$Unique_ID{BRK03178} $Pretitle{} $Title{hydralazine, hydrochlorothiazide, and reserpine combination} $Subject{Cam-ap-es Camall Cherapas Kay H-H-R Geneva Generics Ser-A-Gen Goldline Seralazide Lannett Ser-Ap-Es Ciba Serpazide Major Tri-Hydroserpine Rugby Unipres Solvay Antihypertensive hydralazine hydrochlorothiazide reserpine high blood pressure vasodilator relaxes muscles vessels diuretic water pill fluid accumulation elimination salt water kidneys depleting body chemicals} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. hydralazine, hydrochlorothiazide, and reserpine combination ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Cam-ap-es (Camall) Cherapas (Kay) H-H-R (Geneva Generics) Ser-A-Gen (Goldline) Seralazide (Lannett) Ser-Ap-Es (Ciba) Serpazide (Major) Tri-Hydroserpine (Rugby) Unipres (Solvay) TYPE OF DRUG Antihypertensive INGREDIENTS hydralazine, hydrochlorothiazide, and reserpine DOSAGE FORM Tablets (25 mg hydralazine, 15 mg hydrochlorothiazide, and 0.1 mg reserpine) STORAGE These tablets should be stored at room temperature in a tightly closed, light-resistant container. USES This drug is used to treat high blood pressure. Hydralazine is a vasodilator; it relaxes the muscles of the blood vessels, resulting in a lowering of blood pressure. Hydrochlorothiazide is a diuretic (water pill), which reduces body fluid accumulation by increasing the elimination of salt and water through the kidneys. Reserpine acts by depleting the body of certain chemicals that are responsible for maintaining high blood pressure. TREATMENT In order to avoid stomach irritation, you can take hydralazine, hydrochlorothiazide, and reserpine combination with food or with a full glass of water or milk. To become accustomed to taking this medication, try to take it at the same time(s) each day. Avoid taking a dose after 6:00 p.m.; otherwise, you may have to get up during the night to urinate. If you miss a dose of this medication, take the missed dose as soon as possible, unless it is almost time for your next dose. In that case, do not take the missed dose at all; just return to your regular dosing schedule. Do not double the next dose. Hydralazine, hydrochlorothiazide, and reserpine combination does not cure high blood pressure, but it will help to control the condition as long as you continue to take it. The effects of this medication may not become apparent for up to two weeks after you start to take it. SIDE EFFECTS Minor. Abdominal pain, constipation, decrease in sexual desire, diarrhea, dizziness, flushing, loss of appetite, nasal congestion, or weight gain. These side effects should disappear as your body adjusts to the medication. This medication can cause an increase in 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 more (unless your doctor directs you to do otherwise). To relieve mouth dryness, chew sugarless gum or suck on ice chips or a piece of hard candy. If you feel dizzy or light-headed, sit or lie down for a while; get up slowly from a sitting or reclining position, and be careful on stairs. 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 pushing one foot against the floor while raising the other foot slightly, alternating feet 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 anxiety; blurred vision; breast enlargement (in both sexes); chest pain; depression; difficulty in urinating; drowsiness; dry mouth; fainting; fatigue; fever; headaches; impotence; itching; joint pain; mood changes; muscle pain or spasms; nausea; nervousness; nightmares; palpitations; rapid weight gain (three to five pounds within a week); rash; shortness of breath; sore throat; swelling of the feet, ankles, or lower legs; thirst; tingling in the fingers or toes; tremors; unusual bleeding or bruising; vomiting; weakness; or yellowing of the eyes or skin. INTERACTIONS This medication interacts with several other types of drugs: 1. Concurrent use of it with central nervous system depressants (such as alcohol, antihistamines, barbiturates, benzodiazepine tranquilizers, muscle relaxants, narcotics, pain medications, phenothiazine tranquilizers, and sleeping medications) or with tricyclic antidepressants can cause extreme drowsiness. 2. The use of a monoamine oxidase (MAO) inhibitor within 14 days of this medication can lead to a severe reaction. 3. Tricyclic antidepressants can decrease the blood-pressure-lowering effects of reserpine. Reserpine can also decrease the effectiveness of levodopa and increase side effects (to the heart) of digoxin and quinidine. 4. Hydrochlorothiazide can decrease the effectiveness of warfarin, antigout medications, insulin, oral antidiabetic medicines, and methenamine. 5. Fenfluramine may increase the blood-pressure-lowering effects of hydrochlorothiazide (which can be dangerous). 6. Indomethacin may decrease the blood-pressure-lowering effects of hydrochlorothiazide, thereby counteracting the desired effects. 7. This medication should be taken one hour before or four hours after a dose of cholestyramine or colestipol (if you have also been prescribed one of these medications) because these medications can decrease the absorption of hydrochlorothiazide from the gastrointestinal tract. 8. Hydrochlorothiazide may increase the side effects of amphotericin B, calcium, adrenocorticosteroids (cortisone-like drugs), digitalis, digoxin, lithium, and vitamin D. BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to hydralazine, reserpine, or hydrochlorothiazide, or to any other sulfa drugs (other diuretics, oral antidiabetic medicines, or sulfonamide antibiotics). * Before starting to take this medication, be sure to tell your doctor if you have ever had anuria (decreased urination), blood disorders, chest pain, diabetes mellitus, epilepsy, electroshock therapy, kidney disease, heart disease, liver disease, depression, gallstones or gallbladder disease, Parkinson's disease, peptic ulcers, stroke, systemic lupus erythematosus, or ulcerative colitis. * Some of these products contain the color additive FD&C Yellow No. 5 (tartrazine), which can cause allergic-type reactions (rash, shortness of breath, fainting) in certain susceptible individuals. * A doctor does not usually prescribe this drug or other "fixed-dose" products as the first choice in the treatment of high blood pressure. Generally, the patient first receives each ingredient singly. If the response is adequate to the fixed dose contained in this product, it can then be substituted. An advantage of a combination product is increased convenience. * This drug 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, CONTACT YOUR DOCTOR. To help prevent this problem, your doctor may want to have blood tests performed to monitor your potassium levels. To avoid potassium loss, take this product with a glass of fresh or frozen orange 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 can also be dangerous. * To prevent severe water loss (dehydration) while taking this medication, check with your doctor if you have any illness that causes severe or continuous nausea, vomiting, or diarrhea. * Hydrochlorothiazide can raise blood sugar levels in diabetic patients. Blood sugar should, therefore, be monitored carefully (using blood or urine tests) when this medication is being taken. * In order to prevent dizziness or fainting while taking this drug, try not to stand for long periods of time. You should also avoid drinking alcohol, and avoid becoming overheated by exercising strenuously in hot weather or by taking hot baths, showers, and saunas. * If this drug makes you dizzy or drowsy, avoid taking part in any activity that requires alertness, such as driving a car or operating potentially dangerous machinery. * Before having surgery or other medical or dental treatment, tell your doctor or dentist you are taking this drug. * Before taking any over-the-counter (nonprescription) allergy, asthma, sinus, cough, cold, or diet products, check with your doctor or pharmacist. Some of these products can cause an increase in blood pressure. * Do not stop taking this drug until you first check with your doctor. If this drug is stopped abruptly, you may experience a sudden rise in blood pressure. Your doctor may, therefore, want to decrease your dosage gradually. * The elderly may be at increased risk for side effects, especially depression, confusion, or other mental changes. Report any such changes to your doctor. * Tell your doctor if you are pregnant. Birth defects have been observed in the offspring of animals that received large doses of this drug during pregnancy. Also, tell your doctor if you are breast-feeding an infant. Small amounts of this drug pass into breast milk. ---------------- 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.