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Metoprolol Tartrate and Hydrochlorothiazide

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Overview

What is Metoprolol Tartrate and Hydrochlorothiazide?

Metoprolol tartrate and hydrochlorothiazide tablethas the antihypertensive effect of metoprolol tartrate, a selective beta-adrenoreceptor blocking agent, and the antihypertensive and diuretic actions of hydrochlorothiazide. It is available as tablets for oral administration. The 50/25 tablets contain 50 mg of metoprolol tartrate USP and 25 mg of hydrochlorothiazide USP; the 100/25 tablets contain 100 mg of metoprolol tartrate USP and 25 mg of hydrochlorothiazide USP; and the 100/50 tablets contain 100 mg of metoprolol tartrate USP and 50 mg of hydrochlorothiazide USP. Metoprolol tartrate USP is (±)-1-(Isopropylamino)-3-[-(2-methoxyethyl)phenoxy]-2-propanol L-(+)-tartrate (2:1) salt, and its structural formula is 

Metoprolol tartrate USP is a white, crystalline powder. It is very soluble in water; freely soluble in methylene chloride, in chloroform, and in alcohol; slightly soluble in acetone; and insoluble in ether. Its molecular weight is 684.82. Hydrochlorothiazide is 6-chloro-3,4-dihydro-2-1,2,4-benzothiadiazine-7-sulfonamide 1,1- dioxide, and its structural formula is 

Hydrochlorothiazide USP is a white, or practically white, practically odorless, crystalline powder. It is freely soluble in sodium hydroxide solution, in -butylamine, and in dimethylformamide; sparingly soluble in methanol; slightly soluble in water; and insoluble in ether, in chloroform, and in dilute mineral acids. Its molecular weight is 297.73. colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose, sodium starch glycolate, povidone, lactose, pregelatinized starch.



What does Metoprolol Tartrate and Hydrochlorothiazide look like?



What are the available doses of Metoprolol Tartrate and Hydrochlorothiazide?

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What should I talk to my health care provider before I take Metoprolol Tartrate and Hydrochlorothiazide?

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How should I use Metoprolol Tartrate and Hydrochlorothiazide?

Dosage should be determined by individual titration (see INDICATIONS AND USAGE). Hydrochlorothiazide is usually given at a dosage of 12.5 to 50 mg per day. The usual initial dosage of metoprolol tartrate tablets is 100 mg daily in single or divided doses. Dosage may be increased gradually until optimum blood pressure control is achieved. The effective dosage range is 100 to 450 mg per day. While once-daily dosing is effective and can maintain a reduction in blood pressure throughout the day, lower doses (especially 100 mg) may not maintain a full effect at the end of the 24-hour period, and larger or more frequent daily doses may be required. This can be evaluated by measuring blood pressure near the end of the dosing interval to determine whether satisfactory control is being maintained throughout the day. Beta selectivity diminishes as dosage of metoprolol tartrate tablets is increased. The following dosage schedule may be used to administer from 100 to 200 mg of metoprolol tartrate per day and from 25 to 50 mg of hydrochlorothiazide per day:  

Dosing regimens that exceed 50 mg of hydrochlorothiazide per day are not recommended. When necessary, another antihypertensive agent may be added gradually, beginning with 50% of the usual recommended starting dose to avoid an excessive fall in blood pressure.


What interacts with Metoprolol Tartrate and Hydrochlorothiazide?

Metoprolol


Hydrochlorothiazide


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What are the warnings of Metoprolol Tartrate and Hydrochlorothiazide?

Onset of pseudomembranous colitis symptoms may occur during or after antimicrobial treatment.

Metoprolol

Cardiac Failure:

In Patients Without a History of Cardiac Failure:

Ischemic Heart Disease:

Diabetes and Hypoglycemia:

Pheochromocytoma:

Thyrotoxicosis:

Hydrochlorothiazide

Thiazides should be used with caution in patients with severe renal disease. In patients with renal disease, thiazides may precipitate azotemia. Cumulative effects of the drug may develop in patients with impaired renal function.

Thiazides should be used with caution in patients with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte imbalance may precipitate hepatic coma.

Thiazides may add to or potentiate the action of other antihypertensive drugs. Potentiation occurs with ganglionic or peripheral adrenergic blocking drugs.

Sensitivity reactions are more likely to occur in patients with a history of allergy or bronchial asthma.

The possibility of exacerbation or activation of systemic lupus erythematosus has been reported.

