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All about: Diupres-250

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Generic Name: chlorothiazide and reserpine (klor oh THYE a zide and re SER peen)
Brand Names: Diupres-250, Diupres-500

What is Diupres-250 (chlorothiazide and reserpine)?

Reserpine lowers blood pressure by decreasing the amount of certain chemicals in your body. This allows your blood vessels (veins and arteries) to relax and your heart to beat more slowly and easily.

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

Chlorothiazide and reserpine is used to lower high blood pressure.

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

What is the most important information I should know about Diupres-250 (chlorothiazide and reserpine)?

Stand up slowly from a sitting or lying position. Chlorothiazide and reserpine may make you feel dizzy. Do not stop taking chlorothiazide and reserpine suddenly. Even if you feel better, you need this medication to control your condition. Stopping suddenly could cause severe high blood pressure, anxiety, and other dangerous side effects.

Tell your doctor and dentist that you are taking this medication before having surgery.

Who should not take Diupres-250 (chlorothiazide and reserpine)?

Do not take chlorothiazide and reserpine if you have an allergy to sulfa-based drugs such as sulfa antibiotics. You may have an allergic reaction to chlorothiazide.

You must not take chlorothiazide and reserpine if you

  • have peptic ulcer disease (stomach ulcers);

  • have ulcerative colitis;

  • are suffering from depression (especially if you have suicidal thoughts);

  • are receiving electroconvulsive shock therapy; or

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

Before taking this medication, tell your doctor if you have

  • gallstones or other stomach problems,

  • kidney or liver disease,
  • diabetes,

  • gout,

  • a collagen vascular disease such as systemic lupus erythematosus,

  • high cholesterol or triglyceride levels,

  • pancreatitis,

  • asthma, or

  • any type of heart disease.

You may require a lower dose or special monitoring during therapy with chlorothiazide and reserpine if you have any of the conditions listed above.

Chlorothiazide and reserpine is in the FDA pregnancy category C. This means that it is not known whether chlorothiazide and reserpine will harm an unborn baby. Do not take chlorothiazide and reserpine without first talking to your doctor if you are pregnant. Chlorothiazide and reserpine passes into breast milk and may harm a nursing infant. Do not take chlorothiazide and reserpine 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 side effects from chlorothiazide and reserpine therapy. You may require a lower dose of this medication. Chlorothiazide and reserpine has not been approved for use by children.

How should I take Diupres-250 (chlorothiazide and reserpine)?

Take chlorothiazide and reserpine exactly as directed. 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 chlorothiazide and reserpine with food or milk if it upsets your stomach. Do not stop taking chlorothiazide and reserpine suddenly. Even if you feel better, you need this medication to control your condition. Stopping suddenly could cause severe high blood pressure, anxiety, and other dangerous side effects. 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 chlorothiazide and reserpine overdose include low blood pressure (fainting, dizziness, weakness); sleepiness; uncontrollable hand, leg, or arm movements; a slow pulse; low body temperature; diarrhea; increased urination; vomiting; and slow breathing.

What should I avoid while taking Diupres-250 (chlorothiazide and reserpine)?

Avoid a diet high in salt. Too much salt will cause your body to retain water and will decrease the effects of chlorothiazide.

Use caution when arising from a sitting or lying position, especially first thing in the morning. You may become dizzy while taking chlorothiazide and reserpine and you may fall and injure yourself if you get up quickly.

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 chlorothiazide and reserpine in your body, and you may become very dizzy.

Also, chlorothiazide may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable. Avoid alcohol while taking chlorothiazide and reserpine. Alcohol, which will further lower your blood pressure, will also increase the drowsiness caused by chlorothiazide and reserpine and may increase dizziness. Use caution even with small amounts of alcohol.

Do not take any over the counter cough, cold, allergy, sleep, or diet medications without first asking your doctor or pharmacist. These will interfere with your chlorothiazide and reserpine therapy.

Use caution when you are driving, operating machinery, or performing other hazardous activities until you know how chlorothiazide and reserpine affects you. If it makes you dizzy or drowsy, avoid these activities.

Tell your doctor and dentist that you are taking this medication before having surgery.

Diupres-250 (chlorothiazide and reserpine) side effects

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

  • a very irregular heartbeat;

  • heart failure (shortness of breath, swelling of ankles or legs, sudden weight gain of 5 pounds or more);

  • unusual fatigue;

  • abnormal bleeding or bruising;

  • yellow skin or eyes;

  • confusion;

  • fainting;

  • uncontrollable hand, arm, or leg movements;

  • chest pain; or

  • little or no urine.

