Generic Name: hydrochlorothiazide and metoprolol (HYE droe klor oh THYE a zide and me TOE proe lole)Brand Names: 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 in a group of drugs called beta-blockers. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).
The combination of hydrochlorothiazide and metoprolol is used to treat high blood pressure (hypertension).
Hydrochlorothiazide and metoprolol may also be used for other purposes not listed in this medication guide.What is the most important information I should know about hydrochlorothiazide and metoprolol?You should not use this medication if you have severe or uncontrolled heart failure, a heart condition called "sick sinus syndrome" or "AV block," severe blood circulation problems, an adrenal gland tumor, an allergy to beta-blockers, or if you are unable to urinate.
Before using this medication, tell your doctor if you have congestive heart failure, kidney or liver disease, cirrhosis, asthma or bronchospasm, gout, lupus, diabetes, a thyroid disorder, or if you are allergic to sulfa drugs.
If you are diabetic, check your blood sugar carefully. Using metoprolol can make it harder for you to tell when you have low blood sugar. Your insulin or diabetic medication needs may change while you are taking hydrochlorothiazide and metoprolol. Talk with your doctor before changing any doses.Avoid drinking alcohol, which can lower your blood pressure and may add to the side effects of hydrochlorothiazide and metoprolol.
Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.Keep taking this medication even if you feel fine. High blood pressure often has no symptoms.
There are many other medicines that can interact with hydrochlorothiazide and metoprolol. Tell your doctor about all the prescription and over-the-counter medications you use.What should I discuss with my doctor before taking hydrochlorothiazide and metoprolol?You should not use this medication if you are allergic to hydrochlorothiazide or metoprolol, or if you have:
severe or uncontrolled heart failure;
a heart condition called "sick sinus syndrome" or "AV block" (2nd or 3rd degree);
severe blood circulation problems;
an adrenal gland tumor (pheochromocytoma);
if you are allergic to any beta-blocker medication, such as atenolol (Tenormin), bisoprolol (Zebeta), labetalol (Normodyne, Trandate), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), timolol (Blocadren), and others.
Before using hydrochlorothiazide and metoprolol, tell your doctor if you are allergic to any drugs, or if you have:
congestive heart failure;
asthma or bronchospasm;
a thyroid disorder;
if you are allergic to sulfa drugs.
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.Take the medicine with a meal or right after you eat.
Your doctor may occasionally change your dose to make sure you get the best results from this medication.Do not stop using hydrochlorothiazide and metoprolol suddenly, or you could have a serious or life-threatening heart problem. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.
To be sure this medication is not causing harmful effects, your blood pressure will need to be checked on a regular basis, and you may need blood tests. Do not miss any scheduled appointments.
Your blood and urine may both be tested if you have been vomiting or are dehydrated.
If you are diabetic, check your blood sugar carefully. Using metoprolol can make it harder for you to tell when you have low blood sugar. Your insulin or diabetic medication needs may change while you are taking hydrochlorothiazide and metoprolol. Talk with your doctor before changing any doses.
Hydrochlorothiazide and metoprolol can affect the results of certain thyroid tests. Tell any doctor who treats you that you are using this medication.If you need to have any type of surgery, tell the surgeon ahead of time that you are using hydrochlorothiazide and metoprolol. You may need to stop using the medicine for a short time. Keep taking this medication even if you feel fine. High blood pressure often has no symptoms. Store this medication in a tightly closed container at room temperature, away from heat, moisture, and light.
See also: Hydrochlorothiazide and metoprolol dosage in more detail
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.
Avoid using other medicines that make you light-headed (especially narcotic pain medication or barbiturates). They can add to the side effects of hydrochlorothiazide and metoprolol. Tell your doctor if you regularly use any of these medicines.
Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
swelling, rapid weight gain, feeling short of breath, even with mild exertion;
fast, slow, or uneven heartbeat;
easy bruising or bleeding;
numbness or tingly feeling in your hands or feet;
feeling weak, drowsy, restless, or light-headed;
nausea, vomiting, dry mouth, extreme thirst, headache, confusion, hallucinations, seizure (convulsions);
increased urination, leg discomfort, muscle pain or weakness or limp feeling;
urinating less than usual or not at all;
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or
upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may include:
diarrhea, constipation, upset stomach;
dizziness, spinning sensation;
sore throat, body aches;
blurred vision; or
ringing in your ears.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Hypertension:
Initial dose: 2 tablets of hydrochlorothiazide-metoprolol 25 mg-50 mg per day in single or divided doses, or 1 to 2 tablets of hydrochlorothiazide-metoprolol 25 mg-100 mg per day in single or divided doses, or 1 tablet of hydrochlorothiazide-metoprolol 50 mg-100 mg per day in single or divided doses. Determine dosage by individual titration.
Many drugs can interact with hydrochlorothiazide and metoprolol. Below is just a partial list. Tell your doctor if you are using:
insulin or diabetes medicine you take by mouth;
colestipol (Colestid) or cholestyramine (Prevalite, Questran);
theophylline (Elixophyllin, Respbid, Slo-Bid, Theo-Dur, Uniphyl, and others);
steroids (prednisone and others);
HIV or AIDS medicine such as ritonavir (Norvir);
an antidepressant such as bupropion (Wellbutrin, Zyban), fluoxetine (Prozac), or paroxetine (Paxil);
an antibiotic such as rifampin (Rifadin, Rifamate, Rimactane) or terbinafine (Lamisil);
anti-malaria medication such as hydroxychloroquine (Plaquenil);
medicine to treat psychiatric or mood disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), lithium (Lithobid), or thioridazine (Mellaril);
NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Motrin, Advil), diclofenac (Voltaren), etodolac (Lodine), indomethacin, naproxen (Aleve, Naprosyn), and others; or
other heart or blood pressure medications such as clonidine (Catapres), propafenone (Rythmol), quinidine (Quinidex, Quin-Release Quin-G) reserpine, or verapamil (Calan, Covera, Isoptin, Verelan).
This list is not complete and there may be other drugs that can interact with hydrochlorothiazide and metoprolol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.