Acute Myopia and Secondary Angle-Closure Glaucoma: Hydrochlorothiazide, a sulfonamide, can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma. Symptoms include acute onset of decreased visual acuity or ocular pain and typically occur within hours to weeks of drug initiation. Untreated acute angle-closure glaucoma can lead to permanent vision loss. The primary treatment is to discontinue hydrochlorothiazide as rapidly as possible. Prompt medical or surgical treatments may need to be considered if the intraocular pressure remains uncontrolled. Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy.


What are the precautions of Metoprolol Tartrate and Hydrochlorothiazide?

General

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Information for Patients

Patients should be advised to take metoprolol tartrate and hydrochlorothiazide tablets regularly and continuously, as directed, with or immediately following meals. If a dose should be missed, the patient should take only the next scheduled dose (without doubling it). Patients should not discontinue metoprolol tartrate and hydrochlorothiazide tablets without consulting the physician. Patients should be advised (1) to avoid operating automobiles and machinery or engaging in other tasks requiring alertness until the patient’s response to therapy with metoprolol tartrate and hydrochlorothiazide has been determined; (2) to contact the physician if any difficulty in breathing occurs; (3) to inform the physician or dentist before any type of surgery that he or she is taking metoprolol tartrate and hydrochlorothiazide tablets.

Laboratory Tests

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Drug/Drug Interactions

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Drug/Laboratory Test Interactions

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Hydrochlorothiazide,

Carcinogenesis, Mutagenesis, Impairment of Fertility

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Salmonella typhimurium

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Aspergillus nidulans

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Pregnancy: Teratogenic Effects. Pregnancy Category C

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Nonteratogenic Effects

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Nursing Mothers

Metoprolol is excreted in breast milk in a very small quantity. An infant consuming 1 liter of breast milk daily would receive a dose of metoprolol of less than 1 mg. Thiazides are also excreted in breast milk. If the use of metoprolol tartrate and hydrochlorothiazide tablets is deemed essential, the patient should stop nursing.

Pediatric Use

Safety and effectiveness in pediatric patients have not been established.

Geriatric Use

Clinical studies of metoprolol tartrate and hydrochlorothiazide tablets did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. Hydrochlorothiazide is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function (see WARNINGS). In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant disease or other drug therapy.


What are the side effects of Metoprolol Tartrate and Hydrochlorothiazide?

Metoprolol Tartrate and Hydrochlorothiazide

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What should I look out for while using Metoprolol Tartrate and Hydrochlorothiazide?

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What might happen if I take too much Metoprolol Tartrate and Hydrochlorothiazide?

Acute Toxicity

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How should I store and handle Metoprolol Tartrate and Hydrochlorothiazide?

Store at room temperature between 20C to 25C (68F to 77F), with excursions permitted between 15C to 30C (59F to 86F). Do not store in the refrigerator or freezer.  Use nosepiece immediately after removing from foil pouch.Product: 63629-7331NDC: 63629-7331-1 30 TABLET in a BOTTLEProduct: 63629-7332NDC: 63629-7332-1 30 TABLET in a BOTTLENDC: 63629-7332-2 8 TABLET in a BOTTLEProduct: 63629-7331NDC: 63629-7331-1 30 TABLET in a BOTTLEProduct: 63629-7332NDC: 63629-7332-1 30 TABLET in a BOTTLENDC: 63629-7332-2 8 TABLET in a BOTTLEProduct: 63629-7331NDC: 63629-7331-1 30 TABLET in a BOTTLEProduct: 63629-7332NDC: 63629-7332-1 30 TABLET in a BOTTLENDC: 63629-7332-2 8 TABLET in a BOTTLEProduct: 63629-7331NDC: 63629-7331-1 30 TABLET in a BOTTLEProduct: 63629-7332NDC: 63629-7332-1 30 TABLET in a BOTTLENDC: 63629-7332-2 8 TABLET in a BOTTLEProduct: 63629-7331NDC: 63629-7331-1 30 TABLET in a BOTTLEProduct: 63629-7332NDC: 63629-7332-1 30 TABLET in a BOTTLENDC: 63629-7332-2 8 TABLET in a BOTTLE


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Clinical Information

Chemical Structure

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Clinical Pharmacology

Non-Clinical Toxicology
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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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Professional

Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72
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Tips

Tips

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Interactions

Interactions

A total of 440 drugs (1549 brand and generic names) are known to interact with Imbruvica (ibrutinib). 228 major drug interactions (854 brand and generic names) 210 moderate drug interactions (691 brand and generic names) 2 minor drug interactions (4 brand and generic names) Show all medications in the database that may interact with Imbruvica (ibrutinib).