Propranolol And Hydrochlorothiazide (Oral Route) Side Effects

Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

Inderide

Descriptions

Propranolol and hydrochlorothiazide combination is used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Propranolol is a beta-blocker. It works by affecting the response to some nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart.

Hydrochlorothiazide is a diuretic (water pill). It reduces the amount of water in the body by increasing the flow of urine, which helps lower the blood pressure.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

Tablet

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of propranolol and hydrochlorothiazide combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of propranolol and hydrochlorothiazide combination in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving propranolol and hydrochlorothiazide combination.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Dofetilide
Rizatriptan
Thioridazine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abametapir
Acarbose
Aceclofenac
Acemetacin
Acetyldigoxin
Albiglutide
Albuterol
Alogliptin
Amphetamine
Amtolmetin Guacil
Arsenic Trioxide
Aspirin
Benzphetamine
Bromfenac
Bromocriptine
Bufexamac
Bupivacaine
Bupivacaine Liposome
Buprenorphine
Bupropion
Canagliflozin
Capmatinib
Cefepime
Celecoxib
Ceritinib
Chlorpropamide
Choline Salicylate
Clonidine
Clonixin
Codeine
Crizotinib
Dapagliflozin
Darunavir
Deslanoside
Desmopressin
Desvenlafaxine
Dexibuprofen
Dexketoprofen
Dextroamphetamine
Diatrizoate
Diclofenac
Diflunisal
Digitalis
Digitoxin
Digoxin
Diltiazem
Dipyrone
Dronedarone
Droperidol
Droxicam
Dulaglutide
Empagliflozin
Epinephrine
Escitalopram
Eslicarbazepine Acetate
Etodolac
Etofenamate
Etoricoxib
Exenatide
Fedratinib
Felbinac
Fenoldopam
Fenoprofen
Fentanyl
Fepradinol
Feprazone
Fexinidazole
Fingolimod
Flecainide
Floctafenine
Flufenamic Acid
Fluoxetine
Flurbiprofen
Formoterol
Glimepiride
Glipizide
Glyburide
Haloperidol
Ibuprofen
Indacaterol
Indomethacin
Insulin
Insulin Aspart, Recombinant
Insulin Bovine
Insulin Degludec
Insulin Detemir
Insulin Glulisine
Iobenguane I 131
Iohexol
Ketanserin
Ketoprofen
Ketorolac
Lacosamide
Lercanidipine
Levalbuterol
Levomethadyl
Lidocaine
Linagliptin
Liraglutide
Lisdexamfetamine
Lithium
Lixisenatide
Lornoxicam
Loxoprofen
Lumiracoxib
Meclofenamate
Mefenamic Acid
Mefloquine
Meloxicam
Mepivacaine
Methadone
Methamphetamine
Methotrexate
Metildigoxin
Miglitol
Morniflumate
Nabumetone
Naproxen
Nateglinide
Nepafenac
Niflumic Acid
Nimesulide
Nimesulide Beta Cyclodextrin
Oliceridine
Olodaterol
Ouabain
Oxaprozin
Oxymetazoline
Oxyphenbutazone
Parecoxib
Phenylbutazone
Piketoprofen
Pioglitazone
Piroxicam
Pixantrone
Ponesimod
Porfimer
Pramlintide
Prilocaine
Proglumetacin
Propyphenazone
Proquazone
Proscillaridin
Repaglinide
Rivastigmine
Rofecoxib
Rosiglitazone
Salicylic Acid
Salmeterol
Salsalate
Saxagliptin
Simeprevir
Siponimod
Sitagliptin
Sodium Salicylate
Sotalol
Sparsentan
Sufentanil
Sulindac
Tapentadol
Tenoxicam
Terbutaline
Tiaprofenic Acid
Tolazamide
Tolbutamide
Tolfenamic Acid
Tolmetin
Topiramate
Tramadol
Valdecoxib
Venlafaxine
Verapamil
Vilanterol
Vildagliptin
Vonoprazan
Zileuton

