Hydrochlorothiazide (hye-droe-klor-oh-THYE-a-zide), Metoprolol (met-oh-PROE-lol)

Treats high blood pressure. This medicine is a combination of a beta-blocker and a diuretic (water pill).

Brand Name(s):

Dutoprol, Lopressor HCT

When This Medicine Should Not Be Used:

How to Use This Medicine:

Tablet, Long Acting Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Tablet: Take it with a meal or just after a meal.
• Extended-release tablet: Take it with or without food. Swallow the extended-release tablet whole. Do not crush, break, or chew it.
• Missed dose: If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not use extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some foods and medicines can affect how metoprolol/hydrochlorothiazide works. Tell your doctor if you use the following:
  • Cholestyramine, cimetidine, colestipol, digoxin, diphenhydramine, hydroxychloroquine, lithium, methyldopa, quinidine, reserpine, ritonavir, terbinafine, thioridazine
  • Insulin or oral diabetes medicine
  • MAO inhibitor (MAOI)
  • Medicine to treat depression (including fluoxetine, paroxetine)
  • Medicine to treat heart rhythm problems (including propafenone)
  • NSAIDs (including aspirin, diclofenac, indomethacin, naproxen)
  • Other blood pressure medicine (including clonidine, diltiazem, verapamil)
  • Steroid medicine
• Take this medicine at least 4 hours before or 4 to 6 hours after using bile acid sequestrants (including cholestyramine, colestipol).
• Ask your doctor before you use medicines, supplements, or salt substitutes that contain potassium.
• Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used together with this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart or blood vessel disease, heart rhythm problems (including bradycardia), glaucoma, gout, diabetes, lupus, an overactive thyroid, pheochromocytoma (adrenal gland tumor), Wolff-Parkinson-White syndrome, trouble urinating, or a history of asthma or lung disease. Tell your doctor if you are fasting (including surgery, not eating regularly, vomiting).
• This medicine may cause the following problems:
  • New or worsening heart failure while the dose is being adjusted
  • Eye or vision problems, including glaucoma, myopia
  • Increased risk for skin cancer
  • Increased risk for hypoglycemia (low blood sugar) and cover up the symptoms of low blood sugar (including fast heartbeat)
• Do not stop using this medicine suddenly without asking your doctor, or you could develop life-threatening heart problems.
• Tell any doctor or dentist who treats you that you are using this medicine, especially before you have any type of surgery.
• This medicine may cause you to feel dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you are dizzy or lightheaded.
• This medicine may cause erectile dysfunction in some males. If you have questions about this, talk to your doctor.
• This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Change in how much or how often you urinate
• Chest pain that may spread, unusual sweating
• Confusion, weakness, and muscle twitching
• Dry mouth, increased thirst, or muscle cramps
• Eye pain, vision changes, seeing halos around lights
• Lightheadedness, dizziness, fainting
• Shaking, trembling, hunger
• Slow, fast, pounding, or uneven heartbeat
• Sores, reddish patch or irritated area, shiny bump, pink growth, or white, yellow or waxy scar-like area on the skin
• Sudden and severe stomach pain, nausea, or vomiting
• Swelling in your hands, feet, ankles, or legs, tiredness
• Worsening chest pain, trouble breathing

If you notice these less serious side effects, talk with your doctor:

• Depression
• Diarrhea, constipation, loss of appetite, stomach upset

If you notice other side effects that you think are caused by this medicine, tell your doctor

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