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- $Unique_ID{BRK03352}
- $Pretitle{}
- $Title{timolol and hydrochlorothiazide combination}
- $Subject{Timolide Merck Sharp Dohme Beta-adrenergic blocking agent diuretic
- Stimolol hydrochlorothiazide high blood pressure fluid accumulation
- elimination salt water kidneys beta blockers impulses nerve pathways}
- $Volume{}
- $Log{}
-
- Copyright (C) 1993 Publications International, Ltd.
-
-
- timolol and hydrochlorothiazide combination
- ------------------------------------------------------------------------------
-
- BRAND NAME (Manufacturer)
-
- Timolide (Merck Sharp & Dohme)
-
- TYPE OF DRUG
-
- Beta-adrenergic blocking agent and diuretic
-
- INGREDIENT
-
- Stimolol and hydrochlorothiazide
-
- DOSAGE FORM
-
- Tablets (10 mg timolol and 25 mg hydrochlorothiazide)
-
- STORAGE
-
- Timolol and hydrochlorothiazide combination tablets should be stored at
- room temperature in a tightly closed, light-resistant container.
-
- USES
-
- Timolol and hydrochlorothiazide combination is prescribed to treat high
- blood pressure. Hydrochlorothiazide is a diuretic, which reduces fluid
- accumulation in the body by increasing the elimination of salt and water
- through the kidneys. Timolol belongs to a group of medicines known as
- beta-adrenergic blocking agents or, more commonly, beta blockers. They work
- by controlling impulses along certain nerve pathways.
-
- TREATMENT
-
- This medication can be taken with a glass of water, with meals,
- immediately following meals, or on an empty stomach--depending on your
- doctor's instructions.
- Try to take the medication 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 wait until the next scheduled dose. Do not
- double the dose.
- Timolol 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, constipation, diarrhea, dizziness, drowsiness, dryness of
- the eyes and skin, headache, heartburn, loss of appetite, or tiredness. These
- side effects should disappear as your body adjusts to the medication.
- If you become extra-sensitive to the cold, be sure to dress warmly during
- cold weather.
- Plain, nonmedicated eye drops (artificial tears) may help to relieve eye
- dryness.
- Sucking on ice chips or chewing sugarless gum helps to relieve mouth and
- throat dryness.
- To relieve constipation, increase the amount of fiber in your diet (fresh
- fruits and vegetables, salads, bran, and whole-grain breads) and drink more
- water unless your doctor directs you to do otherwise.
- 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.
- Hydrochlorothiazide can cause increased sensitivity to sunlight. Avoid
- prolonged exposure to sunlight and sunlamps, wear protective clothing and
- sunglasses, and use an effective sunscreen.
-
- Major.
-
- Tell your doctor about any side effects that are persistent or
- particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
- blurred vision, chest pain, cold hands or feet (due to decreased blood
- circulation to skin, fingers, and toes), confusion, decreased sexual ability,
- depression, difficulty in breathing, dry mouth, fever, hair loss,
- hallucinations, itching, joint pain, mood changes, muscle pain or cramps,
- nausea, numbness or tingling in your fingers or toes, palpitations, rapid
- weight gain (three to five pounds within a week), ringing in the ears, skin
- rash, sore throat, thirst, unusual bleeding or bruising, vomiting, weakness,
- or yellowing of the eyes or skin.
-
- INTERACTIONS
-
- This medicine interacts with other types of medications:
- 1. Indomethacin, aspirin, and other salicylates may decrease the
- blood-pressure-lowering effects of beta blockers.
- 2. Concurrent use of timolol and disopyramide or calcium channel blockers
- (diltiazem, nifedipine, verapamil) can lead to heart failure or very low blood
- pressure.
- 3. Side effects can be increased when timolol is taken with cimetidine,
- clonidine, digoxin, epinephrine, phenylephrine, phenylpropanolamine,
- phenothiazine tranquilizers, prazosin, reserpine, chlorpromazine, furosemide,
- hydralazine, oral contraceptives (birth control pills), or monoamine oxidase
- (MAO) inhibitors. At least 14 days should separate the use of timolol and the
- use of an MAO inhibitor.
- 4. Timolol can antagonize (act against) the effects of theophylline,
- aminophylline, albuterol, isoproterenol, metaproterenol, and terbutaline.
- 5. Timolol can also interact with insulin and oral antidiabetic agents,
- raising or lowering blood sugar levels and masking the symptoms of low blood
- sugar.
