Propranolol/Hydrochlorothiazide

DEA Class;  Rx

Common Brand Names; Inderide

  • Thiazide Combos

Hydrochlorothiazide, a thiazide diuretic, and propranolol, a nonspecific, highly lipid-soluble beta-blocker, are combined in 1 tablet to treat hypertension.

Indicated for the treatment of hypertension.

Asthma, COPD

Severe sinus bradycardia or 2°/3° heart block (except in patients with functioning artificial pacemaker)

Cardiogenic shock

Uncompensated congestive heart failure

Hypersensitivity

Overt heart failure

Sick sinus syndrome without permanent pacemaker

No adverse effects specific to the combination have been observed; adverse effects limited to those previously reported with propranolol and hydrochlorothiazide

Propranolol

  • Bradyarrhythmia
  • Dyspnea
  • Fatigue
  • Angina
  • Increased AV conduction disturbance
  • Hypotension
  • Insomnia
  • Congestive heart failure
  • Syncope
  • Cardiogenic shock
  • Nausea/vomiting
  • Paresthesia
  • Pruritis
  • Psychotic disorder
  • Hyperlipidemia

Hydrochlorothiazide

  • Anorexia
  • Epigastric distress
  • Hypotension
  • Orthostatic hypotension
  • Photosensitivity
  • Anaphylaxis
  • Anemia
  • Confusion
  • Erythema multiforme
  • Stevens-Johnson syndrome
  • Exfoliative dermatitis including toxic epidermal necrolysis
  • Hypomagnesemia
  • Dizziness
  • Headache
  • Hyperuricemia

Anesthesia/surgery (myocardial depression); chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery, however the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures

Acute transient myopia and acute angle-closure glaucoma has been reported, particularly with history of sulfonamide or penicillin allergy (hydrochlorothiazide is a sulfonamide)

Avoid abrupt withdrawal

Bronchospastic disease

Cerebrovascular insufficiency

CHF, cardiomegaly

Diabetes mellitus, fluid or electrolyte imbalance, hyperuricemia or gout, SLE

Hyperthyroidism or thyrotoxicosis, liver disease

May aggravate digitalis toxicity

Myasthenic conditions

Peripheral vascular disease

Renal impairment

Risk of male sexual dysfunction

Sensitivity reactions may occur with or without history of allergy or asthma

Pregnancy Category: C

Lactation: excreted in breast milk, use caution

Adults

160 mg/day PO propranolol; 50 mg/day PO hydrochlorothiazide.

Elderly

160 mg/day PO propranolol; 50 mg/day PO hydrochlorothiazide.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

Propranolol hydrochloride/hydrochlorothiazide

tablet

  • 40mg/25mg
  • 80mg/25mg

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