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acarbose
Aceclofenac
Acemetacin
Acetyldigoxin
Albiglutide
Alfuzosin
Alogliptin
Aluminum Carbonate, Basic
Aluminum Hydroxide
Aluminum Phosphate
Aminolevulinic Acid
Amtolmetin Guacil
Aspirin
Bepridil
Bromfenac
Bufexamac
Bunazosin
Calcium Carbonate
Canagliflozin
Carbamazepine
Celecoxib
Chlorpromazine
Chlorpropamide
Cholestyramine
Choline Salicylate
Cimetidine
Clonixin
Dapagliflozin
Deslanoside
Dexibuprofen
Dexketoprofen
Diclofenac
Diflunisal
Digitoxin
Digoxin
Dihydroergotamine
Dihydroxyaluminum Aminoacetate
Dihydroxyaluminum Sodium Carbonate
Dipyrone
Doxazosin
Droxicam
Dulaglutide
Empagliflozin
Ergotamine
Ertugliflozin
Etodolac
Etofenamate
Etoricoxib
Exenatide
Felbinac
Fenoprofen
Fepradinol
Feprazone
Flecainide
Floctafenine
Flufenamic Acid
Flurbiprofen
Fluvoxamine
Ginkgo
Glimepiride
Glipizide
Glyburide
Gossypol
Ibuprofen
Indomethacin
Insulin Aspart, Recombinant
Insulin Degludec
Insulin Detemir
Insulin Glargine, Recombinant
Insulin Glulisine
Insulin Human Inhaled
Insulin Human Isophane (NPH)
Insulin Human Regular
Insulin Lispro, Recombinant
Ketoprofen
Ketorolac
Licorice
Linagliptin
Liraglutide
Lixisenatide
Lornoxicam
Loxoprofen
Lumiracoxib
Magaldrate
Meclofenamate
Mefenamic Acid
Meloxicam
Metformin
Metildigoxin
Miglitol
Morniflumate
Moxisylyte
Nabumetone
Naproxen
Nateglinide
Nepafenac
Niflumic Acid
Nimesulide
Nimesulide Beta Cyclodextrin
Oxaprozin
Oxyphenbutazone
Parecoxib
Phenoxybenzamine
Phentolamine
Phenylbutazone
Piketoprofen
Pioglitazone
Piroxicam
Pramlintide
Pranoprofen
Prazosin
Proglumetacin
Propyphenazone
Proquazone
Quinidine
Repaglinide
Rifapentine
Rofecoxib
Rosiglitazone
Salicylic Acid
Salsalate
Saxagliptin
Sitagliptin
Sodium Salicylate
St John's Wort
Sulindac
Tamsulosin
Tenoxicam
Terazosin
Tiaprofenic Acid
Tolazamide
Tolbutamide
Tolfenamic Acid
Tolmetin
Trimazosin
Urapidil
Valdecoxib
Vildagliptin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Tobacco

Proper Use

This medicine should not be the first medicine you use to treat your condition. It is meant to be used only after you have tried other medicines that have not worked or have caused unwanted side effects.

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Swallow the tablet whole. Do not crush, break, or chew it.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):
- For high blood pressure:
  - Adults—One tablet two times a day. Your doctor may adjust your dose if needed.
  - Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

This medicine may cause serious allergic reactions including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, lips, tongue, or throat while you are using this medicine.

This medicine may cause or worsen heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing, an irregular heartbeat, swelling of the face, fingers, feet, or lower legs, trouble breathing, or weight gain.

Do not interrupt or stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. Some conditions may become worse when the medicine is stopped suddenly, which can be dangerous.

This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.

Serious skin reactions (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis, erythema multiforme) can occur during treatment with this medicine. Check with your doctor right away if you start having skin itching, swelling, rash, or redness, blistering, peeling, or loosening of the skin, or any other unusual effects that may be caused by this medicine.

Check with your doctor right away if you start having dry mouth, increased thirst, muscle cramps, nausea or vomiting, unusual tiredness or weakness, severe drowsiness or dizziness, seizures, a decrease in urine, or a fast heartbeat while you are using this medicine. These may be symptoms of dehydration or mineral imbalance.

Check with your doctor immediately if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment. This could be a sign of a serious eye problem. Your doctor will want you to have your eyes checked by an ophthalmologist (eye doctor).

This medicine may increase your risk of getting skin cancer (eg, non-melanoma skin cancer). Avoid sun exposure. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds. Talk to your doctor if you have concerns about this risk.

Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine. Tell your doctor if you are drinking alcohol or using pain relievers or sleeping pills.

