Metoprolol and hydrochlorothiazide

Name: Metoprolol and hydrochlorothiazide

Metoprolol and Hydrochlorothiazide Overview

Metoprolol and hydrochlorothiazide is a prescription medication used to treat high blood pressure.

Metoprolol and hydrochlorothiazide is a single product containing 2 medications: metoprolol and hydrochlorothiazide. Metoprolol belongs to a group of drugs called beta blockers, which work by relaxing blood vessels and slowing heart rate. This improves blood flow and decreases overall blood pressure. Hydrochlorothiazide belongs to a group of drugs called thiazide diuretics, which work by stopping reabsorption of salt into your body. This prevents fluid from building up in the body.

This medication comes in tablet form and can be given once or twice daily with or immediately following meals. 

Common side effects of metoprolol and hydrochlorothiazide include slow heart rate and headache. Metoprolol and hydrochlorothiazide can also cause dizziness, drowsiness, and blurred vision. Do not drive or operate heavy machinery until you know how this medication affects you. 

Side Effects of Metoprolol and Hydrochlorothiazide

Serious side effects have been reported with metoprolol and hydrochlorothiazide. See the "Metoprolol and hydrochlorothiazide Precautions" section. 

Common side effects of metoprolol and hydrochlorothiazide include the following:

  • dizziness or feeling like your surroundings are spinning (vertigo)
  • headache
  • drowsiness (fatigue)
  • slow heart rate
  • difficulty breathing (dyspnea)
  • diarrhea or constipation
  • dry mouth
  • nausea or vomiting
  • low amount of potassium in your blood (hypokalemia)
  • retaining fluid (edema)
  • painful joint(s) (gout)
  • an eating disorder associated with low body weight (anorexia)
  • blurred vision
  • ringing in the ears (tinnitus)
  • earache
  • sweating
  • rash of purple spots on the skin (purpura)
  • cant get or keep an erection (impotence)
  • muscle pain

This is not a complete list of metoprolol and hydrochlorothiazide side effects. Ask your doctor or pharmacist for more information. 

Tell your doctor if you have any side effect that bothers you or that does not go away.

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

metoprolol 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:

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

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

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 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:

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

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.

How Supplied/Storage and Handling

Metoprolol Succinate Extended Release/Hydrochlorothiazide is supplied as circular, biconvex, film-coated tablets engraved on one side.

Metoprolol/
Hydrochlorothiazide

Engraving

Scored

NDC 69499-xxxx-xx

Bottle/30

25/12.5 mg

A
IH

No

321-30

50/12.5 mg

A
IK

No

323-30

100/12.5 mg

A
IL

Yes

324-30

Store at 25°C (77°F). Excursions permitted to 15-30°C (59‑86°F). (See USP Controlled Room Temperature.)

Patient Counseling Information

Avoid Abrupt Discontinuation

Advise patients to take Metoprolol Succinate Extended Release/Hydrochlorothiazide regularly and continuously, as directed. If a dose is missed, instruct the patient to take only the next scheduled dose (without doubling the dose). Instruct patients not to interrupt or discontinue Metoprolol Succinate Extended Release/Hydrochlorothiazide without consulting a healthcare provider. [See Boxed Warning and Warnings and Precautions (5.1)].

Bronchospasm

Inform patients that beta adrenergic blockers can cause bronchospasm and to inform their healthcare providers if they start to wheeze or have difficulty breathing. [See Warnings and Precautions (5.3)]

Electrolyte Changes

Inform patients that they may need blood tests to monitor their serum electrolytes. [See Warnings and Precautions (5.7)].

Acute Myopia and Secondary Angle-Closure Glaucoma

Inform patients to report decreased visual acuity or ocular pain and to stop Metoprolol Succinate Extended Release/Hydrochlorothiazide and contact their healthcare provider right away if these symptoms occur. [See Warnings and Precautions (5.13)].

Hypersensitivity Reaction

Instruct patients that hypersensitivity reactions to Metoprolol Succinate Extended Release/Hydrochlorothiazide may occur. [See Contraindications (4)].

Lithium Toxicity

Instruct patients to inform other doctors that they are taking a diuretic. [See Drug Interactions (7.2)].

All trademarks are the property of their respective companies.

Revised 08/2017

Manufactured for:
Solubiomix, LLC
Madisonville, LA 70447

© 2017, Solubiomix, LLC.

Brand Names U.S.

  • Dutoprol
  • Lopressor HCT

Pharmacologic Category

  • Antihypertensive
  • Beta-Blocker, Beta-1 Selective
  • Diuretic, Thiazide

Pharmacology

Metoprolol: Selective inhibitor of beta1-adrenergic receptors; competitively blocks beta1-receptors, with little or no effect on beta2-receptors at doses less than 100 mg; does not exhibit any membrane stabilizing or intrinsic sympathomimetic activity.

Hydrochlorothiazide: Inhibits sodium reabsorption in the distal tubules causing increased excretion of sodium and water as well as potassium and hydrogen ions.

Use Labeled Indications

Hypertension: Management of hypertension.

Storage

Store at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Protect from moisture.

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