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All about: Hydra-Zide

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Generic Name: hydralazine and hydrochlorothiazide (hye DRAL a zeen/ hye droe klor oh THYE a zide)
Brand Names: Apresazide, Hydra-Zide

What is Hydra-Zide (hydralazine and hydrochlorothiazide)?

Hydralazine is a vasodilator. It lowers blood pressure by relaxing (widening) blood vessels (veins and arteries) and making it easier for your heart to pump.

Hydrochlorothiazide is a thiazide diuretic (water pill). It helps to lower your blood pressure and decrease edema (swelling or water retention) by increasing the amount of salt and water you lose in your urine.

The combination, hydralazine and hydrochlorothiazide, is used to lower high blood pressure.

Hydralazine and hydrochlorothiazide may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Hydra-Zide (hydralazine and hydrochlorothiazide)?

Do not stop taking hydralazine and hydrochlorothiazide suddenly. Stopping suddenly could cause your blood pressure to become dangerously high and make you feel anxious or uncomfortable. Stand up slowly from a sitting or lying position. Hydralazine and hydrochlorothiazide may make you feel dizzy. Use alcohol cautiously. Alcohol may increase dizziness while you are taking this medication.

What should I discuss with my healthcare provider before taking Hydra-Zide (hydralazine and hydrochlorothiazide)?

Do not take hydralazine and hydrochlorothiazide without first talking to your doctor if you have an allergy to sulfa-based drugs such as sulfa antibiotics. You may have an allergic reaction to hydrochlorothiazide.

Before taking this medication, tell your doctor if you

  • have kidney or liver disease,
  • have coronary heart disease,

  • have mitral valvular rheumatic heart disease,

  • have diabetes,

  • have gout,

  • have systemic lupus erythematosus,

  • have had a stroke or a transient ischemic attack (mini-stroke),

  • have high levels of cholesterol or triglycerides (types of fat) in your blood, or

  • have pulmonary hypertension (a type of lung disease).

You may need a dosage adjustment or special monitoring during your therapy if you have any of the conditions listed above.

Hydralazine and hydrochlorothiazide is in the FDA pregnancy category C. This means that it is not known whether hydralazine and hydrochlorothiazide will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or are planning a pregnancy. Hydralazine and hydrochlorothiazide passes into breast milk and may harm a nursing infant. Do not take this medication without first talking to your doctor if you are breast-feeding a baby. If you are over 60 years of age, you may be more likely to experience dizziness from hydralazine and hydrochlorothiazide. You may require a lower dose or special monitoring during therapy.

How should I take Hydra-Zide (hydralazine and hydrochlorothiazide)?

Take hydralazine and hydrochlorothiazide exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Take hydralazine and hydrochlorothiazide with food.

Do not stop taking hydralazine and hydrochlorothiazide suddenly. Stopping suddenly could cause your blood pressure to become dangerously high and could make you feel anxious or uncomfortable.

Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the dose you missed and take only your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a hydralazine and hydrochlorothiazide overdose include very low blood pressure (fainting, dizziness, confusion), an irregular heartbeat, headache, increased urination, vomiting, diarrhea, and flushing of the skin.

What should I avoid while taking Hydra-Zide (hydralazine and hydrochlorothiazide)?

Use caution when driving, operating machinery, or performing other hazardous activities. Hydralazine and hydrochlorothiazide may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Stand up slowly from a sitting or lying position. Hydralazine and hydrochlorothiazide may make you feel dizzy. Avoid alcohol while taking hydralazine and hydrochlorothiazide. Alcohol may increase the drowsiness caused by hydralazine and hydrochlorothiazide and may also increase dizziness. Use caution even with small amounts of alcohol.

Discuss with your doctor the amount of salt in your diet. Too much salt may cause your body to retain water and may decrease the effects of hydralazine and hydrochlorothiazide. Talk to your doctor before increasing or decreasing the amount of salt in your diet.

Do not let yourself become overheated in hot weather or during exercise, and use caution if you have a fever. These situations increase the effects of hydralazine and hydrochlorothiazide, and you may become very dizzy.

Avoid prolonged exposure to sunlight. Hydrochlorothiazide may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

Hydra-Zide (hydralazine and hydrochlorothiazide) side effects

If you experience any of the following serious side effects, stop taking hydralazine and hydrochlorothiazide and seek emergency medical attention:
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

  • unusual fatigue;

  • abnormal bleeding or bruising;

  • yellow skin or eyes;

  • confusion;

  • blood in your urine or stools;

  • little or no urine;

  • numbness, tingling, pain, or weakness of your arms or legs;

  • heart failure (shortness of breath, swelling of ankles or legs, weight gain of 2 pounds in one day or 5 pounds in one week);

  • irregular or fast heartbeats or a fluttering feeling in your chest;

  • new or worsening chest pain; or

  • fainting.

Other, less serious side effects may be more likely to occur. Continue to take hydralazine and hydrochlorothiazide and talk to your doctor if you experience

  • dizziness, especially upon changing position (e.g., when you sit or stand up from a lying position);

  • excessive urination;

  • muscle weakness or cramps;

  • increased hunger or thirst;

  • nausea, vomiting, diarrhea, or decreased appetite;

  • abdominal pain;

  • sensitivity to sunlight;

  • headache;

  • a rash; or

  • fatigue.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Hydra-Zide (hydralazine and hydrochlorothiazide)?

Before taking this medication, tell your doctor if you are taking any of the following drugs:

  • a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate);

  • a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin), ketoprofen (Orudis, Orudis KT, Oruvail), naproxen (Naprosyn, Anaprox, Aleve), diclofenac (Cataflam, Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), mefenamic acid (Ponstel), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), or tolmetin (Tolectin);
  • a diabetes medication such as glipizide (Glucotrol), glyburide (Micronase, Glynase, Diabeta), chlorpropamide (Diabinese), tolazamide (Tolinase), or tolbutamide (Orinase);

  • a steroid medicine such as cortisone (Cortone), dexamethasone (Decadron, Hexadrol), hydrocortisone (Cortef, Hydrocortone), prednisone (Orasone, Deltasone), prednisolone (Delta Cortef, Prelone), methylprednisolone (Medrol), and others;

  • lithium (Lithobid, Eskalith, others); or

  • digoxin (Lanoxin, Lanoxicaps).

You may not be able to take hydralazine and hydrochlorothiazide, or you may require a lower dose or special monitoring during treatment if you are taking any of the medicines listed above.

Also, before taking hydralazine and hydrochlorothiazide, tell your doctor if you are taking any medicine to treat high blood pressure, water retention, heart problems, prostate problems, or another condition. Some of these medicines may interact with hydralazine and hydrochlorothiazide, and the interaction may increase the effects on your heart.

Hydralazine and hydrochlorothiazide may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves.

Drugs other than those listed here may also interact with hydralazine and hydrochlorothiazide or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

  • Your pharmacist has additional information about hydralazine and hydrochlorothiazide written for health professionals that you may read.

What does my medication look like?

Hydralazine and hydrochlorothiazide is available with a prescription under the brand name Apresazide. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Hydralazine/hydrochlorothiazide strengths are as follows:

  • Apresazide 25/25 (25 mg/25 mg)--light-blue/white, opaque capsules

  • Apresazide 50/50 (50 mg/50 mg)--pink/white, opaque capsules

  • Apresazide 100/50 (100 mg/50 mg)--salmon-pink/white, opaque capsules

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 3.06. Revision Date: 8/19/04 4:35:26 PM.

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