What is the most important information I should know about Propranolol-Hydrochlorothiazide?

· To reduce nighttime urination, take Propranolol-Hydrochlorothiazide before 6 p.m. and preferably in the morning.

· Do not stop taking this medication unless your doctor approves. If you stop taking your medication, your condition could become much worse.


What is Propranolol-Hydrochlorothiazide?

· Propranolol is in a class of drugs called beta-blockers. Propranolol is used to lower blood pressure, lower heart rate, reduce angina (chest pain), and reduce the risk of recurrent heart attacks.

· Hydrochlorothiazide is a thiazide diuretic (water pill). It helps to lower your blood pressure and decrease edema (swelling) by increasing the amount of salt and water you lose in your urine.

· Propranolol-Hydrochlorothiazide is used to treat high blood pressure (hypertension).

· Propranolol-Hydrochlorothiazide may also be used for purposes other than those listed in this medication guide.


Who should not take Propranolol-Hydrochlorothiazide?

· Do not take Propranolol-Hydrochlorothiazide if you have an allergy to sulfa-based drugs such as sulfa antibiotics. You may have an allergic reaction to hydrochlorothiazide.

· Before taking this medication, tell your doctor if you have     ·asthma;     ·a heart condition such as low blood pressure, heart block, a pacemaker, or heart failure, or any other heart problem;     ·diabetes,     ·gout;     ·a collagen vascular disease such as systemic lupus erythematosus;     ·pancreatitis;     ·kidney disease;     ·liver disease;     ·any type of circulatory disease; or     ·thyroid disease.

· You may not be able to take Propranolol-Hydrochlorothiazide, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

· Propranolol-Hydrochlorothiazide is in the FDA pregnancy category C. This means that it is not known whether Propranolol-Hydrochlorothiazide will harm an unborn baby. Do not take Propranolol-Hydrochlorothiazide without first talking to your doctor if you are pregnant.

· Propranolol-Hydrochlorothiazide passes into breast milk and may harm a nursing infant. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.


How should I take Propranolol-Hydrochlorothiazide?

· Take Propranolol-Hydrochlorothiazide exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

· Take each dose with a full glass of water.

· To reduce nighttime urination, take Propranolol-Hydrochlorothiazide before 6 p.m. and preferably in the morning.

· The long-acting formulation is usually taken once daily. Do not crush, chew, or open the capsules. Swallow them whole.

· Do not stop taking this medication unless your doctor approves. If you stop taking your medication, your condition could become much worse.

· Store Propranolol-Hydrochlorothiazide at room temperature away from moisture and heat.


What happens if I miss a dose?

· Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.


What happens if I overdose?

· Seek emergency medical attention.

· Symptoms of a Propranolol-Hydrochlorothiazide overdose include an irregular heartbeat, seizures, confusion, fainting, coma, shortness of breath, and wheezing.


What should I avoid while taking Propranolol-Hydrochlorothiazide?

· Avoid a diet high in salt. Too much salt will cause your body to retain water and will decrease the effects of hydrochlorothiazide.

· Avoid prolonged exposure to sunlight. Propranolol-Hydrochlorothiazide may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

· Avoid becoming overheated in hot weather. It is easy to become dangerously dehydrated while taking hydrochlorothiazide.

· Use caution when driving, operating machinery, and performing other hazardous activities. Propranolol-Hydrochlorothiazide may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Also use caution when rising from a sitting or lying postion.

· Use alcohol cautiously. Alcohol may further lower blood pressure and may increase drowsiness and dizziness while you are taking Propranolol-Hydrochlorothiazide.

· Before having surgery, tell your doctor and dentist that you are taking this medication.


What are the possible side effects of Propranolol-Hydrochlorothiazide?

· If you experience any of the following serious side effects, stop taking Propranolol-Hydrochlorothiazide and seek emergency medical attention:     ·an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);     ·yellow skin or eyes;     ·confusion;     ·abnormal bleeding or bruising;     ·unusual fatigue;     ·slow or irregular heartbeat, chest pain;     ·swelling of your feet and lower legs or sudden weight gain;     ·cold or blue feet and hands; or     ·skin rash.

· Other, less serious side effects may be more likely to occur. Continue to take Propranolol-Hydrochlorothiazide and talk to your doctor if you experience     ·dizziness--especially upon changing position (e.g., sitting or standing from lying down)     ·unusual headache, fatigue, or confusion;     ·tingling or numbness in your arms, legs, hands, or feet;     ·excessive urination or increased hunger or thirst;     ·nausea or decreased appetite;     ·diarrhea, constipation, gas, nausea, or vomiting;     ·weak pulse;     ·muscle weakness or cramps;     ·depression or nightmares; or     ·sensitivity to sunlight.

· Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.


What other drugs will affect Propranolol-Hydrochlorothiazide?

· The following medicines may decrease the effectiveness of Propranolol-Hydrochlorothiazide:     ·cholestyramine (Questran) and colestipol (Colestid);     ·nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil), ketoprofen (Orudis, Orudis KT, Oruvail), and naproxen (Naprosyn, Anaprox, Aleve); and     ·other commonly used NSAIDs, including diclofenac (Cataflam, Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), mefenamic acid (Ponstel), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin).

· Larger doses of Propranolol-Hydrochlorothiazide may be needed if you are taking any of the medicines listed above.

· Before taking Propranolol-Hydrochlorothiazide, tell your doctor if you are taking any of the medicines listed below:     ·Oral diabetes medications such as glipizide (Glucotrol), glyburide (Micronase, Glynase, Diabeta), chlorpropamide (Diabinese), tolazamide (Tolinase), and tolbutamide (Orinase) may not be as effective in lowering your blood sugar when you are taking Propranolol-Hydrochlorothiazide. Your diabetes therapy may have to be adjusted.     ·Lithium (Lithobid, Eskalith, others) generally should not be taken with Propranolol-Hydrochlorothiazide because dangerous side effects may result.     ·Other drugs that lower blood pressure must be used very cautiously. Very low blood pressure can result. Some drugs commonly used to lower blood pressure include acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), carteolol (Cartrol), labetalol (Trandate, Normodyne), propranolol (Inderal), pindolol (Visken), timolol (Blocadren), benazepril (Lotensin), enalapril (Vasotec), captopril (Capoten), fosinopril (Monopril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), amlodipine (Norvasc), bepridil (Vascor), diltiazem (Cardizem, Dilacor), felodipine (Plendil), isradipine (Dynacirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), and verapamil (Calan, Veralan, Isoptin).

· Drugs other than those listed here may also interact with Propranolol-Hydrochlorothiazide or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.


Where can I get more information?

· Your pharmacist has additional information about Propranolol-Hydrochlorothiazide written for health professionals that you may read.