$Unique_ID{BRK03229} $Pretitle{} $Title{methyldopa and hydrochlorothiazide combination} $Subject{Aldoril Merck Sharp Dohme Antihypertensive diuretic methyldopa hydrochlorothiazide high blood pressure central nervous system brain spinal cord chemicals diuretic water pill fluid accumulation elimination salt water kidneys} $Volume{} $Log{ Aldoril 250 + 15 mg*0322901.scf Aldoril 250 + 25 mg*0322902.scf Aldoril 500 + 30 mg*0322903.scf Aldoril 500 + 50 mg*0322904.scf} Copyright (C) 1993 Publications International, Ltd. methyldopa and hydrochlorothiazide combination ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Aldoril (Merck Sharp & Dohme) methyldopa and hydrochlorothiazide combination (various manufacturers) TYPE OF DRUG Antihypertensive and diuretic INGREDIENTS methyldopa and hydrochlorothiazide DOSAGE FORM Tablets (250 mg methyldopa and 15 mg hydrochlorothiazide; 250 mg methyldopa and 25 mg hydrochlorothiazide; 500 mg methyldopa and 30 mg hydrochlorothiazide; 500 mg bmethyldopa and 50 mg hydrochlorothiazide) STORAGE These tablets should be stored at room temperature in a tightly closed container. USES Methyldopa and hydrochlorothiazide combination is used to treat high blood pressure. It is not exactly clear how methyldopa works, but it is thought to act on the central nervous system (brain and spinal cord) to prevent the release of chemicals responsible for maintaining high blood pressure. Hydrochlorothiazide is a diuretic (water pill), which reduces fluid accumulation by increasing the elimination of salt and water through the kidneys. TREATMENT To avoid stomach irritation, you can take methyldopa and hydrochlorothiazide combination with food or with a full glass of water or milk (unless your doctor directs you to do otherwise). In order 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. Methyldopa 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. 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; return to your regular dosing schedule. Do not double the dose. SIDE EFFECTS Minor. Bloating, constipation, diarrhea, dizziness, drowsiness, gas, headache, light-headedness, loss of appetite, nasal congestion, or increased urination. These effects should disappear as your body adjusts to the drug. This medication can increase your sensitivity to sunlight. You should, therefore, 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). 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. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about abdominal distention, blurred vision, breast enlargement (in both sexes), chest pain, confusion, decreased sexual ability, depression, difficulty in breathing, dry mouth, fainting, fatigue, fever, inflamed salivary glands, insomnia, joint pains, muscle pains or spasms, nausea, nightmares, numbness or tingling, rapid weight gain (three to five pounds within a week), severe stomach cramps, sore or "black" tongue, swelling of the feet or ankles, thirst, tremors, unusual bleeding or bruising, unusual body movements, vomiting, weakness, or yellowing of the eyes or skin. INTERACTIONS This medicine interacts with other types of drugs: 1. Methyldopa can either increase or decrease the antiparkinsonism effects of levodopa. 2. The use of a monamine oxidase (MAO) inhibitor within 14 days of methyldopa can cause headaches, severe hypertension, and hallucinations. 3. The combination of methyldopa and methotrimeprazine can cause a severe drop in blood pressure; methyldopa and haloperidol can cause irritability; methyldopa and phenoxybenzamine can cause urinary retention; and methyldopa and alcohol can cause dizziness and fainting. 4. The effects of methyldopa may be increased by verapamil and fenfluramine, which may have a negative effect. 5. Methyldopa can increase the side effects of tolbutamide and lithium. 6. Methyldopa may increase the effects of norepinephrine and phenylpropanolamine, which may increase blood pressure. 7. Hydrochlorothiazide can decrease the effectiveness of oral anticoagulants (blood thinners, such as warfarin), antigout medications, insulin, oral antidiabetic medications, and methenamine. 8. Fenfluramine may increase the blood-pressure-lowering effects of hydrochlorothiazide, and indomethacin may decrease its blood-pressure-lowering effects. 9. Cholestyramine and colestipol can decrease the absorption of hydrochlorothiazide from the gastrointestinal tract. Therefore, this medication should be taken one hour before or four hours after a dose of either of these other drugs. 10. The side effects of amphotericin B, calcium, adrenocorticosteroids (cortisone-like medicines), digitalis, digoxin, lithium, quinidine, sulfonamide antibiotics, and vitamin D may be increased by hydrochlorothiazide. 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 medications, especially to methyldopa or hydrochlorothiazide or to any other sulfa medication (diuretics, oral antidiabetic medicines, sulfonamide antibiotics, dapsone, or sulfone). * Before starting to take this medication, be sure to tell your doctor if you have ever had anemia, angina, diabetes mellitus, gout, kidney disease, liver disease, mental depression, Parkinson's disease, pancreatitis, or stroke. * A doctor generally does not prescribe this drug or other "fixed-dose" products as the first choice in the treatment of high blood pressure. The patient should initially receive each ingredient singly. If the response is adequate to the dose contained in this product, it can then be substituted. The advantage of a combination product is its increased convenience. * This medication 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 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 can also be dangerous. * To prevent severe water loss (dehydration) while taking hydrochlorothiazide, 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 when this medication is being taken. * In order to avoid dizziness or fainting while taking this medication, try not to stand for long periods of time; avoid drinking excessive amounts of alcohol; and try not to get overheated (avoid strenuous exercise in hot weather and do not take hot baths, showers, and saunas). * If this drug makes you dizzy or drowsy, avoid taking part in any activity that requires alertness. * Before having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking this medication. * Before taking any over-the-counter (nonprescription) allergy, asthma, sinus, cough, cold, or diet product, check with your doctor or pharmacist. * Do not stop taking this medication unless you first check with your doctor. If this drug is stopped abruptly, you could experience a sudden rise in blood pressure. Your doctor may, therefore, want to decrease your dosage gradually. * If you have an unexplained fever, especially during the first two to three weeks after starting to take this medication, CONTACT YOUR DOCTOR. Fever can be a sign of a serious reaction to methyldopa. * Tolerance to this drug can develop, usually during the second or third month of therapy. If you notice a decrease in effectiveness of this drug, contact your doctor. * Before donating blood or receiving a blood transfusion, be sure you let the doctor know that you are taking this medication. Methyldopa can cause a change in the blood cells. * Be sure to tell your doctor if you are pregnant. Methyldopa and hydrochlorothiazide cross the placenta and may cause adverse effects in the developing fetus. Also, tell your doctor if you are breast-feeding an infant. Small amounts of both of these drugs 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.