What is the most important information I should know about Combipres?

• Do not stop taking Combipres suddenly. Stopping suddenly could cause severe high blood pressure, nervousness, and anxiety.
• To avoid falls and injuries, stand up slowly from a sitting or lying position. This medication will make you drowsy and may cause some dizziness.
• Do not use alcohol, antihistamines, prescription pain relievers, sleeping pills, and other drugs that may cause drowsiness or dizziness except under the supervision of your doctor.

What is Combipres?

• Combipres decreases the levels of certain hormones in your blood. This effect allows your blood vessels (veins and arteries) to relax and decreases your blood pressure. Combipres also slows your heart rate.
• Combipres is a thiazide diuretic (water pill). It helps to lower your blood pressure and decrease edema (swelling or water retention) by increasing the amount of salt and water you lose in your urine.
• Combipres is used to treat high blood pressure (hypertension).
• Combipres may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Combipres?

• You must not take Combipres if you
  • have any type of liver disease;
  • have an allergy to sulfa-based drugs such as sulfa antibiotics (you may have an allergic reaction to Combipres); 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
  • any type of heart disease,
  • had a heart attack or a stroke,
  • kidney disease,
  • high levels of cholesterol or triglycerides (types of fat) in your blood,
  • diabetes,
  • gout,
  • a collagen vascular disease such as systemic lupus erythematosus, or
  • pancreatitis.
• You may not be able to take Combipres, or you may need a lower dose or special monitoring during treatment if you have any of the conditions listed above.
• Combipres is in the FDA pregnancy category B. This means that it is not likely to harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or planning a pregnancy.
• Combipres passes into breast milk. It is not known whether this drug will harm a nursing infant. Do not take Combipres 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 Combipres therapy. You may require a lower dose or special monitoring during treatment.
• Combipres has not been approved for use by children.

How should I take Combipres?

• Take Combipres exactly as directed by your doctor. 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.
• Do not stop taking this medication suddenly even if you feel better. You may need to take Combipres for the rest of your life to control your condition.
• 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 Combipres overdose include drowsiness, lethargy, weakness, lightheadedness, a slow heart rate, nausea, vomiting, increased urination, and possibly seizures.

What should I avoid while taking Combipres?

• Use caution when driving, operating machinery, or performing other hazardous activities. Combipres may cause dizziness. If you experience dizziness, avoid these activities.
• To avoid falls and injuries, stand up slowly from a sitting or lying position. This medication will make you drowsy and may cause some dizziness.
• Avoid alcohol while taking Combipres. Alcohol may increase the drowsiness caused by Combipres and may increase dizziness. Use caution even with small amounts of alcohol.
• Avoid other drugs such as sleeping pills, prescription pain relievers, antihistamines, and antidepressants. These products will also increase the drowsiness caused by Combipres. Talk to your doctor or pharmacist about any other prescription or over-the-counter medications you are taking.
• Avoid prolonged exposure to sunlight. Combipres may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.
• 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 Combipres in your body, and you may become very dizzy.
• Avoid a diet high in salt. Too much salt may cause your body to retain water and may decrease the effects of Combipres. Talk to your doctor before changing the amount of salt in your diet.

What are the possible side effects of Combipres?

• If you experience any of the following serious side effects, stop taking Combipres 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 slow heart rate (fewer than 60 beats per minute);
  • unusually high or low blood pressure (fainting, a severe headache, flushing of your face);
  • chest pain;
  • yellowing of your skin or eyes;
  • unusual bleeding or bruising; or
  • little or no urine.
• Other, less serious side effects may be more likely to occur. Continue to take Combipres and talk to your doctor if you experience
  • fatigue, dizziness, tiredness;
  • tingling or numbness in your arms, legs, hands, or feet;
  • headache;
  • constipation, nausea, vomiting, abdominal pain, or diarrhea;
  • insomnia;
  • increased hunger or thirst or a dry mouth (sucking on ice chips or sugarless hard candy may relieve this side effect);
  • excessive urination;
  • muscle weakness or cramps;
  • blurred vision;
  • impotence; or
  • sensitivity to sunlight.
• 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 Combipres?

• Do not take Combipres if you are taking a monoamine oxidase inhibitor (MAOI), or if you have taken one in the last 14 days. MAOIs include isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate).
  • a tricyclic antidepressant such as amitriptyline (Elavil, Endep), imipramine (Tofranil), nortriptyline (Pamelor), doxepin (Sinequan), and others;
  • the cholesterol-lowering drugs cholestyramine (Questran) or colestipol (Colestid), which may decrease the effects of hydrochlorothiazide;
  • a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin), ketoprofen (Orudis, Orudis KT, Oruvail), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), nabumetone (Relafen), oxaprozin (Daypro), naproxen (Naprosyn, Anaprox, Aleve), and others;
  • an oral diabetes medicine such as glipizide (Glucotrol), glyburide (Micronase, Glynase, Diabeta), chlorpropamide (Diabinese), tolazamide (Tolinase), or tolbutamide (Orinase);
  • lithium (Lithobid, Eskalith, others);
  • a steroid medicine such as dexamethasone (Decadron, Hexadrol), hydrocortisone (Cortef, Hydrocortone), prednisone (Orasone, Deltasone), prednisolone (Delta Cortef, Prelone), methylprednisolone (Medrol); or
  • another drug used to lower blood pressure or treat other heart conditions.
• You may not be able to take Combipres, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Combipres may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves.
• Drugs other than those listed here may also interact with Combipres or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.