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Generic Name:

hydrochlorothiazide-metoprolol, Oral tablet

All Brands

  • Lopressor HCT
SECTION 1 of 4

Highlights for hydrochlorothiazide-metoprolol

Oral tablet
1

Metoprolol succinate/hydrochlorothiazide is a combination of two drugs in a single form that work in different ways to treat high blood pressure (hypertension).

2

The standard starting dose is 25 mg metoprolol succinate/12.5 mg hydrochlorothiazide taken by mouth once per day.

3

Don’t stop taking this drug without talking to your doctor first. Suddenly stopping this drug can cause chest pain or heart attack. If you need to stop taking this drug, your doctor will slowly decrease your dose.

4

You shouldn’t use this medicine if you have a very slow heart rate unless you have a pacemaker.

5

Common side effects include sore throat, the common cold, tiredness, slow heart rate, and changes to your blood electrolyte levels.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to effects that may be dangerous.

Warning for stopping the drug. Don’t stop taking this drug without talking to your doctor. Suddenly stopping this drug may decrease blood flow to your heart. This can cause chest pain (angina) or heart attack. If you need to stop taking this medicine, your doctor will gradually decrease your dose over 1–2 weeks.

Slow heart rate

This drug can slow your heart rate. You may have a higher risk if you have other heart problems or take other heart medicines.

Changes in blood levels

This drug may change the levels of electrolytes in your blood. It can also change your blood sugar or cholesterol levels. Your doctor may check these levels during treatment with this medicine.

Eye problems

This medicine can cause more pressure in your eye (glaucoma). Tell your doctor right away if you have any changes in your vision or eye pain.

Drug features

This drug is a prescription drug. It’s available as an oral tablet.

This drug isn’t available as a generic drug.

This drug is a combination product. It contains two medications in a single tablet. If you’re stable on these two drugs, giving a combination with both drugs in a single tablet make it more convenient.

This drug may be taken in combination with other drugs to treat high blood pressure.

Why it's used

This drug is used to treat high blood pressure (hypertension).

How it works

Hydrochlorothiazide belongs to a class of drugs called thiazide diuretics. Metoprolol succinate belongs to a class of drugs called beta-blockers.

More Details

How it works

Hydrochlorothiazide belongs to a class of drugs called thiazide diuretics. Metoprolol succinate belongs to a class of drugs called beta-blockers. A class of drugs is a group of medications that work in a similar way. They’re often used to treat similar conditions.

It’s thought that hydrochlorothiazide works to remove excess salt and water from your body. This keeps your heart from working as hard to pump blood. This lowers your blood pressure levels. Metoprolol works by relaxing your blood vessels and slowing down your heart rate.

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SECTION 2 of 4

hydrochlorothiazide-metoprolol Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with metoprolol succinate/hydrochlorothiazide include:

  • sore throat or the common cold

  • tiredness

  • slow heart rate

  • low blood potassium levels

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have any of these serious side effects. Call 9-1-1 if your symptoms feel life threatening or if you think you’re having a medical emergency.

  • chest pain

  • heart failure. Symptoms include:

    • shortness of breath
    • getting tired easily
    • swelling of your ankles or legs
    • needing more pillows when you lay down so that you can breathe more easily
    • nausea
    • loss of appetite
    • confusion or trouble thinking
  • trouble breathing or wheezing

  • increased pressure in your eye (glaucoma). Symptoms include:

    • vision changes
    • eye pain
  • low blood sugar in people with diabetes. Symptoms include:

    • dizziness or lightheadedness
    • sweating more than normal
  • pancreatitis. Symptoms include:

    • severe stomach pain
    • stomach swelling
    • nausea
    • vomiting
    • low-grade fever
  •  changes in your blood electrolyte levels. Symptoms include:

    • dry mouth
    • increased thirst
    • weakness
    • fatigue
    • restlessness
    • muscle pain or cramps
    • muscle weakness
    • producing less urine than usual
    • nausea
    • vomiting
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug causes tiredness and fatigue.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

hydrochlorothiazide-metoprolol May Interact with Other Medications

Oral tablet

Metoprolol succinate/hydrochlorothiazide can interact with other medications, herbs, or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or cause the drugs that you take to not work as well. To help prevent interactions, your doctor should manage all of your medications carefully. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

The use of drinks that contain alcohol can increase your risk of having a sudden drop in blood pressure when you stand up from a sitting or lying position (orthostatic hypotension). You should avoid alcohol while you’re taking this medication.

