$Unique_ID{BRK01864}
$Pretitle{}
$Title{CAPTOPRIL AND HYDROCHLOROTHIAZIDE COMBINATION}
$Subject{Capozide (Squibb)}
$Volume{}
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Copyright (C) 1991 Publications International, Ltd.


CAPTOPRIL AND HYDROCHLOROTHIAZIDE COMBINATION
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BRAND NAME (Manufacturer):
     Capozide (Squibb)
TYPE OF DRUG:
     Antihypertensive and diuretic
INGREDIENTS:
     captopril and hydrochlorothiazide
DOSAGE FORM:
     Tablets (25 mg captopril and 15 mg hydrochlorothiazide; 25 mg captopril
       and 25 mg hydrochlorothiazide; 50 mg captopril and 15 mg
       hydrochlorothiazide; 50 mg captopril and 25 mg hydrochlorothiazide)
STORAGE:
     Captopril and hydrochlorothiazide combination tablets should be stored at
       room temperature in a tightly closed container.  This medication should
       be stored away from moisture and high heat (above 86 degrees_F).

USES

     Captopril and hydrochlorothiazide combination is used to treat high blood
pressure.  Captopril is a vasodilator (it widens the blood vessels) that acts
by blocking the production of chemicals that may be responsible for
constricting blood vessels.  Hydrochlorothiazide is a diuretic (water pill),
which reduces body fluid accumulation by increasing the elimination of salt
and water through the kidneys.

TREATMENT

     To obtain the maximum benefit from this medication, take it on an empty
stomach one hour before meals.  In order to become accustomed to taking this
medication, try to take it at the same time(s) every day.
     Avoid taking a dose of this medication after 6:00 P.M.; otherwise, you
may have to get up during the night to urinate.
     It may be several weeks before you notice the full effects of this
medication.
     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 wait until the next scheduled dose.  Do not
double the dose.
     Captopril 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.

SIDE EFFECTS

     Minor.

     Abdominal pain, blurred vision, constipation, cramping, diarrhea,
dizziness, fatigue, flushing, headache, insomnia, loss of appetite, or loss of
taste.  These side effects should disappear as your body adjusts to this
medication.
     Hydrochlorothiazide can increase your 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
(unless your doctor directs you to do otherwise).
     To relieve mouth dryness, suck on ice chips or hard candy or chew
sugarless gum.
     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
alternately pushing one foot against the floor while raising the other foot
slightly, 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
chest pain; chills; cough; difficult or painful urination; dry mouth; fever;
hair loss; itching; mouth sores; muscle pain or cramps; nausea; palpitations;
rash; shortness of breath; sore throat; swelling of the face, hands, or feet;
thirst; tingling in the fingers or toes; unusual bleeding or bruising;
vomiting; weakness; or yellowing of the eyes or skin.

INTERACTIONS

     Captopril and hydrochlorothiazide combination can interact with several
other types of medications:
     1. The combination of captopril with spironolactone, triamterene,
amiloride, potassium supplements, or salt substitutes can lead to hyperkalemia
(dangerously high levels of potassium in the bloodstream).
     2. Antineoplastic agents (anticancer drugs) and chloramphenicol can
increase the bone marrow side effects of captopril.
     3. Concurrent use of captopril and allopurinol can increase the risk of
developing an allergic reaction.
     4. Diuretics (water pills) and other antihypertensive medications can
cause an excessive drop in blood pressure when combined with captopril
(especially with the first dose).
     5. Hydrochlorothiazide can decrease the effectiveness of oral
anticoagulants, antigout medications, insulin, oral antidiabetic medicines,
and methenamine.
     6. Fenfluramine can increase the blood-pressure-lowering effects of
hydrochlorothiazide (which can be dangerous).
     7. Indomethacin can decrease the blood-pressure-lowering effects of
captopril and hydrochlorothiazide, thereby counteracting the desired effects.
     8. Cholestyramine and colestipol decrease the absorption of
hydrochlorothiazide from the gastrointestinal tract.  Hydrochlorothiazide
should, therefore, be taken one hour before or four hours after a dose of
cholestyramine or colestipol (if you have also been prescribed one of these
drugs).
     9. Hydrochlorothiazide may increase the side effects of amphotericin B,
calcium supplements, cortisone and cortisone-like steroids (such as
dexamethasone, hydrocortisone, prednisone, and prednisolone), digoxin,
digitalis, lithium, quinidine, sulfonamide antibiotics, and vitamin D.
     Before starting captopril and hydrochlorothiazide combination, 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 captopril or to hydrochlorothiazide or other
diuretics (such as bendroflumethiazide, benzthiazide, chlorothiazide,
chlorthalidone, cyclothiazide, hydroflumethiazide, methyclothiazide,
metolozone, polythiazide, quinethazone, trichlormethiazide, and furosemide) or
to sulfa medications (oral antidiabetic medications or sulfonamide
antibiotics).
     * Tell your doctor if you have ever had aortic stenosis, blood disorders,
diabetes mellitus, gout, kidney disease or problems with urination, liver
disease, pancreatic disease, a heart attack, or systemic lupus erythematosus.
     * Hydrochlorothiazide 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, call your doctor.  To help
prevent this problem, your doctor may 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 may also be
dangerous.
     * Limit your intake of alcoholic beverages while taking this medication,
in order to prevent dizziness and light-headedness.  If you have high blood
pressure, do not take any over-the-counter (nonprescription) medications for
weight control or for allergy, asthma, cough, cold, or sinus problems, unless
your doctor directs you to do so.
     * To prevent dehydration (severe water loss) while taking this
medication, check with your doctor if you have any illness that causes severe
or continuous diarrhea, nausea, or vomiting.  This medication can raise blood
sugar levels in diabetic patients.  Therefore, sugar levels should be
carefully monitored with blood or urine tests when this medication is started.
     * Before having surgery or any other medical or dental treatment, be sure
to tell your doctor or dentist that you are taking this medication.
     * This drug may cause dizziness.  Use caution while driving or operating
potentially dangerous machinery.
     * A "fixed-dose" drug like this is not generally the first choice in the
treatment of high blood pressure.  Usually, the patient first receives each
ingredient singly.  If there is an adequate response to the fixed dose
contained in this product, it can then be substituted.  The advantage of a
combination product is increased convenience and (often) decreased cost.
     * Do not stop taking this medication unless you first consult your
doctor.  Stopping this drug abruptly may lead to a rise in blood pressure.
     * Be sure to tell your doctor if you are pregnant.  Although this drug
combination appears to be safe in animals, studies in pregnant women have not
been conducted.  Hydrochlorothiazide can cause adverse effects in the newborn
infant if it is given to the mother close to term.  Also, tell your doctor if
you are breast-feeding an infant.  Although problems in humans have not been
reported, small amounts of this drug can pass into breast milk, so caution is
warranted.

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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.
