You should not use this medicine if you have had an allergic reaction to metoprolol, hydrochlorothiazide, other blood pressure medicines (such as atenolol, propranolol), or sulfa drugs. You should not use this medicine if you have problems urinating, or if you have certain heart problems such as cardiac failure, AV block, or bradycardia.
Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
You may take this medicine with or without food.
Swallow the extended-release tablet whole. Do not crush, break, or chew it.
Carefully follow your doctor's instructions about any special diet.You may need to eat foods that are high in potassium (such as oranges or bananas) to prevent potassium loss while you are using this medicine.
If a dose is missed:
If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
Keep all medicine away from children and never share your medicine with anyone.
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
Make sure your doctor knows if you are using diet pills, amiodarone (Cordarone®), cholestyramine (Questran®), chlordiazepoxide (Limbitrol®), colestipol (Colestid®), digoxin (Lanoxin®), lithium (Eskalith®), mirtazapine (Remeron®), reserpine (Ser-ap-es®), theophylline (Slo-Bid®, Theo-Dur®), medicine to treat depression (such as fluoxetine, paroxetine, Paxil®, or Prozac®), medicine for seizures (such as phenobarbital, primidone, or Mysoline®), pain medicine (such as Percocet®, Percodan®, or Vicodin®), medicine for heart rhythm problems (such as disopyramide, quinidine, propafenone, Norpace®, or Rythmol®), or a monoamine oxidase (MAO) inhibitor (such as Eldepryl®, Marplan®, Nardil®, or Parnate®).
Make sure your doctor knows if you are also using diabetes medicine (insulin or oral medicine such as glipizide, glyburide, metformin, Avandia®, Glucophage®, or Glucotrol®), diuretics or "water pills" (such as furosemide, Hyzaar®, Lasix®, or Moduretic®), pain or arthritis medicine (such as aspirin, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Ecotrin®, Motrin®, or Orudis®), steroids (such as cortisone, dexamethasone, prednisolone, prednisone, Azmacort®, Flonase®, or Medrol®), or other blood pressure medicine (such as atenolol, clonidine, diltiazem, lisinopril, metoprolol, verapamil, propranolol, Accupril®, Adalat®, Altace®, Calan®, Cardizem®, Catapres®, Combipres®, Dilacor XR®, Inderal®, Ismelin®, Lotensin®, Lotrel®, Plendil®, Procardia®, Tenormin®, Tiazac®, Toprol®, Vasotec®, Zestril®).
Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
Do not drink alcohol while you are using this medicine.
Make sure your doctor knows if you are pregnant or breastfeeding, or if you have heart disease, blood vessel disorders, lung disease, diabetes, an overactive thyroid, kidney disease, liver disease, lupus, gout, pheochromocytoma (an adrenal gland tumor), problems urinating, or a history of depression.
This medicine may make you dizzy, lightheaded, or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
Check with your doctor immediately if you start having dry mouth, increased thirst, muscle cramps, nausea or vomiting, unusual tiredness or weakness, severe drowsiness or dizziness, seizures, a decrease in urine, or a fast heartbeat while you are using this medicine. These may be symptoms of dehydration or mineral imbalance.
Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments.
This medicine may raise or lower your blood sugar, or it may cover up symptoms of very low blood sugar (hypoglycemia).
This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.
Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
If you stop using this medicine, your blood pressure may go up. High blood pressure usually has no symptoms. Even if you feel well, do not stop using this medicine suddenly without asking your doctor.