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Metoprolol+hydrochlorothiazide

About

Metoprolol+hydrochlorothiazide belongs to the class of anti-hypertensives, primarily taken to treat hypertension (high blood pressure) and reduce stroke risk in patients with high blood pressure. Metoprolol+hydrochlorothiazide is a combination medication generally used when a single medicine is unable to control high blood pressure. Hypertension or high blood pressure is a life-long or chronic condition in which the force exerted against the artery wall becomes too high. It can lead to the risk of heart diseases like heart attack and stroke.

Metoprolol+hydrochlorothiazide is a combination of two medicines: Metoprolol and Hydrochlorothiazide. Metoprolol belongs to the class of drugs known as β-blockers that works by relaxing the blood vessels by blocking the action of certain natural substances in your body. It helps slow down the heart rate, making it easier to pump more blood around your body and lower blood pressure. On the other hand, Hydrochlorothiazide is a diuretic or water pill that works by removing extra water/fluid and certain electrolyte overload from the body. Together, Metoprolol+hydrochlorothiazide lowers fluid overload, raises blood pressure, improves blood flow, and reduces the future risk of a heart attack and stroke. This medicine needs to be taken regularly to be effective.

Take Metoprolol+hydrochlorothiazide as prescribed by your doctor. Depending on your medical conditions, you are advised to take Metoprolol+hydrochlorothiazide for as long as your doctor has prescribed it for you. You may experience nausea, fatigue, constipation, diarrhoea, headache, dizziness, increased blood uric acid, slow heart rate, decreased potassium level in the blood, altered blood lipid level, glucose intolerance, increased calcium level in the blood, and decreased magnesium level in blood. Most of these side effects of Metoprolol+hydrochlorothiazide do not require medical attention and gradually resolve over time. However, if the side effects are persistent, reach out to your doctor.

Inform your doctor if you have had an allergic reaction to Metoprolol+hydrochlorothiazide, have liver disease, kidney disease, asthma, heart failure, a heart valve problem, or have a history of a heart attack. Pregnant and breastfeeding women should consult their doctor before taking Metoprolol+hydrochlorothiazide. Orthostatic hypotension (sudden lowering of blood pressure) might occur, so patients taking Metoprolol+hydrochlorothiazide should get up with caution. A prolonged intake of Metoprolol+hydrochlorothiazide may decrease your blood potassium levels. So, it is better to ask your doctor about foods high in potassium, like bananas or orange juice. Regular monitoring of blood pressure, kidney function, and electrolyte (sodium, potassium, calcium, etc.) are recommended while taking Metoprolol+hydrochlorothiazide. And also, a healthy diet and regular exercise are necessary to keep blood pressure under control.

Uses of Metoprolol+hydrochlorothiazide

Hypertension (high blood pressure)

Medicinal Benefits

Metoprolol+hydrochlorothiazide contains a combination of medicines: Metoprolol (beta-blockers) and Hydrochlorothiazide (thiazide diuretic or water pill). Metoprolol plays a vital role in relaxing our blood vessels by blocking the action of certain natural substances in our bodies. It helps slow down the heart rate, making it easier to pump more blood around your body and lower blood pressure. Hydrochlorothiazide is a diuretic that prevents excess salt absorption in the body, preventing fluid retention. Collectively, both help reduces blood pressure and the chance of a stroke, heart attack, and oedema (fluid overload).

Directions for Use

Swallow it as a whole with water; do not crush, break or chew it.

Storage

Store in a cool and dry place away from sunlight

Side Effects of Metoprolol+hydrochlorothiazide

  • Nausea
  • Fatigue
  • Headache
  • Dizziness
  • Diarrhoea
  • Stuffy nose, sore throat
  • Slow heart rate
  • Increased blood uric acid
  • Decreased potassium/ magnesium level in the blood
  • Increased calcium level in the blood
  • Altered blood lipid level
  • Glucose intolerance

In-Depth Precautions and Warning

Drug Warnings

Don't stop taking Metoprolol+hydrochlorothiazide without talking to your doctor first. Stopping Metoprolol+hydrochlorothiazide gradually may cause changes in your heart rhythm and blood pressure, cause chest pain, or a heart attack. Your doctor will lower your dose gradually over a period of time to help prevent these symptoms. You should not use Metoprolol+hydrochlorothiazide if you have allergic to Metoprolol+hydrochlorothiazide, have low blood pressure (less than 90 mm of Hg), very slow heartbeat, serious lung condition (like asthma), serious heart condition (sick sinus syndrome), or any heart blockage. Do not use Metoprolol+hydrochlorothiazide if you are pregnant, planning for pregnancy, breastfeeding, or unable to urinate (anuria). It should not be given to the children as safety and effectiveness have not been established. Before taking Metoprolol+hydrochlorothiazide you should tell the doctor if you have any muscle disorder (myasthenia gravis, rhabdomyolysis), breathing problem (COPD, bronchitis, emphysema), low blood sugar level (hypoglycemia), eye problem (glaucoma), low blood pressure (hypotension), depression, previous heart failure, liver/kidney disease, thyroid hormone disorder like overactive thyroid (hyperthyroidism), adrenal gland cancer, or severe blood circulation problem (Raynaud’s syndrome). You should monitor your blood pressure regularly to make sure the Metoprolol+hydrochlorothiazide is working efficiently. Besides this, prolonged intake of Metoprolol+hydrochlorothiazide can lead to lowering of blood pressure (hypotension). So, daily monitoring of blood pressure is advisable.

