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Hydrochlorothiazide / metoprolol Side Effects

Medically reviewed by Last updated on Jun 20, 2023.


Commonly reported side effects of hydrochlorothiazide/metoprolol include: drowsiness, lethargy, thrombocytopenia, and vomiting. Continue reading for a comprehensive list of adverse effects.

Applies to hydrochlorothiazide / metoprolol: oral tablet.

Serious side effects

Along with its needed effects, hydrochlorothiazide/metoprolol may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking hydrochlorothiazide / metoprolol:

More common

  • Chest pain or discomfort
  • 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
  • seizures
  • slow or irregular heartbeat
  • unusual tiredness or weakness

Less common

  • Ankle, knee, or great toe joint pain
  • chest tightness
  • 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

Incidence not known

  • Persistent non-healing sore
  • pink growth
  • reddish patch or irritated area
  • shiny bump
  • white, yellow or waxy scar-like area

Get emergency help immediately if any of the following symptoms of overdose occur while taking hydrochlorothiazide / metoprolol:

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
  • 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
  • sweating
  • trembling
  • unconsciousness
  • very drowsy or sleepy
  • weak pulse
  • weakness and heaviness of the legs
  • weight gain

Other side effects

Some side effects of hydrochlorothiazide / metoprolol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

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 (hydrochlorothiazide-metoprolol). Novartis Pharmaceuticals. 2022.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.