Hydrochlorothiazide, HCTZ; metoprolol Extended Release tablets

What is this medicine?

METOPROLOL; HYDROCHLOROTHIAZIDE (me TOE proe lole; hye droe klor oh THYE a zide) is a combination of a beta-blocker and a diuretic. It is used to treat high blood pressure.

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. You can take it with or without food. If it upsets your stomach, take it with food. Do not crush or chew this medicine. Take your medicine at regular intervals. Do not take it more often than directed. Do not stop taking except on your doctor's advice.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• breathing problems

• changes in vision

• depressed mood

• eye pain

• feeling faint or lightheaded, falls

• increased hunger or thirst

• increased urination

• redness, blistering, peeling or loosening of the skin, including inside the mouth

• swelling of the ankles, feet, hands

• symptoms of gout

• unusual skin rash or bruising

• unusually slow heartbeat

• unusually weak or tired

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• change in sex drive or performance

• diarrhea

• dizziness

• general ill feeling or flu-like symptoms

• nausea

• tiredness

What may interact with this medicine?

• alcohol

• certain medicines for blood pressure, heart disease, irregular heart beat

• certain medicines for cholesterol like cholestyramine and colestipol

• certain medicines for depression, anxiety, or psychotic disturbances

• certain medicines for seizures like phenobarbital

• lithium

• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

• medicines for diabetes

• medicines that relax muscles for surgery

• narcotic medicines for pain

• norepinephrine

• NSAIDS, medicines for pain and inflammation, like ibuprofen or naproxen

• steroid medicines like prednisone or cortisone

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• diabetes

• heart disease

• history of irregular heartbeat

• kidney disease

• liver disease

• lung or breathing disease, like asthma

• lupus

• peripheral vascular disease

• pheochromocytoma

• thyroid disease

• an unusual or allergic reaction to hydrochlorothiazide, metoprolol, sulfonamide drugs, or other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. Check your blood pressure as directed. Ask your doctor or health care professional what your blood pressure should be and when you should contact him or her.

Do not treat yourself for coughs, colds, or pain while you are using this medicine without asking your doctor or health care professional for advice. Some ingredients may increase your blood pressure.

Check with your doctor or health care professional if you get an attack of severe diarrhea, nausea and vomiting, or if you sweat a lot. The loss of too much body fluid can make it dangerous for you to take this medicine.

You may get dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Avoid alcoholic drinks; they can make you more dizzy.

This medicine may affect blood sugar levels. If you have diabetes, check with your doctor or health care professional before you change your diet or the dose of your diabetic medicine.

This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

Tell your doctor or health care professional right away if you have any change in your eyesight.