Can you take metoprolol and hydrochlorothiazide together

Lopressor HCT

Brand Names: Dutoprol, Lopressor HCT

Generic Name: hydrochlorothiazide and metoprolol

  • What is hydrochlorothiazide and metoprolol (Dutoprol, Lopressor HCT)?
  • What are the possible side effects of hydrochlorothiazide and metoprolol (Dutoprol, Lopressor HCT)?
  • What is the most important information I should know about hydrochlorothiazide and metoprolol (Dutoprol, Lopressor HCT)?
  • What should I discuss with my healthcare provider before taking hydrochlorothiazide and metoprolol (Dutoprol, Lopressor HCT)?
  • How should I take hydrochlorothiazide and metoprolol (Dutoprol, Lopressor HCT)?
  • What happens if I miss a dose (Dutoprol, Lopressor HCT)?
  • What happens if I overdose (Dutoprol, Lopressor HCT)?
  • What should I avoid while taking hydrochlorothiazide and metoprolol (Dutoprol, Lopressor HCT)?
  • What other drugs will affect hydrochlorothiazide and metoprolol (Dutoprol, Lopressor HCT)?
  • Where can I get more information (Dutoprol, Lopressor HCT)?

What is hydrochlorothiazide and metoprolol (Dutoprol, Lopressor HCT)?

Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Metoprolol is a beta-blocker. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).

Hydrochlorothiazide and metoprolol is a combination medicine used to treat high blood pressure (hypertension).

Hydrochlorothiazide and metoprolol may also be used for purposes not listed in this medication guide.

What are the possible side effects of hydrochlorothiazide and metoprolol (Dutoprol, Lopressor HCT)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • bronchospasm (wheezing, chest tightness, trouble breathing);
  • slow heart rate, weak pulse, fainting, slow breathing (breathing may stop);
  • blurred vision, tunnel vision, eye pain, or seeing halos around lights;
  • low potassium–constipation, numbness or tingling, tiredness, muscle weakness, slow heart rate, fainting; or
  • low levels of sodium in the body–headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.

Common side effects may include:

  • tired feeling; or
  • stuffy nose, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about hydrochlorothiazide and metoprolol (Dutoprol, Lopressor HCT)?

You should not use hydrochlorothiazide and metoprolol if you have a serious heart condition such as “sick sinus syndrome” or “AV block” (unless you have a pacemaker), slow heartbeats that have caused you to faint, or if your heart cannot pump blood properly.

You should not use this medicine if you are unable to urinate.

Do not stop using this medicine suddenly, even if you feel fine. Stopping suddenly may cause serious or life-threatening heart problems. Follow your doctor’s instructions about tapering your dose.

A COMPARATIVE STUDY OF EFFICACY AND TOLERABILITY OF GENERIC AND ORIGINAL LOW-DOSE BISOPROLOL/HYDROCHLOROTHIAZIDE COMBINATION IN PATIENTS WITH ARTERIAL HYPERTENSION OF 1-2 DEGREES. RESULTS OF CLINICAL RANDOMIZED CROSSOVER STUDY

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9. Martsevich S.Y., Tolpygina S.N., Boitchenko E.S., et al. Comparative study of antiplatelet efficacy of original and generic of acetylsalicylic acid in the gastro-soluble form in patients at high risk of cardiovascular complications. Single-blind crossover randomized controlled trial (ICAR). Rational Pharmacother Card 2010; 6 (6):800-806. Russian (Марцевич С.Ю., Толпыгина С.Н., Бойченко Е.С., и др. Сравнительное изучение дезагрегантной эффективности оригинального и воспроизведенного препарата ацетилсалициловой кислоты в кишечно-растворимой форме у пациентов высокого риска сердечно-сосудистых осложнений. Простое слепое перекрестное рандомизированное контролируемое исследование (ИКАР). Рациональная Фармакотерапия в Кардиологии 2010;6(6):800-806).

10. Lukina, Y., Deev A.D, Dmitrieva N.A. et al. A comparative study of a new drug metoprolol tartrate sustained release – Egilok retard and original drug metoprolol succinate – Betalok ZOC in patients with mild to moderate hypertension. Rational Pharmacother Card 2005; (3):35-40. Russian (Лукина Ю.В., Деев А.Д, Дмитриева Н.А. и др. Сравнительное изучение нового препарата метопрололатартрата пролонгированного действия – Эгилока ретард и оригинального препарата метопролола сукцината – Беталока ЗОК у больных мягкой и умеренной артериальной гипертонией. Рациональная Фармакотерапия в Кардиологии 2005;(3):35-40).

