Chlorthalidone and reserpine

Generic Name: chlorthalidone and reserpine (klor THAL i done and re SER peen)Brand Names: Demi-Regroton, Regroton

What is chlorthalidone and reserpine?

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

Chlorthalidone 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.

Together, chlorthalidone and reserpine are used to lower high blood pressure.

Chlorthalidone 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 chlorthalidone and reserpine?

Stand up slowly from a sitting or lying position. Chlorthalidone and reserpine may make you feel dizzy. Do not stop taking chlorthalidone 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 chlorthalidone and reserpine?

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

You must not take chlorthalidone 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 receiving a monoamine oxidase inhibitor 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 chlorthalidone and reserpine if you have any of the conditions listed above.

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

How should I take chlorthalidone and reserpine?

Take chlorthalidone 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 chlorthalidone and reserpine with food or milk if it upsets your stomach.

Do not stop taking chlorthalidone and reserpine suddenly. Stopping suddenly could make your condition much worse or cause very serious side effects.

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

See also: Chlorthalidone and reserpine dosage in more detail

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 treatment.

Symptoms of a chlorthalidone and reserpine overdose include low blood pressure (fainting, dizziness, weakness); sleepiness; uncontrollable hand, arm, or leg movements; a slow pulse; low body temperature; diarrhea; increased urination; vomiting; and slow breathing.

What should I avoid while taking chlorthalidone and reserpine?

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

Use caution when arising from a sitting or lying position, especially first thing in the morning. You may become dizzy while taking chlorthalidone 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 chlorthalidone and reserpine in your body, and you may become very dizzy.

Also, chlorthalidone 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 chlorthalidone and reserpine. Alcohol, which will further lower your blood pressure, will also increase the drowsiness caused by chlorthalidone 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 medicines will interfere with your chlorthalidone and reserpine therapy.

Use caution when you are driving, operating machinery, or performing other hazardous activities until you know how chlorthalidone 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.

Chlorthalidone and reserpine side effects

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

  • a very irregular heartbeat;

  • chest pain;

  • 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; or

  • little or no urine.

Other, less serious side effects are more likely to occur. Continue to take chlorthalidone 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 acid stomach (take chlorthalidone 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.

Chlorthalidone and reserpine Dosing Information

Usual Adult Dose for Hypertension:

Initial dose: 1 tablet orally once a day (should conform to the dosages of the individual components established during titration). Maintenance dose: 1 to 2 tablets orally once a day.

What other drugs will affect chlorthalidone and reserpine?

Do not take chlorthalidone and reserpine 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 chlorthalidone and reserpine;
  • 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 chlorthalidone and reserpine;

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

  • 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 also may cause extreme sleepiness or dizziness if taken with chlorthalidone and reserpine;

  • 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 chlorthalidone;

  • 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;

  • 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 chlorthalidone;

  • 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 (your diabetes therapy may have to be adjusted);

  • lithium (Lithobid, Eskalith), should not be taken with chlorthalidone 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, Verelan, Isoptin).

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

What does my medication look like?

Chlorthalidone and reserpine is available with a prescription under the brand names Regroton and Demi-Regroton. 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.

  • 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: 4.03. Revision Date: 2/13/04 4:03:52 PM.