Beta-adrenergic Blocking Agents and Thiazide Diuretics (Systemic)

Precautions While Using This Medicine

It is important that your doctor check your progress at regular visits. This is to make sure the medicine is properly controlling your blood pressure and to allow the dosage to be changed if needed.

Do not stop taking this medicine without first checking with your doctor . Your doctor may want you to reduce gradually the amount you are taking before stopping completely. Some conditions may become worse when the medicine is stopped suddenly, and the risk of heart attack is increased in some patients.

Make sure that you have enough medicine on hand to last through weekends, holidays, or vacations. You may want to carry an extra written prescription in your billfold or purse in case of an emergency. You can then have it filled if you run out of medicine while you are away from home.

Your doctor may want you to carry medical identification stating that you are taking this medicine.

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

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine .

For diabetic patients :

• This medicine may increase your blood sugar levels . Also, this medicine may cover up signs of hypoglycemia (low blood sugar) , such as change in pulse rate. While you are taking this medicine, be especially careful in testing for sugar in your urine. If you have any questions about this, check with your doctor.

The thiazide diuretic contained in this medicine may cause a loss of potassium from your body .

• To help prevent this, your doctor may want you to:
  • eat or drink foods that have a high potassium content (for example, orange or other citrus fruit juices), or
  • take a potassium supplement, or
  • take another medicine to help prevent the loss of the potassium in the first place.
• It is very important to follow these directions. Also, it is important not to change your diet on your own. This is more important if you are already on a special diet (as for diabetes), or if you are taking a potassium supplement or a medicine to reduce potassium loss. Extra potassium may not be necessary and, in some cases, too much potassium could be harmful.

Check with your doctor if you become sick and have severe or continuing vomiting or diarrhea. These problems may cause you to lose additional water and potassium.

This medicine may cause some people to become dizzy, drowsy, lightheaded, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert . If the problem continues or gets worse, check with your doctor.

The beta-blocker (atenolol, bisoprolol, metoprolol, nadolol, pindolol, propranolol, or timolol) contained in this medicine may make you more sensitive to cold temperatures, especially if you have blood circulation problems. Beta-blockers tend to decrease blood circulation in the skin, fingers, and toes. Dress warmly during cold weather and be careful during prolonged exposure to cold, such as in winter sports.

This medicine may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin taking this medicine:

• Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible.
• Wear protective clothing, including a hat. Also, wear sunglasses.
• Apply a sun block product that has a skin protection factor (SPF) of at least 15. Some patients may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your health care professional.
• Apply a sun block lipstick that has an SPF of at least 15 to protect your lips.
• Do not use a sunlamp or tanning bed or booth.

If you have a severe reaction from the sun, check with your doctor .

Before you have any medical tests, tell the doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

For patients with allergies to foods, medicines, or insect stings:

• There is a chance that this medicine will make allergic reactions worse and harder to treat. If you have a severe allergic reaction while you are being treated with this medicine, check with a doctor right away so that it can be treated.