11. Martsevich S.Y., Kutishenko N.P., Deev A.D. et al. The study of the therapeutic equivalence of two drugs amlodipine (original and reproduced) in hypertensive patients. Results of a double-blind, randomized, crossover study. Russian Journal of Cardiology 2004; (4): 53-56. Russian (Марцевич С.Ю., Кутишенко Н.П., Деев А.Д. и др. Изучение терапевтической эквивалентности двух препаратов амлодипина (оригинального и воспроизведенного) у больных артериальной гипертонией. Результаты двойного слепого рандомизированного перекрестного исследования. Российский Кардиологический Журнал 2004;(4): 53-6).

12. Nedogoda S.V., Marchenko I.V., Chalyabi T.A. Comparative antihypertensive efficacy of generic ACE inhibitor enalapril – Renitek (Enap, Ednit, Invoril, Envasa and Enam) and the cost of treatment in patients with hypertension. Arterial Hypertension 2000; (1):52-54. Russian (Недогода С.В., Марченко И.В., Чаляби Т.А. Сравнительная антигипертензивная эффективность генериков ингибитора ангиотензинпревращающего фермента эналаприла Ренитека (Энапа, Эднита, Инворила, Энваса и Энама) и стоимость лечения у больных гипертонической болезнью. Артериальная Гипертензия 2000;(1):52-4).

14. Martsevich S.Yu, Lukinа Yu.V, Deev A.D. et al. A comparative study of combination products of enalapril and hydrochlorothiazide, “Renipril GT” and “Co-Renitek” in patients with mild to moderate hypertension. Rational Pharmacother Card 2005; (3): 29-34. Russian (Марцевич С.Ю., Лукина Ю.В., Деев А.Д. и др. Сравнительное изучение комбинированных препаратов эналаприла малеата и гидрохлоротиазида “Рениприла ГТ” и “Ко-Ренитека” у больных мягкой и умеренной АГ. Рациональная Фармакотерапия в Кардиологии 2005;(3):29-34).

15. Tolpygina S.N, Shilova E.V., Martsevich S.Yu. A comparative study of the efficacy and tolerability of the original drug and its generic version of bisoprolol in patients with mild to moderate hypertension. Rational Pharmacother Card 2007; (3):15-21. Russian (Толпыгина С.Н., Шилова Е.В., Марцевич С.Ю. Сравнительное изучение эффективности и переносимости оригинального препарата бисопролола и его дженерика у больных мягкой и умеренной артериальной гипертонией. Рациональная Фармакотерапия в Кардиологии 2007;(3):15-21).

16. Martsevich S.Yu., Tolpygina S.N., Voronina V.P., et al. A comparative study of the efficacy and toler- ability of the original and of generic drugs in the bisoprolol alone or in combination with S-amlodipine and indapamide in patients with moderate hypertension. Results of a clinical, randomized, crossover study. Rational Pharmacother Card 2011; 7 (2):167-73. Russian (Марцевич С.Ю., Толпыгина С.Н., Воронина В.П., и др. Сравнительное изучение эффективности и переносимости оригинального и дженерического препарата бисопролола в виде монотерапии или комбинации с S-амлодипином и индапамидом у больных умеренной АГ. Результаты клинического, рандомизированного, перекрестного исследования. Рациональная Фармакотерапия в Кардиологии 2011; 7(2):167-73).

18. National guidelines for the diagnosis and treatment of hypertension (fourth revision). Systemic Hypertension 2010;(3):5-26. Russian (Национальные рекомендации по диагностике и лечению артериальной гипертонии (четвертый пересмотр). Системные гипертензии 2010; (3): 5-26).

19. Bakris G.L., Williams M., Dworkin L. et al. for the National Kidney Foundation Hypertension and Di- abetes Executive Committees Working Group. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis 2000; 36: 646–661.

22. Arima H, Chalmers J, Woodward M, et al. PROGRESS Collaborative Group. Lower target blood pressures are safe and effective for the prevention of recurrent stroke: the PROGRESS trial. J Hypertens 2006; 24:1201-1208.

23. Zanchetti A, Hansson L, Clement D, et al. HOT Study Group. Benefits and risks of more intensive blood pressure lowering in hypertensive patients of the HOT study with different risk profiles: does a J-shaped curve exist in smokers? J Hypertens 2003; 21:797-804.

24. Freemantle N, Cleland J, Young P, et al. Beta blockade after myocardial infarction: systematic review and meta regression analysis. Br Med Journal 1999; 318:1730-1737.

25. Shekelle P.G., Rich M.W., Morton S.C., et al. Efficacy of angiotensin-converting enzyme inhibitors and beta-blockers in the management of left ventricular systolic dysfunction according to race, gender, and diabetic status: a meta-analysis of major clinical trials. J Am Coll Cardiol 2003; 41:1529-1538.

