Propranolol and hydrochlorothiazide

Generic name: Propranolol And Hydrochlorothiazide
Drug class: Beta blockers with thiazides

Usage of Propranolol and hydrochlorothiazide

Propranolol and hydrochlorothiazide combination is used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Propranolol is a beta-blocker. It works by affecting the response to some nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart.

Hydrochlorothiazide is a diuretic (water pill). It reduces the amount of water in the body by increasing the flow of urine, which helps lower the blood pressure.

This medicine is available only with your doctor's prescription.

Propranolol and hydrochlorothiazide side effects

Along with its needed effects, a medicine 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:

Incidence not known

Black, tarry stools

bleeding gums

blistering, peeling, or loosening of the skin

bloating

blood in the urine

bloody nose

bloody stools

blurred or loss of vision

body aches or pain

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

chest pain, discomfort, or tightness

clay-colored stools

cold sweats

confusion about identity, place, and time

congestion

constipation

cough

coughing up blood

cracks in the skin

crying

darkened urine

decreased awareness or responsiveness

decreased urine output

depersonalization

diarrhea

difficulty with breathing or swallowing

dilated neck veins

disturbed color perception

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

double vision

dry mouth

dryness or soreness of the throat

dysphoria

false or unusual sense of well-being

fast, pounding, slow, or irregular heartbeat

fever or chills

flushing or redness of the skin

fruit-like breath odor

general feeling of discomfort or illness

general feeling of tiredness or weakness

hair loss

halos around lights

headaches

heavier menstrual periods

hives or welts, itching

hoarseness

increased hunger

increased sensitivity of the skin to sunlight

increased thirst

increased urination

indigestion

irregular breathing

irregular heartbeat

joint pain, stiffness, or swelling

lightheadedness, dizziness, or fainting

loss of appetite

loss of heat from the body

loss of strength or energy

lower back or side pain

mental depression

mimicry of speech or movements

muscle pain or weakness

mutism

nausea or vomiting

negativism

night blindness

noisy breathing

overbright appearance of lights

painful or difficult urination

pains in the stomach, side, or abdomen, possibly radiating to the back

paleness or cold feeling in the fingertips and toes

paranoia

peculiar postures or movements, mannerisms or grimacing

persistent non-healing sore

pink growth

pinpoint red or purple spots on the skin

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

quick to react or overreact emotionally

rapidly changing moods

rectal bleeding

red skin lesions, often with a purple center

red, irritated eyes

red, swollen skin

reddening of the skin, especially around the ears

reddish patch or irritated area

runny nose

scaly skin

seeing, hearing, or feeling things that are not there

severe sleepiness

severe sunburn

shiny bump

short-term memory loss

skin irritation or rash, including rash that looks like psoriasis

sleeplessness

sore throat

sores, ulcers, or white spots on the lips or in the mouth

stomach pain or tenderness

sugar in the urine

sweating

swelling of the eyes, face, or inside of the nose

swelling of the fingers, feet, or lower legs

tender, swollen, or painful glands in the neck

tenderness of salivary glands

tenderness, burning, or peeling of the skin

thickening of bronchial secretions

tingling or pain in the fingers or toes when exposed to cold

trouble breathing

trouble with sleeping

trouble with swallowing

tunnel vision

unable to sleep

unpleasant breath odor

unusual bleeding or bruising

unusual tiredness or weakness

unusual weight loss

unusually warm skin

voice changes

vomiting of blood

weight gain

white, yellow or waxy scar-like area

yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Change in consciousness

decreased urination

fast, slow, or shallow breathing

gas

heartburn

increase in heart rate

increased sweating

indigestion

loss of consciousness

low blood pressure

muscle cramps

pale or blue lips, fingernails, or skin

rapid breathing

seizures

sunken eyes

unusual drowsiness, dullness, or feeling of sluggishness

unusual paleness

weakness and heaviness of the legs

wrinkled skin

Some side effects 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:

Incidence not known

Decreased interest in sexual intercourse

dry eyes

feeling of constant movement of self or surroundings

inability to have or keep an erection

loss in sexual ability, desire, drive, or performance

muscle spasm

pain of the penis on erection

pain or discomfort in the chest, upper stomach, or throat

restlessness

sensation of spinning

stomach cramps

thinning of the hair

vivid dreams

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking Propranolol and hydrochlorothiazide