- 6. Alcohol, barbiturates, and rifampin can decrease the blood
- concentrations of beta blockers, which can result in a decrease of
- effectiveness.
- 7. Hydrochlorothiazide can decrease the effectiveness of oral
- anticoagulants (blood thinners, such as warfarin), antigout medications, and
- methenamine.
- 8. Fenfluramine may increase the blood-pressure-lowering effects of this
- drug, which can be dangerous.
- 9. Cholestyramine and colestipol can decrease the absorption of
- hydrochlorothiazide from the gastrointestinal tract. This medication 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
- medications).
- 10. Hydrochlorothiazide may increase the side effects of amphotericin B,
- calcium, cortisone and cortisone-like steroids (such as dexamethasone,
- hydrocortisone, prednisone, and prednisolone), digoxin, digitalis, lithium,
- quinidine, sulfonamide antibiotics, and vitamin D.
- Before starting to take timolol and hydrochlorothiazide combination, BE
- SURE TO TELL YOUR DOCTOR about any medications you are currently taking,
- especially any of the medications that are listed above.
-
- WARNINGS
-
- * Be sure to tell your doctor about unusual or allergic reactions you
- have had to any medications, especially to timolol or any other beta blockers
- (acebutolol, atenolol, betaxolol, carteolol, esmolol, labetalol, metoprolol,
- nadolol, penbutolol, pindolol, propranolol), hydrochlorothiazide or other
- diuretics (such as bendroflumethiazide, benzthiazide, chlorothiazide,
- chlorthalidone, cyclothiazide, hydroflumethiazide, methyclothiazide,
- metolazone, polythiazide, quinethazone, trichlormethiazide, and furosemide),
- or to any other sulfa drug (oral antidiabetic medication, or sulfonamide
- antibiotic).
- * Be sure to tell your doctor if you now have or if you have ever had any
- of the following: asthma, diabetes mellitus, heart disease, gout, kidney
- disease or problems with urination, liver disease, pancreatitis, systemic
- lupus erythematosus, thyroid disease, or poor circulation in the fingers or
- toes.
- * 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, however, until you discuss it with
- your doctor. Too much potassium can also be dangerous.
- * While taking this medication, you should limit your intake of alcoholic
- beverages in order to prevent dizziness and light-headedness.
- * While taking this medication, do not take any over-the-counter
- (nonprescription) medication for weight control or for allergy, asthma, cough,
- cold, or sinus problems unless you first check with your doctor.
- * 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.
- * This medication can raise blood sugar levels in diabetic patients.
- Blood sugar levels should be monitored carefully with blood or urine tests
- when this medication is being taken.
- * You may want to check your pulse while taking this medication. If your
- pulse is much slower than your usual rate (or if it is less than 50 beats per
- minute), check with your doctor. A pulse rate that is too slow may cause
- circulation problems.
- * Timolol can affect your body's response to exercise. Make sure you ask
- your doctor what an appropriate amount of exercise would be for you, taking
- into account your medical condition.
- * Before having surgery or any other medical or dental treatment, tell
- your doctor or dentist that you are taking this medicine. Often, this
- medication will be discontinued 48 hours prior to any major surgery.
- * This medication can cause dizziness, drowsiness, light-headedness, or
- decreased alertness. Therefore, you should exercise caution while driving a
- car or operating potentially dangerous machinery.
- * A doctor does not usually prescribe a "fixed-dose" drug like this as
- 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 advantages of a combination product are increased
- convenience and (often) decreased cost.
- * It is important that you do not stop taking this medicine unless you
- first check with your doctor. Some conditions worsen when this medicine is
- stopped suddenly, and the danger of a heart attack is increased in some
- patients. Your doctor may, therefore, want you to gradually reduce the amount
- of medicine you take before stopping completely. Make sure that you have
- enough medicine on hand to last through weekends, holidays, and vacations.
- * Be sure to tell your doctor if you are pregnant. Animal studies have
- shown that some beta blockers can cause problems in pregnancy when used at
- very high doses. Extensive studies have not been conducted in humans, but
- there has been some association between beta blockers used during pregnancy
- and low birth weight, as well as breathing problems and slow heart rate in
- newborn infants. However, some other reports have shown this type of
- medication to have no effects on newborn infants. Also, tell your doctor if
- you are breast-feeding an infant. Although problems in humans have not yet
- been reported, small amounts of timolol and hydrochlorothiazide may 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.
-