Hydrochlorothiazide Methyldopa

Hydrochlorothiazide Methyldopa Brand Names- Aldoril | Aldoril D

What is Hydrochlorothiazide Methyldopa

Hydrochlorothiazide and methyldopa are used together in an oral preparation for the treatment of hypertension.

Hydrochlorothiazide is a commonly used thiazide diuretic. Methyldopa is a centrally acting antiadrenergic agent, with declining use due to the development of other antihypertensive agents with a more favorable adverse effect profile.

The extent of blood pressure reduction with the combination of hydrochlorothiazide and methyldopa is additive. Hydrochlorothiazide; methyldopa is not indicated for initial treatment of hypertension (black box warning). The dosage must be individualized by titration of the individual components.

The combination product may be used once the patient has been successfully titrated and the optimal dose corresponds to a ratio contained in the combination formulation. The use, however, of this combination product should be minimal due to dosing constraints from each individual component found in the combination product.

Hydrochlorothiazide doses greater than 50 mg/day should be avoided, so only those patients whose blood pressure is maintained with daily doses of methyldopa equal to or less than 500 mg can be treated with the combination product.

Although methyldopa is the drug used most often in the treatment of chronic hypertension in pregnant women, many experts consider hydrochlorothiazide contraindicated in pregnancy, thereby negating the use of this combination product in pregnancy.

Hydrochlorothiazide methyldopa (Aldoril®) was granted final FDA approval for the treatment of hypertension on January 23, 1986.

Indications

  • hypertension

Side Effects

  1. abdominal pain
  2. agranulocytosis
  3. alopecia
  4. amenorrhea
  5. anaphylactoid reactions
  6. angina
  7. anorexia
  8. aplastic anemia
  9. arthralgia
  10. asthenia
  11. azotemia
  12. blurred vision
  13. bradycardia
  14. breast enlargement
  15. cholestasis
  16. choreoathetosis
  17. cirrhosis
  18. colitis
  19. constipation
  20. depression
  21. diarrhea
  22. dizziness
  23. drowsiness
  24. edema
  25. ejaculation dysfunction
  26. elevated hepatic enzymes
  27. eosinophilia
  28. erythema multiforme
  29. exfoliative dermatitis
  30. fever
  31. flatulence
  32. galactorrhea
  33. glycosuria
  34. gout
  35. gynecomastia
  36. headache
  37. heart failure
  38. hemolysis
  39. hemolytic anemia
  40. hepatic necrosis
  41. hepatitis
  42. hyperbilirubinemia
  43. hypercalcemia
  44. hypercholesterolemia
  45. hyperglycemia
  46. hyperkeratosis
  47. hyperprolactinemia
  48. hypertriglyceridemia
  49. hyperuricemia
  50. hypochloremia
  51. hypokalemia
  52. hypomagnesemia
  53. hyponatremia
  54. hypotension
  55. hypovolemia
  56. impotence (erectile dysfunction)
  57. interstitial nephritis
  58. jaundice
  59. leukopenia
  60. libido decrease
  61. lupus-like symptoms
  62. metabolic alkalosis
  63. myalgia
  64. myocarditis
  65. myopia
  66. nasal congestion
  67. nausea
  68. nightmares
  69. nocturia
  70. ocular hypertension
  71. orgasm dysfunction
  72. orthostatic hypotension
  73. pancreatitis
  74. paresthesias
  75. pericarditis
  76. photosensitivity
  77. pneumonitis
  78. polyuria
  79. psychosis
  80. pulmonary edema
  81. purpura
  82. rash
  83. renal failure (unspecified)
  84. restlessness
  85. sialadenitis
  86. Stevens-Johnson syndrome
  87. syncope
  88. thrombocytopenia
  89. tongue discoloration
  90. toxic epidermal necrolysis
  91. urticaria
  92. vasculitis
  93. vertigo
  94. vomiting
  95. weakness
  96. xanthopsia
  97. xerostomia

Monitoring Parameters

  • blood glucose
  • blood pressure
  • Coombs’ test
  • heart rate
  • hemoglobin/hematocrit
  • LFTs
  • red blood cell count (RBC)
  • serum calcium
  • serum creatinine/BUN
  • serum electrolytes
  • serum magnesium
  • serum uric acid