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of propranolol and hydrochlorothiazide combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of propranolol and hydrochlorothiazide combination in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving propranolol and hydrochlorothiazide combination.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Dofetilide

Rizatriptan

Thioridazine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abametapir

Acarbose

Aceclofenac

Acemetacin

Acetyldigoxin

Albiglutide

Albuterol

Alogliptin

Amphetamine

Amtolmetin Guacil

Arsenic Trioxide

Aspirin

Benzphetamine

Bromfenac

Bromocriptine

Bufexamac

Bupivacaine

Bupivacaine Liposome

Buprenorphine

Bupropion

Canagliflozin

Capmatinib

Celecoxib

Ceritinib

Chlorpropamide

Choline Salicylate

Clonidine

Clonixin

Codeine

Crizotinib

Dapagliflozin

Darunavir

Deslanoside

Desmopressin

Desvenlafaxine

Dexibuprofen

Dexketoprofen

Dextroamphetamine

Diatrizoate

Diclofenac

Diflunisal

Digitalis

Digitoxin

Digoxin

Diltiazem

Dipyrone

Dronedarone

Droperidol

Droxicam

Dulaglutide

Empagliflozin

Epinephrine

Escitalopram

Eslicarbazepine Acetate

Etodolac

Etofenamate

Etoricoxib

Exenatide

Fedratinib

Felbinac

Fenoldopam

Fenoprofen

Fepradinol

Feprazone

Fexinidazole

Fingolimod

Flecainide

Floctafenine

Flufenamic Acid

Fluoxetine

Flurbiprofen

Formoterol

Glimepiride

Glipizide

Glyburide

Haloperidol

Ibuprofen

Indacaterol

Indomethacin

Insulin

Insulin Aspart, Recombinant

Insulin Bovine

Insulin Degludec

Insulin Detemir

Insulin Glulisine

Iobenguane I 131

Iohexol

Ketanserin

Ketoprofen

Ketorolac

Lacosamide

Lercanidipine

Levalbuterol

Levomethadyl

Lidocaine

Linagliptin

Liraglutide

Lisdexamfetamine

Lithium

Lixisenatide

Lornoxicam

Loxoprofen

Lumiracoxib

Meclofenamate

Mefenamic Acid

Mefloquine

Meloxicam

Mepivacaine

Methamphetamine

Methotrexate

Metildigoxin

Miglitol

Morniflumate

Nabumetone

Naproxen

Nateglinide

Nepafenac

Niflumic Acid

Nimesulide

Nimesulide Beta Cyclodextrin

Olodaterol

Ouabain

Oxaprozin

Oxymetazoline

Oxyphenbutazone

Parecoxib

Phenylbutazone

Piketoprofen

Pioglitazone

Piroxicam

Pixantrone

Ponesimod

Porfimer

Pramlintide

Prilocaine

Proglumetacin

Propyphenazone

Proquazone

Proscillaridin

Repaglinide

Rivastigmine

Rofecoxib

Rosiglitazone

Salicylic Acid

Salmeterol

Salsalate

Saxagliptin

Simeprevir

Siponimod

Sitagliptin

Sodium Salicylate

Sotalol

Sparsentan

Sulindac

Tapentadol

Tenoxicam

Terbutaline

Tiaprofenic Acid

Tolazamide

Tolbutamide

Tolfenamic Acid

Tolmetin

Topiramate

Valdecoxib

Venlafaxine

Verapamil

Vilanterol

Vildagliptin

Zileuton

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acarbose

Aceclofenac

Acemetacin

Acetyldigoxin

Albiglutide

Alfuzosin

Alogliptin

Aluminum Carbonate, Basic

Aluminum Hydroxide

Aluminum Phosphate

Aminolevulinic Acid

Amtolmetin Guacil

Aspirin

Bepridil

Bromfenac

Bufexamac

Bunazosin

Calcium carbonate

Canagliflozin

Carbamazepine

Celecoxib

Chlorpromazine

Chlorpropamide

Cholestyramine

Choline Salicylate

Cimetidine

Clonixin

Dapagliflozin

Deslanoside

Dexibuprofen

Dexketoprofen

Diclofenac

Diflunisal

Digitoxin

Digoxin

Dihydroergotamine

Dihydroxyaluminum Aminoacetate

Dihydroxyaluminum Sodium Carbonate

Dipyrone

Doxazosin

Droxicam

Dulaglutide

Empagliflozin

Ergotamine

Ertugliflozin

Etodolac

Etofenamate

Etoricoxib

Exenatide

Felbinac

Fenoprofen

Fepradinol

Feprazone

Flecainide

Floctafenine

Flufenamic Acid

Flurbiprofen

Fluvoxamine

Ginkgo

Glimepiride

Glipizide

Glyburide

Gossypol

Ibuprofen

Indomethacin

Insulin Aspart, Recombinant

Insulin Degludec

Insulin Detemir

Insulin Glargine, Recombinant

Insulin Glulisine

Insulin Human Inhaled

Insulin Human Isophane (NPH)