26. Zanchetti A. Emerging data on calcium-channel blockers: the COHORT study. Clin Cardiol 2003; 26 (Suppl2) II: 17-20.

27. Pischon T, Sharma A.M. Use of beta-blockers in obesity hypertension: potential role of weight gain. Obes Rev 2001; 2:275-280.

28. Jacob S, Rett K, Henriksen E.J. Antihypertensive therapy and insulin sensitivity: do we have to redefine the role of beta-blocking agents? Am J Hypertens 1998; 11:1258-1265.

29. Mancia G, Grassi G, Zanchetti A. New-onset diabetes and antihypertensive drugs. J Hypertens 2006; 24:3-10.

GENERIC NAME: BETA-BLOCKERS W/THIAZIDE DIURETICS – ORAL

Warning | Medication Uses | How To Use | Side Effects | Precautions | Drug Interactions | Overdose | Notes | Missed Dose | Storage | Medical Alert

WARNING: If you have angina or have had heart problems, do not suddenly stop using this medication without first consulting your doctor. If your doctor decides you should no longer use this medication, you must stop this medication gradually according to your doctor’s instructions.

USES: This combination medication is used to treat hypertension (high blood pressure). Beta-blockers slow the heart rate. Thiazide diuretics, also known as “water pills”, reduce fluid accumulation in the body by increasing urination.

HOW TO USE: Take this medication exactly as prescribed. Do not adjust the dose without consulting your doctor. Take with food or milk if stomach upset occurs. Because this drug increases urination, avoid taking a dose in the late evening before bedtime. Do not suddenly stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped.

SIDE EFFECTS: You may experience dizziness, lightheadedness, drowsiness or blurred vision as your body adjusts to the medication. Use caution engaging in activities requiring alertness. Because beta-blockers reduce blood circulation to the extremities, your hands and feet may be more susceptible to cold. Thiazide diuretics can cause potassium loss from the body. It is advisable to eat foods or drink liquids high in potassium such as citrus juice, bananas, melons, raisins and dates. Use of salt substitutes also help prevent potassium loss. Sometimes potassium supplement medication may be prescribed by your doctor. Inform your doctor if you develop: breathing difficulty, easy bruising or bleeding, swollen hands or feet, confusion or depression, excessive thirst, muscle cramps, yellowing of the eyes or skin, sore throat. Tell your doctor immediately if any of these unlikely but serious side effects occur: slow/irregular heartbeat. This medication may increase sensitivity to the sun. Avoid prolonged sun exposure. Wear protective clothing and use a sunscreen. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: You may want to check your pulse everyday while taking this drug. Discuss with your doctor what changes in your pulse rate mean. Tell your doctor if you are allergic to sulfa drugs. You may also be allergic to this medication. This medication is not recommended for use during pregnancy. Consult your doctor for details. This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Did you know that nearly 7 in 10 Americans take a prescription drug, and about 50% of Americans take at least two? In many cases, taking more than one drug is necessary to cure an ailment, treat symptoms, or control a chronic disease. But in others, multiple drugs may not mix well in your body, and in your pocketbook.

We’ve compiled a list of drugs commonly taken together. We’ll tell you more about why these drugs are taken together, and which ones work. But are all of these combinations safe?

Top 10 Two Drug Combinations

Rank Drugs What is it for?
1 lisinopril
atorvastatin
Heart disease
2 lisinopril
metformin
Heart disease & diabetes
3 amlodipine
lisinopril
Heart disease
4 alprazolam
amphetamine salt combo
ADHD & anxiety
5 amphetamine salt combo
amphetamine salt combo xr
ADHD
6 hydrocodone/acetaminophen
alprazolam
Pain & anxiety
7 amlodipine
atorvastatin
Heart disease
8 lisinopril
hydrochlorothiazide
Heart disease
9 atorvastatin
clopidogrel
Heart disease
10 atorvastatin
metformin
Heart disease & diabetes
Top 10 Three Drug Combinations

Rank Drugs What is it for?
1 metformin
lisinopril
atorvastatin
Heart disease & diabetes
2 clopidogrel
atorvastatin
lisinopril
Heart disease
3 glipizide
metformin
lisinopril
Heart disease & diabetes
4 atorvastatin
amlodipine
lisinopril
Heart disease
5 amlodipine
hydrochlorothiazide
lisinopril
Heart disease
6 carvedilol
atorvastatin
lisinopril
Heart disease
7 atorvastatin
metoprolol
lisinopril
Heart disease
8 clopidogrel
metoprolol
atorvastatin
Heart disease
9 lisinopril
carvedilol
furosemide
Heart disease
10 amlodipine
metformin
lisinopril
Heart disease and diabetes

What’s going on in this table?

