$Unique_ID{BRK03064} $Pretitle{} $Title{captopril and hydrochlorothiazide combination} $Subject{Capozide Squibb Antihypertensive diuretic captopril hydrochlorothiazide high blood pressure vasodilator widens blood vessels production chemicals diuretic water pill body fluid accumulation elimination salt water kidneys} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. captopril and hydrochlorothiazide combination ------------------------------------------------------------------------------ BRAND NAME (Manufacturer) Capozide (Squibb) TYPE OF DRUG Antihypertensive and diuretic INGREDIENTS captopril and hydrochlorothiazide DOSAGE FORM Tablets (25 mg captopril and 15 mg hydrochlorothiazide; 25 mg captopril and 25 mg hydrochlorothiazide; 50 mg captopril and 15 mg hydrochlorothiazide; 50 mg captopril and 25 mg hydrochlorothiazide) STORAGE Captopril and hydrochlorothiazide combination tablets should be stored at room temperature in a tightly closed container. This medication should be stored away from moisture and high heat (above 86 degrees_F). USES Captopril and hydrochlorothiazide combination is used to treat high blood pressure. Captopril is a vasodilator (it widens the blood vessels) that acts by blocking the production of chemicals that may be responsible for constricting blood vessels. Hydrochlorothiazide is a diuretic (water pill), which reduces body fluid accumulation by increasing the elimination of salt and water through the kidneys. TREATMENT To obtain the maximum benefit from this medication, take it on an empty stomach one hour before meals. In order to become accustomed to taking this medication, try to take it at the same time(s) every day. Avoid taking a dose of this medication after 6:00 p.m.; otherwise, you may have to get up during the night to urinate. It may be several weeks before you notice the full effects of this medication. If you miss a dose of this medication, take the missed dose as soon as possible, unless it is almost time for the next dose. In that case, do not take the missed dose at all; just wait until the next scheduled dose. Do not double the dose. Captopril and hydrochlorothiazide combination does not cure high blood pressure, but it will help to control the condition as long as you continue to take it. SIDE EFFECTS Minor. Abdominal pain, blurred vision, constipation, cough, cramping, diarrhea, dizziness, fatigue, flushing, headache, insomnia, loss of appetite, or loss of taste. These side effects should disappear as your body adjusts to this medication. Hydrochlorothiazide can increase your sensitivity to sunlight. It is, therefore, important to avoid prolonged exposure to sunlight and sunlamps. Wear protective clothing and sunglasses, and use an effective sunscreen. To relieve constipation, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads) and exercise (unless your doctor directs you to do otherwise). To relieve mouth dryness, suck on ice chips or hard candy or chew sugarless gum. To avoid dizziness or light-headedness when you stand, contract and relax the muscles of your legs for a few moments before rising. Do this by alternately pushing one foot against the floor while raising the other foot slightly, so that you are "pumping" your legs in a pedaling motion. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about chest pain; chills; cough; difficult or painful urination; dry mouth; fever; hair loss; itching; mouth sores; muscle pain or cramps; nausea; palpitations; rash; shortness of breath; sore throat; swelling of the face, hands, or feet; thirst; tingling in the fingers or toes; unusual bleeding or bruising; vomiting; weakness; or yellowing of the eyes or skin. INTERACTIONS Captopril and hydrochlorothiazide combination can interact with several other types of medications: 1. The combination of captopril with spironolactone, triamterene, amiloride, potassium supplements, or salt substitutes can lead to hyperkalemia (dangerously high levels of potassium in the bloodstream). 2. Antineoplastic agents (anticancer drugs) and chloramphenicol can increase the bone marrow side effects of captopril. 3. Concurrent use of captopril and allopurinol can increase the risk of developing an allergic reaction. 4. Diuretics (water pills) and other antihypertensive medications can cause an excessive drop in blood pressure when combined with captopril (especially with the first dose). 5. Hydrochlorothiazide can decrease the effectiveness of oral anticoagulants, antigout medications, insulin, oral antidiabetic medicines, and methenamine. 6. Captopril can delay the body's elimination of lithium. Concurrent use of captopril and lithium may cause lithium toxicity. 7. Fenfluramine can increase the blood-pressure-lowering effects of hydrochlorothiazide (which can be dangerous). 8. Indomethacin can decrease the blood-pressure-lowering effects of captopril and hydrochlorothiazide, thereby counteracting the desired effects. 9. Cholestyramine and colestipol decrease the absorption of hydrochlorothiazide from the gastrointestinal tract. Hydrochlorothiazide should, therefore, be taken one hour before or four hours after a dose of cholestyramine or colestipol (if you have also been prescribed one of these drugs). 10. Hydrochlorothiazide may increase the side effects of amphotericin B, calcium supplements, cortisone and cortisone-like steroids (such as dexamethasone, hydrocortisone, prednisone, and prednisolone), digoxin, digitalis, lithium, quinidine, sulfonamide antibiotics, and vitamin D. Before starting captopril and hydrochlorothiazide combination, BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to captopril or to hydrochlorothiazide or other diuretics (such as bendroflumethiazide, benzthiazide, chlorothiazide, chlorthalidone, cyclothiazide, hydroflumethiazide, methyclothiazide, metolozone, polythiazide, quinethazone, trichlormethiazide, and furosemide) or to sulfa medications (oral antidiabetic medications or sulfonamide antibiotics). * Tell your doctor if you have ever had aortic stenosis, blood disorders, diabetes mellitus, gout, kidney disease or problems with urination, kidney transplant, liver disease, pancreatic disease, a heart attack, or systemic lupus erythematosus. * Hydrochlorothiazide can cause potassium loss. Signs of potassium loss include dry mouth, thirst, weakness, muscle pain or cramps, nausea, and vomiting. If you experience any of these symptoms, call your doctor. To help prevent this problem, your doctor may have blood tests performed periodically to monitor your potassium levels. To help avoid potassium loss, take this medication with a glass of fresh or frozen orange juice or cranberry juice, or eat a banana every day. The use of a salt substitute also helps to prevent potassium loss. Do not change your diet or use a salt substitute, however, until you discuss it with your doctor. Too much potassium may also be dangerous. * Limit your intake of alcoholic beverages while taking this medication, in order to prevent dizziness and light-headedness. * If you have high blood pressure, do not take any over-the-counter (nonprescription) medications for weight control or for allergy, asthma, cough, cold, or sinus problems, unless your doctor directs you to do so. * To prevent dehydration (severe water loss) while taking this medication, check with your doctor if you have any illness that causes severe or continuous diarrhea, nausea, or vomiting. * This medication can raise blood sugar levels in diabetic patients. Therefore, sugar levels should be carefully monitored with blood or urine tests when this medication is started. * Before having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking this medication. * This drug may cause dizziness. Use caution while driving or operating potentially dangerous machinery. * A "fixed-dose" drug like this is not generally the first choice in the treatment of high blood pressure. Usually, the patient first receives each ingredient singly. If there is an adequate response to the fixed dose contained in this product, it can then be substituted. The advantage of a combination product is increased convenience and (often) decreased cost. * Do not stop taking this medication unless you first consult your doctor. Stopping this drug abruptly may lead to a rise in blood pressure. * Be sure to tell your doctor if you are pregnant. Captopril has been found to cause birth defects in the fetus if taken during the second or third trimester of pregnancy. Hydrochlorothiazide can cause adverse effects in the newborn infant if it is given to the mother close to term. Also, tell your doctor if you are breast-feeding an infant. Although problems in humans have not been reported, small amounts of this drug can pass into breast milk, so caution is warranted. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.