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Propranolol/Hydrochlorothiazide

    DEA Class;  Rx

    Common Brand Names; Inderide

    • Thiazide Combos

    Hydrochlorothiazide, a thiazide diuretic, and propranolol, a nonspecific, highly lipid-soluble beta-blocker, are combined in 1 tablet to treat hypertension.

    Indicated for the treatment of hypertension.

    Asthma, COPD

    Severe sinus bradycardia or 2°/3° heart block (except in patients with functioning artificial pacemaker)

    Cardiogenic shock

    Uncompensated congestive heart failure

    Hypersensitivity

    Overt heart failure

    Sick sinus syndrome without permanent pacemaker

    No adverse effects specific to the combination have been observed; adverse effects limited to those previously reported with propranolol and hydrochlorothiazide

    Propranolol

    • Bradyarrhythmia
    • Dyspnea
    • Fatigue
    • Angina
    • Increased AV conduction disturbance
    • Hypotension
    • Insomnia
    • Congestive heart failure
    • Syncope
    • Cardiogenic shock
    • Nausea/vomiting
    • Paresthesia
    • Pruritis
    • Psychotic disorder
    • Hyperlipidemia

    Hydrochlorothiazide

    • Anorexia
    • Epigastric distress
    • Hypotension
    • Orthostatic hypotension
    • Photosensitivity
    • Anaphylaxis
    • Anemia
    • Confusion
    • Erythema multiforme
    • Stevens-Johnson syndrome
    • Exfoliative dermatitis including toxic epidermal necrolysis
    • Hypomagnesemia
    • Dizziness
    • Headache
    • Hyperuricemia

    Anesthesia/surgery (myocardial depression); chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery, however the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures

    Acute transient myopia and acute angle-closure glaucoma has been reported, particularly with history of sulfonamide or penicillin allergy (hydrochlorothiazide is a sulfonamide)

    Avoid abrupt withdrawal

    Bronchospastic disease

    Cerebrovascular insufficiency

    CHF, cardiomegaly

    Diabetes mellitus, fluid or electrolyte imbalance, hyperuricemia or gout, SLE

    Hyperthyroidism or thyrotoxicosis, liver disease

    May aggravate digitalis toxicity

    Myasthenic conditions

    Peripheral vascular disease

    Renal impairment

    Risk of male sexual dysfunction

    Sensitivity reactions may occur with or without history of allergy or asthma

    Pregnancy Category: C

    Lactation: excreted in breast milk, use caution

    Adults

    160 mg/day PO propranolol; 50 mg/day PO hydrochlorothiazide.

    Elderly

    160 mg/day PO propranolol; 50 mg/day PO hydrochlorothiazide.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Propranolol hydrochloride/hydrochlorothiazide

    tablet

    • 40mg/25mg
    • 80mg/25mg