$Unique_ID{BRK01978}
$Pretitle{}
$Title{HYDRALAZINE, HYDROCHLOROTHIAZIDE, AND RESERPINE COMBINATION}
$Subject{Cam-ap-es (Camall)
Cherapas (Kay)
H-H-R (Geneva Generics)
Ser-A-Gen (Goldline)
Seralazide (Lannett)
Ser-Ap-Es (Ciba)
Serpazide (Major)
Tri-Hydroserpine (Rugby)
Unipres (Reid-Rowell)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


HYDRALAZINE, HYDROCHLOROTHIAZIDE, AND RESERPINE COMBINATION
------------------------------------------------------------------------------

BRAND NAMES (Manufacturers):
     Cam-ap-es (Camall)
     Cherapas (Kay)
     H-H-R (Geneva Generics)
     Ser-A-Gen (Goldline)
     Seralazide (Lannett)
     Ser-Ap-Es (Ciba)
     Serpazide (Major)
     Tri-Hydroserpine (Rugby)
     Unipres (Reid-Rowell)
TYPE OF DRUG:
     Antihypertensive
INGREDIENTS:
     hydralazine, hydrochlorothiazide, and reserpine
DOSAGE FORM:
     Tablets (25 mg hydralazine, 15 mg hydrochlorothiazide, and 0.1 mg
       reserpine)
STORAGE:
     These tablets should be stored at room temperature in a tightly closed,
       light-resistant container.

USES

     Hydralazine, hydrochlorothiazide, and reserpine combination is used to
treat high blood pressure.  Hydralazine is a vasodilator; it relaxes the
muscles of the blood vessels, resulting in a lowering of blood pressure.
Hydrochlorothiazide is a diuretic (water pill), which reduces body fluid
accumulation by increasing the elimination of salt and water through the
kidneys.  Reserpine acts by depleting the body of certain chemicals that are
responsible for maintaining high blood pressure.

TREATMENT

     In order to avoid stomach irritation, you can take hydralazine,
hydrochlorothiazide, and reserpine combination with food or with a full glass
of water or milk.  To become accustomed to taking this medication, try to take
it at the same time(s) each day.  Avoid taking a dose after 6:00 P.M.;
otherwise, you may have to get up during the night to urinate.
     If you miss a dose of this medication, take the missed dose as soon as
possible, unless it is almost time for your next dose.  In that case, do not
take the missed dose at all; just return to your regular dosing schedule.  Do
not double the next dose.
     Hydralazine, hydrochlorothiazide, and reserpine combination does not cure
high blood pressure, but it will help to control the condition as long as you
continue to take it.
     The effects of this medication may not become apparent for up to two
weeks after you start to take it.

TREATMENT

     In order to avoid stomach irritation, you can take hydralazine,
hydrochlorothiazide, and reserpine combination with food or with a full glass
of water or milk.  To become accustomed to taking this medication, try to take
it at the same time(s) each day.  Avoid taking a dose after 6:00 P.M.;
otherwise, you may have to get up during the night to urinate.
     If you miss a dose of this medication, take the missed dose as soon as
possible, unless it is almost time for your next dose.  In that case, do not
take the missed dose at all; just return to your regular dosing schedule.  Do
not double the next dose.
     Hydralazine, hydrochlorothiazide, and reserpine combination does not cure
high blood pressure, but it will help to control the condition as long as you
continue to take it.
     The effects of this medication may not become apparent for up to two
weeks after you start to take it.

SIDE EFFECTS

     Minor.

     Abdominal pain, constipation, decrease in sexual desire, diarrhea,
dizziness, flushing, loss of appetite, nasal congestion, or weight gain.
These side effects should disappear as your body adjusts to the medication.
     This medication can cause an increase in sensitivity to sunlight.  It is,
therefore, important to avoid prolonged exposure to sunlight and sunlamps.
Wear protective clothing and sunglasses, and use an effective sunscreen.
     To relieve constipation, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads) and exercise more
(unless your doctor directs you to do otherwise).
     To relieve mouth dryness, chew sugarless gum or suck on ice chips or a
piece of hard candy.
     If you feel dizzy or light-headed, sit or lie down for a while; get up
slowly from a sitting or reclining position, and be careful on stairs.  To
avoid dizziness or light-headedness when you stand, contract and relax the
muscles of your legs for a few moments before rising.  Do this by pushing one
foot against the floor while raising the other foot slightly, alternating feet
so that you are "pumping" your legs in a pedaling motion.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
anxiety; blurred vision; breast enlargement (in both sexes); chest pain;
depression; difficulty in urinating; drowsiness; dry mouth; fainting; fatigue;
fever; headaches; hearing loss; impotence; itching; joint pain; mood changes;
muscle pain or spasms; nausea; nervousness; nightmares; palpitations; rapid
weight gain (three to five pounds within a week); rash; shortness of breath;
sore throat; swelling of the feet, ankles, or lower legs; thirst; tingling in
the fingers or toes; tremors; unusual bleeding or bruising; vomiting;
weakness; or yellowing of the eyes or skin.