Insulin Human Regular

Insulin Lispro, Recombinant

Ketoprofen

Ketorolac

Licorice

Linagliptin

Liraglutide

Lixisenatide

Lornoxicam

Loxoprofen

Lumiracoxib

Magaldrate

Meclofenamate

Mefenamic Acid

Meloxicam

Metformin

Metildigoxin

Miglitol

Morniflumate

Moxisylyte

Nabumetone

Naproxen

Nateglinide

Nepafenac

Niflumic Acid

Nimesulide

Nimesulide Beta Cyclodextrin

Oxaprozin

Oxyphenbutazone

Parecoxib

Phenoxybenzamine

Phentolamine

Phenylbutazone

Piketoprofen

Pioglitazone

Piroxicam

Pramlintide

Pranoprofen

Prazosin

Proglumetacin

Propyphenazone

Proquazone

Quinidine

Repaglinide

Rifapentine

Rofecoxib

Rosiglitazone

Salicylic Acid

Salsalate

Saxagliptin

Sitagliptin

Sodium Salicylate

St John's Wort

Sulindac

Tamsulosin

Tenoxicam

Terazosin

Tiaprofenic Acid

Tolazamide

Tolbutamide

Tolfenamic Acid

Tolmetin

Trimazosin

Urapidil

Valdecoxib

Vildagliptin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Tobacco

Relate drugs

How to use Propranolol and hydrochlorothiazide

This medicine should not be the first medicine you use to treat your condition. It is meant to be used only after you have tried other medicines that have not worked or have caused unwanted side effects.

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Swallow the tablet whole. Do not crush, break, or chew it.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):

For high blood pressure:

Adults—One tablet two times a day. Your doctor may adjust your dose if needed.

Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Warnings

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

This medicine may cause serious allergic reactions including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, lips, tongue, or throat while you are using this medicine.

This medicine may cause or worsen heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing, an irregular heartbeat, swelling of the face, fingers, feet, or lower legs, trouble breathing, or weight gain.

Do not interrupt or stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. Some conditions may become worse when the medicine is stopped suddenly, which can be dangerous.

This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.

Serious skin reactions (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis, erythema multiforme) can occur during treatment with this medicine. Check with your doctor right away if you start having skin itching, swelling, rash, or redness, blistering, peeling, or loosening of the skin, or any other unusual effects that may be caused by this medicine.

Check with your doctor right away if you start having dry mouth, increased thirst, muscle cramps, nausea or vomiting, unusual tiredness or weakness, severe drowsiness or dizziness, seizures, a decrease in urine, or a fast heartbeat while you are using this medicine. These may be symptoms of dehydration or mineral imbalance.

Check with your doctor immediately if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment. This could be a sign of a serious eye problem. Your doctor will want you to have your eyes checked by an ophthalmologist (eye doctor).

This medicine may increase your risk of getting skin cancer (eg, non-melanoma skin cancer). Avoid sun exposure. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds. Talk to your doctor if you have concerns about this risk.

Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine. Tell your doctor if you are drinking alcohol or using pain relievers or sleeping pills.

Do not take other medicines unless they have been discussed with your doctor. This especially includes prescription or nonprescription (over-the-counter) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may increase your blood pressure.

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