We compiled a representative sample of nationwide U.S. prescription drug claims to see common drug combinations. Here are some patterns we found interesting.

  • Heart disease medications dominate the list. In many cases, certain heart medications may be taken together to increase effectiveness, or treat different symptoms. Most people with a heart condition will likely take any combination of an ace inhibitor (lisinopril), a beta blocker (metoprolol) a diuretic (furosemide) or a statin (atorvastatin). Heart disease is currently the leading cause of death for men and women in the US, so it makes sense that these medications overtake the list.
  • Heart medications and diabetes medications are a common combination. Over time, high blood sugar from diabetes can damage the blood vessels and heart, increasing your chances for heart disease. In many cases, people with diabetes will be prescribed metformin along with a heart medication like lisinopril or atorvastatin to reduce the risk for heart complications.
  • Anxiety medication alprazolam. After heart and diabetes medications, alprazolam for anxiety also makes the list. Alprazolam is a popular benzodiazepine used to treat anxiety and panic attacks and is commonly prescribed with amphetamine salt combo for ADHD and hydrocodone/acetaminophen for pain. But are these combinations safe? Read on.

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Dangerous combinations

It’s hard to imagine that people would be prescribed drugs that have dangerous interactions. Unfortunately, it’s more common than you think. Most dangerous combinations happen when two different doctors prescribe two different medications and are unaware of the other prescription. In order to avoid taking drugs that may interact, make sure you discuss any medication you are on with every doctor you see.

  • Hydrocodone/acetaminophen & alprazolam. Opioids (hydrocodone/acetaminophen) should not be taken with benzodiazepines (alprazolam)—they are the two most common drug classes associated with emergency department visits and prescription drug overdose deaths. The combination can result in severe breathing difficulties. Not good.
  • Alprazolam & amphetamine salt combo. This is a common combination as alprazolam, a common anxiety medication, can help combat the restlessness and insomnia that people typically feel after taking an amphetamine. While the combination isn’t necessarily dangerous, alprazolam should not be taken on a regular basis. One way to combat the restlessness and insomnia? Try taking a long-acting stimulant, like amphetamine salt combo XR, instead. Longer-acting amphetamines tend to have more constant delivery and can have negative side effects.
  • Lisinopril & metformin. Most people with diabetes are treated with metformin, and an ace inhibitor, like lisinopril. In most cases, there are few interactions between the two. However, lisinopril can increase the effects of metformin, and cause blood sugar to dip too low. If you are taking both of these medications and consistently experience signs of low blood sugar, be sure to speak with your doctor—this combo could be the culprit.

What’s the good news?

Although some drug combinations can be dangerous, there are some combinations that work very well together, with few side effects or interactions.

  • Atorvastatin & lisinopril. The American Association of Clinical Endocrinologists and American Diabetes Association recommend that all diabetics with a blood pressure greater than 140/90 be on a statin (atorvastatin, simvastatin, rosuvastatin, etc) and an ace inhibitor (lisinopril, benazepril, etc).
  • Amphetamine salt combo & amphetamine salt combo XR. It might seem odd that people fill for both the short (amphetamine salt combo) and long (amphetamine salt combo XR) version. However, it’s quite common. Most people who fill for this combination use the short-acting amphetamine like a booster—taken only if they feel the long-acting amphetamine is wearing off. If taken responsibly, there are no interactions between the two.
  • Most heart medications. There are many types of heart medications on this list—ace inhibitors, statins, diuretics, and beta blockers—all treating some component or symptom of heart disease. But do they work well together, and can you take them long term? If taken appropriately, yes.

Are there ways to save?

Believe it or not, in some cases, you can save by taking fewer drugs, or switching to a less expensive alternative. These common combinations have less expensive alternatives you might want to discuss with your doctor.

  • Lisinopril & hydrochlorothiazide. This combination is good for high blood pressure/hypertension, and are both first-line therapies. However, there they come in a combination pill–Zestoretic (lisinopril/hctz)–that is more affordable, and more convenient, than taking two separate medications.
  • Amlodipine & lisinopril. Both of these medications tend to work well together to control blood pressure. However, if you currently take these together, you have another option that can help save you time and money! Lotrel (amlodipine/benazepril) is a combination calcium channel blocker/ace inhibitor that works just like amlodipine and lisinopril, in just one pill!

Information on drug interactions and savings tips come from Dr. Sharon Orrange, MD MPH, a contributor on the GoodRx Medical Team. Data comes from several sources, including pharmacy data and insurer data, and provides a representative sample of nationwide US prescription drug claims.

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