$Unique_ID{BRK02028}
$Pretitle{}
$Title{METHYLDOPA AND HYDROCHLOROTHIAZIDE COMBINATION}
$Subject{Aldoril (Merck Sharp & Dohme)
methyldopa and hydrochlorothiazide combination (various manufacturers)}
$Volume{}
$Log{
Aldoril 250 + 15*0202801.scf
Aldoril 250 + 25*0202802.scf
Aldoril 250 + 30*0202803.scf
Aldoril 250 + 50*0202804.scf}

Copyright (C) 1991 Publications International, Ltd.


METHYLDOPA AND HYDROCHLOROTHIAZIDE COMBINATION
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BRAND NAMES (Manufacturers):
     Aldoril (Merck Sharp & Dohme)
     methyldopa and hydrochlorothiazide combination (various manufacturers)
TYPE OF DRUG:
     Antihypertensive and diuretic
INGREDIENTS:
     methyldopa and hydrochlorothiazide
DOSAGE FORM:
     Tablets (250 mg methyldopa and 15 mg hydrochlorothiazide; 250 mg
       methyldopa and 25 mg hydrochlorothiazide; 500 mg methyldopa and 30 mg
       hydrochlorothiazide; 500 mg methyldopa and 50 mg hydrochlorothiazide)
STORAGE:
     These tablets should be stored at room temperature in a tightly closed
       container.

USES

     Methyldopa and hydrochlorothiazide combination is used to treat high
blood pressure.  It is not exactly clear how methyldopa works, but it is
thought to act on the central nervous system (brain and spinal cord) to
prevent the release of chemicals responsible for maintaining high blood
pressure.  Hydrochlorothiazide is a diuretic (water pill), which reduces fluid
accumulation by increasing the elimination of salt and water through the
kidneys.

TREATMENT

     To avoid stomach irritation, you can take methyldopa and
hydrochlorothiazide combination with food or with a full glass of water or
milk (unless your doctor directs you to do otherwise).  In order 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.
     Methyldopa and hydrochlorothiazide combination does not cure high blood
pressure, but it will help to control the condition as long as you continue to
take it.
     If you miss a dose of this medication, take the missed dose as soon as
possible, unless it is almost time for the 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.

SIDE EFFECTS

     Minor.

     Bloating, constipation, diarrhea, dizziness, drowsiness, gas, headache,
light-headedness, loss of appetite, nasal congestion, or increased urination.
These side effects should disappear as your body adjusts to the medication.
     This medication can increase your sensitivity to sunlight.  You should,
therefore, 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
(unless your doctor directs you to do otherwise).
     Chew sugarless gum or suck on ice chips or a piece of hard candy to
relieve mouth dryness.
     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
abdominal distention, blurred vision, breast enlargement (in both sexes),
chest pain, confusion, decreased sexual ability, depression, difficulty in
breathing, dry mouth, fainting, fatigue, fever, inflamed salivary glands,
insomnia, joint pains, muscle pains or spasms, nausea, nightmares, numbness or
tingling, rapid weight gain (three to five pounds within a week), severe
stomach cramps, sore or "black" tongue, swelling of the feet or ankles,
thirst, tremors, unusual bleeding or bruising, unusual body movements,
vomiting, weakness, or yellowing of the eyes or skin.

INTERACTIONS

     This medicine interacts with other types of drugs:
     1. Methyldopa can either increase or decrease the antiparkinsonism
effects of levodopa.
     2. The use of a monamine oxidase (MAO) inhibitor within 14 days of
methyldopa can cause headaches, severe hypertension, and hallucinations.
     3. The combination of methyldopa and methotrimeprazine can cause a severe
drop in blood pressure; methyldopa and haloperidol can cause irritability;
methyldopa and phenoxybenzamine can cause urinary retention; and methyldopa
and alcohol can cause dizziness and fainting.
     4. The effects of methyldopa may be increased by verapamil and
fenfluramine, which may have a negative effect.
     5. Methyldopa can increase the side effects of tolbutamide and lithium.
     6. Methyldopa may increase the effects of norepinephrine and
phenylpropanolamine, which may increase blood pressure.
     7. Hydrochlorothiazide can decrease the effectiveness of oral
anticoagulants (blood thinners, such as warfarin), antigout medications,
insulin, oral antidiabetic medications, and methenamine.
     8. Fenfluramine may increase the blood-pressure-lowering effects of
hydrochlorothiazide, and indomethacin may decrease its blood-pressure-lowering
effects.
     9. Cholestyramine and colestipol can decrease the absorption of
hydrochlorothiazide from the gastrointestinal tract.  Therefore, this
medication should be taken one hour before or four hours after a dose of
either of these other drugs.
     10. The side effects of amphotericin B, calcium, adrenocorticosteroids
(cortisonelike medicines), digitalis, digoxin, lithium, quinidine, sulfonamide
antibiotics, and vitamin D may be increased by hydrochlorothiazide.
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any of those listed above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
medications, especially to methyldopa or hydrochlorothiazide or to any other
sulfa medication (diuretics, oral antidiabetic medicines, sulfonamide
antibiotics, dapsone, or sulfone).
     * Before starting to take this medication, be sure to tell your doctor if
you have ever had anemia, angina, diabetes mellitus, gout, kidney disease,
liver disease, mental depression, Parkinson's disease, pancreatitis, or
stroke.
     * A doctor generally does not prescribe this drug or other "fixed-dose"
products as the first choice in the treatment of high blood pressure.  The
patient should initially receive each ingredient singly.  If the response is
adequate to the dose contained in this product, it can then be substituted.
The advantage of a combination product is its increased convenience.
     * This medication 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 medication with a glass of fresh or frozen orange juice 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
hydrochlorothiazide, 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 when this medication is
being taken.
     * In order to avoid dizziness or fainting while taking this medication,
try not to stand for long periods of time; avoid drinking excessive amounts of
alcohol; and try not to get overheated (avoid strenuous exercise in hot
weather and do not take 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 any other medical or dental treatment, be sure
to tell your doctor or dentist that you are taking this medication.
     * 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 unless you first check with your
doctor.  If this drug is stopped abruptly, you could experience a sudden rise
in blood pressure.  Your doctor may, therefore, want to decrease your dosage
gradually.
     * If you have an unexplained fever, especially during the first two to
three weeks after starting to take this medication, CONTACT YOUR DOCTOR.
Fever can be a sign of a serious reaction to methyldopa.
     * Occasionally, tolerance to this medication develops, usually during the
second or third month of therapy.  If you notice a decrease in effectiveness
of this medication, contact your doctor.
     * Before donating blood or receiving a blood transfusion, be sure you let
the doctor know that you are taking this medication.  Methyldopa can cause a
change in the blood cells.
     * Be sure to tell your doctor if you are pregnant.  Methyldopa and
hydrochlorothiazide cross the placenta and may cause adverse effects in the
developing fetus.  Also, tell your doctor if you are breast-feeding an infant.
Small amounts of both of these drugs pass into breast milk.

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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.