Medications that might interact with this drug

Bipolar disorder drugs

Metoprolol succinate/hydrochlorothiazide may decrease how fast your bipolar disorder drug is removed from your body. This may increase your risk of toxic effects. Your doctor may lower your dose of your bipolar disorder medicine.

These drugs include:

  • lithium

Blood pressure medications

Taking these drugs with metoprolol succinate/hydrochlorothiazide can increase your risk for a very slow heart rate.

These drugs include:

  • calcium channel blockers, such as:
    • verapamil
    • diltiazem
    • nifedipine

Cholesterol-lowering drugs

Certain cholesterol drugs may stop metoprolol succinate/hydrochlorothiazide from being absorbed by your body. This could cause higher blood pressure levels. You shouldn’t take metoprolol succinate/hydrochlorothiazide within 4 hours of taking these drugs.

These drugs include:

  • cholestyramine
  • colestipol

Clonidine

Taking clonidine with metoprolol succinate/hydrochlorothiazide can increase your risk of slow heart rate. If both of these drugs need to be stopped at the same time, your doctor will have you stop metoprolol succinate/hydrochlorothiazide a few days before stopping clonidine.

Depression medications

Taking this drug with monoamine oxidase inhibitors (MAOIs) or other drugs used to treat depression may increase the effect of metoprolol in your body. This can cause your blood pressure to become too low, a slow heart rate, or dizziness.

These drugs include:

  • MAOIs, such as:
    • phenelzine
    • isocarboxazid
    • tranylcypromine
    • selegiline
  • reserpine
  • fluoxetine
  • paroxetine

Diabetes drugs

Diabetes drugs may not work as well when taken with metoprolol succinate/hydrochlorothiazide. This could cause higher or lower blood sugar levels. Your doctor may change the dose of your diabetes drug.

These drugs include:

  • glyburide
  • glimepiride
  • glipizide
  • insulin
  • metformin
  • dapaglifozin
  • liraglutide

Epinephrine

Epinephrine may not work as well when used with metoprolol succinate/hydrochlorothiazide. You may need to have a different rescue medication available if you usually use epinephrine for allergic reactions.

Heart rate or rhythm (arrhythmia) drugs

Taking these drugs together can increase the levels of metoprolol succinate in your body. This could cause blood pressure that is too low or slow heart rate.

These drugs include:

  • quinidine
  • propafenone

Taking this drug won’t increase the level of metoprolol in your body, but it may still increase your risk for a slow heart rate:

  • digoxin

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs may decrease the effect of metoprolol succinate/hydrochlorothiazide. This means that it may not work as well to lower your blood pressure.

These drugs include:

  • naproxen
  • ibuprofen
  • indomethacin
  • piroxicam
  • meloxicam
  • sulindac

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
heart problems
People with heart problems

This drug may cause or worsen heart failure. You shouldn’t use this drug if you have unstable heart failure, second- or third-degree heart block, or a very low heart rate (bradycardia). If you have coronary heart disease and you stop taking this drug suddenly, you’re at high risk for chest pain (angina) and a heart attack.

kidney disease
People with kidney disease

This medication is removed from your body by your kidneys. If your kidneys don’t work well, the medication may build up in your system. This may put you at higher risk for side effects and may worsen your condition. Your doctor may choose to stop this drug if your kidney problems get severe.

certain lung problems
People with certain lung problems

Use this drug with caution if you have asthma or chronic obstructive pulmonary disorder (COPD). It may make it harder for you to breathe or make certain breathing medications not work as well. You should always carry your rescue inhaler with you.

poor blood flow
People with poor blood flow in the legs

People with peripheral vascular disease may have more leg pain or discomfort when taking this drug.

thyroid disease
People with thyroid disease

If you need to stop taking this drug, stop taking it slowly if you have hyperthyroidism. Stopping the drug too quickly can make your condition worse.

lupus
People with lupus

Use this drug with caution if you have lupus. This drug may make this condition worse.

liver disease
People with liver disease

This drug may change your fluid and electrolyte levels. If you have liver disease, this can cause problems that may cause you to lose consciousness. Use this drug with extreme caution if you have liver disease. Your doctor may keep you at a lower dose and monitor you more closely.