Contraindications

  • acid/base imbalance
  • anuria
  • asthma
  • autoimmune disease
  • breast-feeding
  • cardiac disease
  • cerebrovascular disease
  • depression
  • diabetes mellitus
  • dialysis
  • diarrhea
  • driving or operating machinery
  • electrolyte imbalance
  • geriatric
  • gout
  • hemolytic anemia
  • hepatic disease
  • hepatitis
  • hyperaldosteronism
  • hypercalcemia
  • hyperparathyroidism
  • hyperuricemia
  • hypochloremia
  • hypokalemia
  • hypomagnesemia
  • hyponatremia
  • hypotension
  • hypovolemia
  • initial treatment
  • jaundice
  • MAOI therapy
  • mental status changes
  • metabolic alkalosis
  • orthostatic hypotension
  • pancreatitis
  • Parkinson’s disease
  • penicillin hypersensitivity
  • pheochromocytoma
  • preeclampsia
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • sulfonamide hypersensitivity
  • sunlight (UV) exposure
  • sympathectomy
  • systemic lupus erythematosus (SLE)
  • thiazide diuretic hypersensitivity
  • vomiting

Interactions

  • Acarbose
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Acetazolamide
  • Acetohexamide
  • Aclidinium; Formoterol
  • Acrivastine; Pseudoephedrine
  • Albiglutide
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  • Aldesleukin, IL-2
  • Alemtuzumab
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  • Alfentanil
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  • Alogliptin
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  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Atracurium
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
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  • Baclofen
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  • Benazepril
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  • Brompheniramine; Pseudoephedrine
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  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Carbonic anhydrase inhibitors
  • Cardiac glycosides
  • Cariprazine
  • Celecoxib
  • Cenobamate
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
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  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chloroprocaine
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  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Chlorpropamide
  • Cholestyramine
  • Cidofovir
  • Cisapride
  • Cisatracurium
  • Citalopram
  • Clindamycin; Tretinoin
  • Clonazepam
  • Clorazepate
  • Clozapine
  • Co-Enzyme Q10, Ubiquinone
  • Cocaine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colchicine; Probenecid
  • Colestipol
  • COMT inhibitors
  • Conivaptan
  • Corticosteroids
  • Cosyntropin
  • Cyclophosphamide
  • Dapagliflozin
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  • Degarelix
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  • Dexlansoprazole
  • Dexmethylphenidate
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  • Dextromethorphan; Quinidine
  • Diazepam
  • Diazoxide
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  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Dobutamine
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  • Donepezil; Memantine
  • Dopamine
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  • Droperidol
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  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Enflurane
  • Entacapone
  • Ephedrine
  • Epinephrine
  • Epoprostenol
  • Ergocalciferol, Vitamin D2
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Escitalopram
  • Esketamine
  • Esomeprazole
  • Esomeprazole; Naproxen
  • Estazolam
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Ethanol
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Etodolac
  • Etomidate
  • Exenatide
  • Famotidine; Ibuprofen
  • Fenfluramine
  • Fenoprofen
  • Fentanyl
  • Fexofenadine; Pseudoephedrine
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Flavoxate
  • Fluconazole
  • Fluocinolone; Hydroquinone; Tretinoin
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Flurazepam
  • Flurbiprofen
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Fluvoxamine
  • Formoterol
  • Formoterol; Mometasone
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fospropofol
  • Gabapentin
  • Gallium Ga 68 Dotatate
  • General anesthetics
  • Glimepiride
  • Glimepiride; Pioglitazone
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  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Goserelin
  • Granisetron
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Halobetasol; Tazarotene
  • Halofantrine
  • Haloperidol
  • Halothane
  • Histrelin
  • Homatropine; Hydrocodone
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hyoscyamine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibritumomab Tiuxetan
  • Ibuprofen
  • Ibuprofen lysine
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Icosapent ethyl
  • Iloperidone
  • Iloprost
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  • Incretin Mimetics
  • Indacaterol
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  • Indomethacin
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  • Insulin Degludec; Liraglutide
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  • Insulins
  • Intravenous Lipid Emulsions
  • Iron
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  • Isocarboxazid
  • Isoflurane
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  • Isosorbide Dinitrate, ISDN
  • Isosorbide Mononitrate
  • Ketamine
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  • Lasmiditan
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