Do not take other medicines unless they have been discussed with your doctor. This especially includes prescription or nonprescription (over-the-counter) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may increase your blood pressure.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

Black, tarry stools
bleeding gums
blistering, peeling, or loosening of the skin
bloating
blood in the urine
bloody nose
bloody stools
blurred or loss of vision
body aches or pain
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chest pain, discomfort, or tightness
clay-colored stools
cold sweats
confusion about identity, place, and time
congestion
constipation
cough
coughing up blood
cracks in the skin
crying
darkened urine
decreased awareness or responsiveness
decreased urine output
depersonalization
diarrhea
difficulty with breathing or swallowing
dilated neck veins
disturbed color perception
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
double vision
dry mouth
dryness or soreness of the throat
dysphoria
false or unusual sense of well-being
fast, pounding, slow, or irregular heartbeat
fever or chills
flushing or redness of the skin
fruit-like breath odor
general feeling of discomfort or illness
general feeling of tiredness or weakness
hair loss
halos around lights
headaches
heavier menstrual periods
hives or welts, itching
hoarseness
increased hunger
increased sensitivity of the skin to sunlight
increased thirst
increased urination
indigestion
irregular breathing
irregular heartbeat
joint pain, stiffness, or swelling
lightheadedness, dizziness, or fainting
loss of appetite
loss of heat from the body
loss of strength or energy
lower back or side pain
mental depression
mimicry of speech or movements
muscle pain or weakness
mutism
nausea or vomiting
negativism
night blindness
noisy breathing
overbright appearance of lights
painful or difficult urination
pains in the stomach, side, or abdomen, possibly radiating to the back
paleness or cold feeling in the fingertips and toes
paranoia
peculiar postures or movements, mannerisms or grimacing
persistent non-healing sore
pink growth
pinpoint red or purple spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
quick to react or overreact emotionally
rapidly changing moods
rectal bleeding
red skin lesions, often with a purple center
red, irritated eyes
red, swollen skin
reddening of the skin, especially around the ears
reddish patch or irritated area
runny nose
scaly skin
seeing, hearing, or feeling things that are not there
severe sleepiness
severe sunburn
shiny bump
short-term memory loss
skin irritation or rash, including rash that looks like psoriasis
sleeplessness
sore throat
sores, ulcers, or white spots on the lips or in the mouth
stomach pain or tenderness
sugar in the urine
sweating
swelling of the eyes, face, or inside of the nose
swelling of the fingers, feet, or lower legs
tender, swollen, or painful glands in the neck
tenderness of salivary glands
tenderness, burning, or peeling of the skin
thickening of bronchial secretions
tingling or pain in the fingers or toes when exposed to cold
trouble breathing
trouble with sleeping
trouble with swallowing
tunnel vision
unable to sleep
unpleasant breath odor
unusual bleeding or bruising
unusual tiredness or weakness
unusual weight loss
unusually warm skin
voice changes
vomiting of blood
weight gain
white, yellow or waxy scar-like area
yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Change in consciousness
decreased urination
fast, slow, or shallow breathing
gas
heartburn
increase in heart rate
increased sweating
indigestion
loss of consciousness
low blood pressure
muscle cramps
pale or blue lips, fingernails, or skin
rapid breathing
seizures
sunken eyes
unusual drowsiness, dullness, or feeling of sluggishness
unusual paleness
weakness and heaviness of the legs
wrinkled skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Decreased interest in sexual intercourse
dry eyes
feeling of constant movement of self or surroundings
inability to have or keep an erection
loss in sexual ability, desire, drive, or performance
muscle spasm
pain of the penis on erection
pain or discomfort in the chest, upper stomach, or throat
restlessness
sensation of spinning
stomach cramps
thinning of the hair
vivid dreams

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: May 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/propranolol-and-hydrochlorothiazide-oral-route/side-effects/drg-20071210

Propranolol And Hydrochlorothiazide (Oral Route)

Description and Brand Names

US Brand Name

Descriptions

Before Using

Allergies

Pediatric

Geriatric

Breastfeeding

Drug Interactions

Other Interactions

Other Medical Problems

Proper Use

Dosing

Missed Dose

Storage

Precautions

Side Effects

Incidence not known

Symptoms of overdose

Incidence not known

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