diabetes
People with diabetes

If you usually have a faster heart rate when you have low blood sugar, this drug may mask that symptom. You may still notice other signals of low blood sugar, such as dizziness/lightheadedness or sweating.

gout
People with gout

This medication may increase the levels of uric acid in your body. This may raise your risk of gout flare-ups.

untreated pheochromocytoma
People with untreated pheochromocytoma

Don’t use this medication if you have untreated pheochromocytoma (a tumor that can cause very high blood pressure). It can mask the symptoms of pheochromocytoma.

pregnant women
Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

breastfeeding
Women who are breast-feeding

This drug may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

for seniors
For seniors

Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

for children
For children

This medicine hasn’t been studied in children and shouldn’t be used in children under the age of 18 years.

call doctor
When to call the doctor

Call your doctor if:

  • your blood pressure is too high
  • plan to have surgery. Tell your doctor about all the drugs that you take before you have any surgeries or medical procedures. This drug may increase your risk of complications with anesthesia and surgical procedures. You shouldn’t stop taking this drug before surgery, unless your doctor tells you to.
allergies
Allergies

This drug can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives
  • rash

Don’t take this drug again if you’ve ever had an allergic reaction to it or other sulfonamide drugs. Taking it again could be fatal (cause death).

SECTION 4 of 4

How to Take hydrochlorothiazide-metoprolol (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your doctor will tell you what dosage is right for you. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

High blood pressure

Brand: Dutoprol

Form: Oral tablet
Strengths:
  • 25 mg metoprolol succinate/12.5 mg hydrochlorothiazide
  • 50 mg metoprolol succinate/12.5 mg hydrochlorothiazide
  • 100 mg metoprolol succinate/12.5 mg hydrochlorothiazide
Adult dosage (ages 18–64 years)

The starting dose is 25 mg metoprolol succinate/12.5 mg hydrochlorothiazide taken by mouth once per day. Your doctor may increase your dose every 2 weeks to a maximum dose of 200 mg metoprolol succinate/25 mg hydrochlorothiazide taken once per day.

Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children and shouldn’t be used in children under the age of 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with serious risks if you don't take it as prescribed.

If you don't take it at all

This drug reduces high blood pressure. Medicines that lower your blood pressure reduce your chance of having a stroke or heart attack.

If you stop taking It suddenly

Don’t stop taking this drug without talking to your doctor. Stopping this drug suddenly may cause your blood pressure to spike. This may increase your chance for a heart attack or chest pain (angina).

If you don't take it on schedule

Your blood pressure may not improve or may get worse. You may have a higher chance of a heart attack or stroke.

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time.

Never try to catch up by taking two doses at once. This could cause toxic side effects.

If you take too much

Taking too much of this drug may increase your risk of side effects, such as:

  • fatigue
  • dizziness
  • drowsiness
  • very low blood pressure
  • very low heart rate
  • trouble breathing
  • muscle cramps
  • swelling in your legs, ankles, or chest

If you think you’ve taken too much of the drug, act right away. Call your doctor or local Poison Control Center, or go to the nearest emergency room.

How to tell if the drug is working

You can tell if this drug is working because your blood pressure will be lower. You may also notice that you need to urinate more.

This drug is a long-term drug treatment. It’s used to manage high blood pressure.

Important considerations for taking this drug
take with or without food
This medication can be taken with or without food
can crush or cut
You can crush or cut the tablet
storage
Store this drug close to 77°F (25°C)
See Details
refillable
Prescription is refillable
travel
Travel
See Details
self-management
Self-management
See Details
clinical monitoring
Clinical monitoring
See Details
refillable
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.
hidden costs
Hidden costs
See Details
prior authorization
Insurance
See Details

Store this drug close to 77°F (25°C)

This drug may be stored briefly from 59–86°F (15–30°C).

Don’t freeze this drug.

Keep it away from light and high temperature.

Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry your medication with you, such as in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

You may need to check your blood pressure at home. You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

You may need to buy your own blood pressure monitoring machine. These are available at most pharmacies.

Clinical monitoring

During treatment with this drug, your doctor may check your:

  • electrolyte levels
  • blood pressure
  • heart rate
  • kidney function
  • liver function
  • weight

Hidden costs

If your doctor asks you to check your blood pressure at home, you’ll need a blood pressure monitor.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other options that may work for you.


Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on August 31, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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