Propranolol and Hydrochlorothiazide

treats high blood pressure. Do not suddenly stop taking this medication. Your doctor will decrease your dose slowly.

Propranolol and Hydrochlorothiazide Overview

Reviewed: July 27, 2015
Updated: 

Propranolol and hydrochlorothiazide is a prescription medication used to treat high blood pressure. This medication is a single product containing 2 medications: propranolol and hydrochlorothiazide.

Propranolol belongs to a group of drugs called beta blockers. It works to decrease blood pressure and heart rate by blocking beta receptors in the body. Hydrochlorothiazide belongs to a group of drugs called thiazide diuretics, which work by stopping reabsorption of salt into your body. This prevents fluid from building up in the body. This medication comes in a tablet form and is typically taken twice daily with or without food. 

Common side effects include low blood pressure, headache, and slow heart rate. 

Propranolol and hydrochlorothiazide can also cause dizziness and weakness. Do not drive or operate heavy machinery until you know how this medication affects you.

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Propranolol and Hydrochlorothiazide Cautionary Labels

precautionsprecautionsprecautionsprecautions

Uses of Propranolol and Hydrochlorothiazide

Propranolol and hydrochlorothiazide is a prescription medication used to treat high blood pressure.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. 

Propranolol and Hydrochlorothiazide Brand Names

Propranolol and Hydrochlorothiazide may be found in some form under the following brand names:

Propranolol and Hydrochlorothiazide Drug Class

Propranolol and Hydrochlorothiazide is part of the drug class:

Side Effects of Propranolol and Hydrochlorothiazide

Serious side effects have been reported with propranolol and hydrochlorothiazide. See the "Propranolol and hydrochlorothiazide Precautions" section. 

Common side effects of propranolol and hydrochlorothiazide include the following:

  • low blood pressure
  • dizziness
  • headache
  • slow heart rate
  • purple patches on the skin (thrombocytopenic purpura)
  • an abnormal sensation of tingling or pricking in the hands (paresthesia of the hands)
  • difficulty sleeping (insomnia)
  • a state of physical or mental weariness (lassitude)
  • weakness or fatigue
  • disorientation of time and place
  • short-term memory loss
  • emotional changes
  • hallucinations, visual changes, and vivid dreams
  • light-headedness
  • nausea and vomiting
  • stomach cramping
  • diarrhea or constipation
  • constriction of airways (bronchospasm)

This is not a complete list of propranolol and hydrochlorothiazide side effects. Ask your doctor or pharmacist for more information. 

Tell your doctor if you have any side effect that bothers you or that does not go away.

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

Propranolol and Hydrochlorothiazide Interactions

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • other beta blockers such as metoprolol (Toprol XL, Lopressor), carvedilol (Coreg), bisoprolol (Zebeta), betaxolol (Kerlone), and nebivolol (Bystolic)
  • drugs that deplete a substance in the body called catecholamines such as reserpine (Serpalan) or guanethidine (Ismelin)
  • medications that slow the heart or help treat abnormal heart rhythms such as verapamil (Calan), diltiazem (Cardizem), digoxin (Lanoxicaps, Lanoxin), and digitoxin 
  • nonsteroidal anti-inflammatory drugs (NSAIDS) such as naproxen (Aleve) and ibuprofen (Advil)
  • haloperidol (Haldol)
  • aluminum hydroxide gel
  • phenytoin (Dilantin), rifampin 
  • chlorpromazine (Thorazine)
  • antipyrine and lidocaine
  • thyroxine
  • cimetidine (Tagamet)
  • theophylline (Theolair)
  • norepinephrine (Levophed)
  • tubocurarine
  • medicines that provide relief for inflamed areas of the body (corticosteroids) such as methylprednisolone (Medrol) and dexamethasone (Decadron)

Do not drink alcohol while taking this medication. 

This is not a complete list of propranolol and hydrochlorothiazide drug interactions. Ask your doctor or pharmacist for more information. 

