlorothiazide extended-release tablets. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to metoprolol/hydrochlorothiazide extended-release tablets. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using metoprolol/hydrochlorothiazide extended-release tablets.
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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