Drug Interactions

Drug-Drug Interactions: Metoprolol+hydrochlorothiazide may interact with other blood pressure-lowering pills or beta-blockers (acebutolol, atenolol, bisoprolol, carteolol, esmolol, nadolol,) other blood pressure-related medicines (lisinopril, enalapril, diltiazem, prazosin, terazosin, ramipril, atorvastatin), diuretics (furosemide, chlorothiazide, chlorthalidone, indapamide, metolazone), asthma medications (theophylline, aminophylline), pain killers (ibuprofen, aspirin), antifungals (terbinafine), anticancer (aldesleukin), blood thinner (dipyridamole), antibiotics (rifampicin), antivirals (ritonavir), antihistamines used to treat hay fever (diphenhydramine), medicines used to treat irregular heartbeat (amiodarone, propafenone, quinidine, disopyramide, procainamide, digoxin, lidocaine), anti-epilepsy medications (carbamazepine, phenobarbital), immune-suppressing drugs (cyclosporine).

Drug-Food Interactions: Metoprolol+hydrochlorothiazide severely interacts with grapefruit and protein-enriched foods. Using Metoprolol+hydrochlorothiazide with ayurvedic, homoeopathy, Unani, herbal supplements, or other OTC items may decrease the effects of Metoprolol+hydrochlorothiazide. Hence, it is better to maintain at least 2 hours gap between the administration of Metoprolol+hydrochlorothiazide and these products.

Drug-Disease Interactions: Metoprolol+hydrochlorothiazide should not be given to people with diabetes, thyroid disease, asthma, cardiogenic shock (when the heart fails to pump required blood to the body), heart valve problem (stenosis), low blood pressure (hypotension), coronary heart disease, liver disease or heart failure, gout, low serum potassium (hypokalemia), patients with nil urine output (anuria).

Drug-Drug Interactions Checker List:

  • ACEBUTOLOL
  • ATENOLOL
  • BISOPROLOL
  • CARTEOLOL
  • ESMOLOL
  • NADOLOL
  • LISINOPRIL
  • ENALAPRIL
  • DILTIAZEM
  • PRAZOSIN
  • TERAZOSIN
  • RAMIPRIL
  • ATORVASTATIN
  • FUROSEMIDE
  • CHLOROTHIAZIDE
  • CHLORTHALIDONE
  • INDAPAMIDE
  • METOLAZONE
  • THEOPHYLLINE
  • AMINOPHYLLINE
  • IBUPROFEN
  • ASPIRIN
  • TERBINAFINE
  • ALDESLEUKIN
  • DIPYRIDAMOLE
  • RIFAMPICIN
  • RITONAVIR
  • DIPHENHYDRAMINE
  • AMIODARONE
  • PROPAFENONE
  • QUINIDINE
  • DISOPYRAMIDE
  • PROCAINAMIDE
  • FLECAINIDE
  • DIGOXIN
  • LIDOCAINE
  • CARBAMAZEPINE
  • PHENOBARBITAL
  • CYCLOSPORINE
  • Safety Advice

    • Safety Warning

      Alcohol

      caution

      Drinking alcohol may increase tiredness, lower blood pressure causing dizziness or drowsiness. So avoid its intake with Metoprolol+hydrochlorothiazide

    • Safety Warning

      Pregnancy

      caution

      Metoprolol+hydrochlorothiazide is a pregnancy category C drug. It is not recommended during pregnancy unless your doctor considers it essential. Your doctor will weigh the benefits and any potential risks before prescribing it to you.

    • Safety Warning

      Breast Feeding

      caution

      Small amounts of Metoprolol+hydrochlorothiazide passes into the breast milk. However which is not enough to cause any problems to your baby. But, still, it is advisable to contact your doctor before breastfeeding your baby.

    • Safety Warning

      Driving

      caution

      You may experience dizziness, tiredness, or blurred vision while taking Metoprolol+hydrochlorothiazide. So, it is not recommended to drive, use machinery, or perform other tasks.

    • Safety Warning

      Liver

      caution

      Metoprolol+hydrochlorothiazide should be used with caution in patients with impaired hepatic function or progressive liver disease since minor alterations of fluid and electrolyte balance may precipitate hepatic coma. Your doctor may adjust your dose depending upon your current liver conditions.

    • Safety Warning

      Kidney

      caution

      Metoprolol+hydrochlorothiazide to be taken with caution, especially if you have had a history of kidney disease. Your doctor will have to change the dosage depending on your medical condition and your reaction to treatment.

