Metoprolol/Hydrochlorothiazide

DEA Class;  Rx

Common Brand Names; Lopressor HCT, Dutoprol

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

Metoprolol tartrate

• Bradycardia (3%), cold extremities(1%), constipation (1%), depression (5%), diarrhea (5%), dizziness (10%), dyspepsia (1%), dyspnea (3%), fatigue (10%), headache (10%), heart failure (1%), hypokalemiahypotension (1%), influenza-like symptomsnausea (1%), pruritus (5%), wheezing (1%)

Hydrochlorothiazide

• Anorexia, epigastric distress, hypokalemia, hypotension, phototoxicity

Anesthesia/surgery (myocardial depression); chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery, however, the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and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

Bradycardia, including sinus pause, heart block, and cardiac arrest reported; patients with first-degree atrioventricular block, sinus node dysfunction, conduction disorders (including Wolff-Parkinson-White) or on concomitant drugs that cause bradycardia may be at increased risk; monitor heart rate in patients receiving drug; if severe bradycardia develops, reduce or stop treatment

If drug is used in the setting of pheochromocytoma, it should be given in combination with an alpha-blocker, and only after the alpha-blocker has been initiated; administration of beta-blockers alone in the setting of pheochromocytoma has been associated with a paradoxical increase in blood pressure due to attenuation of beta-mediated vasodilatation in skeletal muscle

While taking beta-blockers, patients with a history of severe anaphylactic reactions to a variety of allergens may be more reactive to repeated challenges and may be unresponsive to usual doses of epinephrine used to treat an allergic reaction

Untreated hypertension during pregnancy can lead to adverse outcomes for the mother and the fetus; available data from published observational studies have not demonstrated a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes with metoprolol use during pregnancy

There are no data on presence of the drug in human milk, effects on breastfed infant, or on milk production; available data from published literature on metoprolol and hydrochlorothiazide report that each drug is present in human milk

metoprolol/hydrochlorothiazide

tablet (Lopressor HCT)

• 50mg/25mg
• 100mg/25mg
• 100mg/50mg

tablet (Dutoprol)

• 25mg/12.5mg
• 50mg/12.5mg
• 100mg/12.5mg