Propranolol and Hydrochlorothiazide Precautions

Serious side effects have been reported with propranolol and hydrochlorothiazide including the following:

  • Imbalances in the levels of salts and fluids in your body (electrolyte and fluid imbalance). Tell your healthcare provider right away if you have some or all of the following symptoms:
    • dry mouth
    • thirst
    • weakness
    • drowsiness
    • restlessness
    • muscle pains or cramps
    • low blood pressure
    • low output of urine
    • fast heart rate
    • nausea
    • vomiting
  • a condition of excess of uric acid in the blood (hyperuricemia)
  • painful joint(s) (gout)
  • abruptly stopping this medicine has been reported with worsening chest pain 
  • slowed heart rhythm in patients with AV block
  • slowing of the brain to a state of apparent unresponsiveness (reversible mental depression progressing to catatonia)
  • disruption of intestinal blood flow (mesenteric arterial thrombosis, ischemic colitis)
  • allergic reactions. More common with a history of allergic reactions. 
  • a low amount of white blood cells (agranulocytosis) that increases the chances of getting an infection
  • low red blood cell amount in the blood (aplastic anemia)
  • an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue (systemic lupus erythematosus)
  • serious skin disorders such as a rare, serious disorder of the skin and mucous membranes that begins with flu-like symptoms, followed by a painful red or purplish rash that spreads and blisters (Stevens-Johnson Syndrome)
  • liver damage
  • a condition that slows or stops the flow of blood through your blood vessels that carry blood from the heart to other places in your body (arterial insufficiency)

Do not take propranolol and hydrochlorothiazide if you:

  • are allergic to propranolol and hydrochlorothiazide or any of its ingredients or sulfonamide-drugs
  • have a condition where your heart suddenly can't pump enough blood to meet your body's needs (cardiogenic shock)
  • have heart failure
  • have a condition that blocks the conduction of impulses in the heart (greater than first degree block) 
  • severely slow heart rate
  • have bronchial asthma
  • your kidneys fail to produce urine (anuria)

Propranolol and Hydrochlorothiazide Food Interactions

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of propranolol and hydrochlorothiazide, there are no specific foods that you must exclude from your diet when receiving this medication. 

Inform MD

Before taking propranolol and hydrochlorothiazide, tell your doctor about all of your medical conditions. Especially tell your doctor if:

  • are allergic to propranolol and hydrochlorothiazide or any of its ingredients or sulfonamide-drugs
  • have a condition where your heart suddenly can't pump enough blood to meet your body's needs (cardiogenic shock)
  • have heart failure
  • have a condition that blocks the conduction of impulses in the heart (greater than first degree block) 
  • severely slow heart rate
  • have bronchial asthma
  • your kidneys fail to produce urine (anuria) or have kidney disease
  • have liver disease
  • are a diabetic patient
  • you are pregnant or plan to become pregnant
  • you are breastfeeding or plan to breastfeed

Tell you doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. 

Propranolol and Hydrochlorothiazide and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Propranolol and hydrochlorothiazide falls into category C. No studies have been done in animals, and no well-controlled studies have been done in pregnant women. Propranolol and hydrochlorothiazide should be given to a pregnant woman only if clearly needed. 

Propranolol and Hydrochlorothiazide and Lactation

Tell your doctor is you are breastfeeding or plan to breastfeed. 

Propranolol and hydrochlorothiazide have both been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from propranolol and hydrochlorothiazide, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered. 

Propranolol and Hydrochlorothiazide Usage

  • Take propranolol and hydrochlorothiazide exactly as prescribed. 
  • Propranolol and hydrochlorothiazide comes in a tablet form and is usually taken by mouth twice daily with or without food. 
  • Do not suddenly stop this medication. Your doctor will decrease your dose slowly. 

Propranolol and Hydrochlorothiazide Dosage

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. 

The dose your doctor recommends may be based on the following:

  • your blood pressure
  • previous medications used
  • how you respond to this medication

The recommended starting dose of propranolol and hydrochlorothiazide to treat high blood pressure is one 40/25 mg tablet twice daily. The maximum dosage is 160 mg of propranolol.

 

Propranolol and Hydrochlorothiazide Overdose

If you take too much propranolol and hydrochlorothiazide, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away. 

Other Requirements

  • Store at 68° to 77°F (20° to 25°C).
  • Keep this and all medicines out of the reach of children.