INTERACTIONS

     This medication interacts with several other types of drugs:
     1. Concurrent use of it with central nervous system depressants (such as
alcohol, antihistamines, barbiturates, benzodiazepine tranquilizers, muscle
relaxants, narcotics, pain medications, phenothiazine tranquilizers, and
sleeping medications) or with tricyclic antidepressants can cause extreme
drowsiness.
     2. The use of a monoamine oxidase (MAO) inhibitor within 14 days of this
medication can lead to a severe reaction.
     3. Reserpine combined with tricyclic antidepressants can lead to a severe
drop in blood pressure (which can be dangerous).  Reserpine can also decrease
the effectiveness of levodopa and increase side effects (to the heart) of
digoxin and quinidine.
     4. Hydrochlorothiazide can decrease the effectiveness of warfarin,
antigout medications, insulin, oral antidiabetic medicines, and methenamine.
     5. Fenfluramine may increase the blood-pressure-lowering effects of
hydrochlorothiazide (which can be dangerous).
     6. Indomethacin may decrease the blood-pressure-lowering effects of
hydrochlorothiazide, thereby counteracting the desired effects.
     7. This medication should be taken one hour before or four hours after a
dose of cholestyramine or colestipol (if you have also been prescribed one of
these medications) because these medications can decrease the absorption of
hydrochlorothiazide from the gastrointestinal tract.
     8. Hydrochlorothiazide may increase the side effects of amphotericin B,
calcium, adrenocorticosteroids (cortisone-like drugs), digitalis, digoxin,
lithium, quinidine, sulfonamide antibiotics, and vitamin D.
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any listed above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to hydralazine, reserpine, or hydrochlorothiazide,
or to any other sulfa drugs (other diuretics, oral antidiabetic medicines, or
sulfonamide antibiotics).
     * Before starting to take this medication, be sure to tell your doctor if
you have ever had anuria (decreased urination), blood disorders, chest pain,
diabetes mellitus, epilepsy, electroshock therapy, kidney disease, heart
disease, liver disease, depression, gallstones or gallbladder disease,
Parkinson's disease, peptic ulcers, stroke, systemic lupus erythematosus, or
ulcerative colitis.
     * Some of these products contain the color additive FD&C Yellow No. 5
(tartrazine), which can cause allergic-type reactions (rash, shortness of
breath, fainting) in certain susceptible individuals.
     * A doctor does not usually prescribe this drug or other "fixed-dose"
products as the first choice in the treatment of high blood pressure.
Generally, the patient first receives each ingredient singly.  If the response
is adequate to the fixed dose contained in this product, it can then be
substituted.  An advantage of a combination product is increased convenience.
     * This drug can cause potassium loss.  Signs of potassium loss include
dry mouth, thirst, weakness, muscle pain or cramps, nausea, and vomiting.  If
you experience any of these symptoms, CONTACT YOUR DOCTOR.  To help prevent
this problem, your doctor may want to have blood tests performed periodically
to monitor your potassium levels.  To help avoid potassium loss, take this
product with a glass of fresh or frozen orange or cranberry juice, or eat a
banana every day.  The use of a salt substitute also helps to prevent
potassium loss.  Do not change your diet or use a salt substitute, however,
until you discuss it with your doctor.  Too much potassium can also be
dangerous.
     * To prevent severe water loss (dehydration) while taking this
medication, check with your doctor if you have any illness that causes severe
or continuous nausea, vomiting, or diarrhea.
     * Hydrochlorothiazide can raise blood sugar levels in diabetic patients.
Blood sugar should, therefore, be monitored carefully (using blood or urine
tests) when this medication is being taken.
     * In order to prevent dizziness or fainting while taking this medication,
try not to stand for long periods of time.  You should also avoid drinking
excessive amounts of alcohol, and avoid becoming overheated by exercising
strenuously in hot weather or by taking hot baths, showers, and saunas.
     * If this drug makes you dizzy or drowsy, avoid taking part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous machinery.
     * Before having surgery or other medical or dental treatment, tell your
doctor or dentist you are taking this drug.
     * Before taking any over-the-counter (nonprescription) allergy, asthma,
sinus, cough, cold, or diet product, check with your doctor or pharmacist.
Some of these products can cause an increase in blood pressure.
     * Do not stop taking this medication until you first check with your
doctor.  If this drug is stopped abruptly, you may experience a sudden rise in
blood pressure.  Your doctor may, therefore, want to decrease your dosage
gradually.
     * The elderly may be at increased risk for side effects, especially
depression, confusion, or other mental changes.  Report any such changes to
your doctor.
     * Be sure to tell your doctor if you are pregnant.  Birth defects have
been observed in the offspring of animals that received large doses of
reserpine and hydralazine during pregnancy.  Studies of this drug in humans
during pregnancy have not been conducted.  Also, tell your doctor if you are
breast-feeding an infant.  Small amounts of this drug pass into breast milk
and can cause side effects in nursing infants.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