Other, less serious side effects are more likely to occur. Continue to take chlorothiazide and reserpine and talk to your doctor if you experience

  • fatigue or drowsiness;

  • dizziness (avoid standing up too quickly and use caution when performing hazardous activities);

  • anxiety, depression, or nightmares;

  • diarrhea, nausea, vomiting, or an acid stomach (take chlorothiazide and reserpine with food or milk if it upsets your stomach);

  • abdominal pain;

  • stuffy nose or a dry mouth (sucking on ice chips or sugarless hard candy may relieve a dry mouth);

  • blurred vision;

  • headache;

  • tingling or numbness in your arms, legs, hands, or feet;

  • excessive urination;

  • muscle weakness or cramps;

  • increased hunger or thirst;

  • weight gain;

  • sensitivity to sunlight; or

  • impotence or difficulty ejaculating.

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 Diupres-250 (chlorothiazide and reserpine)?

Do not take reserpine and chlorothiazide if you are taking a monoamine oxidase inhibitor (MAOI), or if you have taken one in the last 14 days. MAOIs, used to treat depression, include isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate).

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

  • tricyclic antidepressants such as amitriptyline (Elavil, Endep) or doxepin (Sinequan), which may decrease the effects of reserpine and chlorothiazide;
  • other commonly used tricyclic antidepressants, including amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor), and protriptyline (Vivactil);
  • digoxin (Lanoxin) or quinidine (Cardioquin, Quinidex, Quinora, Quinaglute), which will increase the risk that you will experience an irregular heartbeat when it is taken with chlorothiazide and reserpine;

  • barbiturates such as phenobarbital (Luminal, Solfoton), amobarbital (Amytal), and secobarbital (Seconal), which may cause extreme sleepiness or dizziness if taken with reserpine and chlorothiazide;

  • narcotic pain relievers such as codeine (Tylenol #3, Tylenol #4, others), propoxyphene (Darvon, Darvocet, Wygesic), oxycodone (Percodan, Percocet, Tylox), meperidine (Demerol), morphine (MS Contin, Duramorph, others), and others, which also may cause extreme sleepiness or dizziness if taken with reserpine and chlorothiazide;

  • steroid medications such as hydrocortisone (Hydrocortone, Cortef), prednisone (Deltasone, Orasone), prednisolone (Delta Cortef, Prelone), methylprednisolone (Medrol), betamethasone (Celestone), dexamethasone (Decadron, Hexadrol), and others, which may increase the side effects of chlorothiazide;

  • prescription and over-the-counter cough, cold, allergy, diet, and sleeping pills, any of which may contain drugs that increase your blood pressure and heart rate and thus decrease the effects of reserpine;

  • the cholesterol-lowering drugs cholestyramine (Questran) and colestipol (Colestid), which may decrease the effects of chlorothiazide;

  • nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil), ketoprofen (Orudis, Orudis, KT, Oruvail), and naproxen (Naprosyn, Anaprox, Aleve), which may also decrease the effects of chlorothiazide;

  • other commonly used NSAIDs, including diclofenac (Cataflam, Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), mefenamic acid (Ponstel), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin);

  • oral antidiabetic drugs such as Glipizide (Glucotrol), glyburide (Micronase, Glynase, Diabeta), chlorpropamide (Diabinese), tolazamide (Tolinase) and tolbutamide (Orinase), which may not lower your blood sugar as well during therapy with chlorothiazide and reserpine (your diabetes therapy may have to be adjusted);

  • lithium (Lithobid, Eskalith, others), which should not be taken with chlorothiazide because serious side effects may result; or

  • other drugs that also lower blood pressure, including acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), carteolol (Cartrol), labetalol (Trandate, Normodyne), propranolol (Inderal), pindolol (Visken), timolol (Blocadren), benazepril (Lotensin), enalapril (Vasotec), captopril (Capoten), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), amlodipine (Norvasc), bepridil (Vascor), diltiazem (Cardizem, Dilacor), felodipine (Plendil), isradipine (Dynacirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), and verapamil (Calan, Veralan, Isoptin).

Drugs other than those listed here may also interact with chlorothiazide and reserpine 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 chlorothiazide and reserpine written for health professionals that you may read.

What does my medication look like?

Chlorothiazide and reserpine is available with a prescription under the brand name Diupres. 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.

Chlorothiazide/reserpine strengths are as follows:

  • Diupres-250 (250 mg/ 0.125 mg)--pink, round, scored, compressed tablets

  • Diupres-500 (500 mg/ 0.125 mg)--pink, round, scored, compressed tablets

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only f or 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: 5.03. Revision Date: 2/13/04 4:03:52 PM.

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