    • Safety Warning

      Children

      unsafe

      The safety and efficacy of Metoprolol+hydrochlorothiazide in children have not been established. Metoprolol+hydrochlorothiazide is not recommended in children.

    Habit Forming

    No

    Diet & Lifestyle Advise

    • Consume antioxidant-rich food. Blueberries, cherries, tomatoes, squash, and bell peppers are high in antioxidants.
    • Eat natural diuretic foods. Asparagus, beets, green beans, grapes, onion, leafy greens, pineapple, leeks, pumpkin, and garlic are all-natural diuretic foods.
    • Use healthy cooking oils like soybean, olive, canola, and coconut oil.
    • You should avoid refined foods such as white bread, spaghetti, sugar, and red meat.
    • Reduce or eliminate Trans fatty acids, which are found in commercially baked items such as cookies, cakes, crackers, French fries, onion rings, doughnuts, and processed foods.
    • Avoid the consumption of too much salt or salty food.
    • Keep your weight under control with a BMI of 19.5-24.9.
    • Regular physical activity or exercise like walking improves your blood flow.
    • When possible, elevate your legs or the swollen area on a chair or pillows.
    • Avoid standing or sitting for extended periods of time.
    • Avoid chronic stress as it can raise your blood pressure.
    • Spend time with your loved ones to cope with stress and practice mindfulness techniques.
    • Quitting smoking and alcohol consumption is the best strategy to lower the risk of many health complications.

    Patients Concern

    Disease/Condition Glossary

    Hypertension: It is a chronic condition when blood pressure is too high. This condition can lead to hardened arteries (blood vessels), decreasing the blood and oxygen flow to the heart. Blood pressure is the measurement of the force our heart uses to pump blood to all body parts. Raised blood pressure can cause chest pain (angina) and heart attack (when the blood supply to the heart is blocked). Additionally, high blood pressure also causes brain damage (stroke) and kidney failure. High blood pressure can be diagnosed with the help of a blood pressure monitor or sphygmomanometer. Systolic pressure is the pressure when the heart pumps blood out. On the other hand, diastolic pressure is when your heart is at the resting stage between heartbeats. If your blood pressure is 140/90 mm of Hg, it means the systolic pressure is 140 mm of Hg, and diastolic pressure is 90 mm of Hg. Ideal blood pressure should be between 90/60 mm of Hg and 120/80 mm of Hg.

    FAQs

    Metoprolol+hydrochlorothiazide contains a combination of drugs, namely; Metoprolol and Hydrochlorothiazide. Metoprolol is a beta-blocker that works specifically on the heart to reduce heart rate and make the heart more efficient at pumping blood throughout the body. Hydrochlorothiazide is a diuretic that lowers blood pressure by removing extra water and certain electrolytes from the body. Over time it also relaxes blood vessels and improves blood flow.

    Use of Metoprolol+hydrochlorothiazide in diabetes may mask tachycardia (fast heart rate) occurring with low blood sugar level, but other symptoms like dizziness and sweating may not be significantly affected. So, if you are diabetic patients always consult a doctor before taking Metoprolol+hydrochlorothiazide.

    Your doctor may probably tell you to stop taking Metoprolol+hydrochlorothiazide as it lowers blood pressure (hypotension) when combined with general anesthesia before surgery. So, please inform your doctor before surgery if you are taking Metoprolol+hydrochlorothiazide.

    No, Metoprolol+hydrochlorothiazide is not recommended if you have frequent asthma attacks, severe asthma, or COPD (chronic obstructive pulmonary disease). Metoprolol in Metoprolol+hydrochlorothiazide may cause wheezing (bronchospasm) and dyspnea. Thereby, it can make asthma worse. It is advised to consult your doctor before taking Metoprolol+hydrochlorothiazide. You may need a dose adjustment and more frequent monitoring of your lung function to safely use both medications.

    Metoprolol+hydrochlorothiazide can be safely taken as long as your doctor has prescribed it to you. Conditions such as high blood pressure are life-long conditions, and one should not abruptly discontinue it without discussing it with a doctor. Discontinuing Metoprolol+hydrochlorothiazide may lead to increased blood pressure with a high risk of heart attack and stroke in the future.

    Yes, prolonged intake of Metoprolol+hydrochlorothiazide may decrease your potassium levels in the bloodstream. So, it is better to ask your doctor about foods high in potassium like bananas or orange juice. Besides this, consult a doctor regarding the use of table salt or sodium chloride, or salt substitute containing potassium.

    Hydrochlorothiazide in Metoprolol+hydrochlorothiazide may make your more skin more sensitive to the sun and may also increase your risk for skin cancer if used for a long time. Try to limit your time in the sun and avoid tanning booths and sunlamps. You can also use sunscreen and wear protective clothing when outdoors.

    Available Medicines for

    Metoprolol+hydrochlorothiazide

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