High blood pressure, or "pressure" as we all know it, is a health problem that many people in our country are currently experiencing. So, your doctor may have prescribed you medication to control your blood pressure. Sometimes, instead of one medication, you may be given a combination pill that combines two medications. Today, we are going to talk about one such medication, a combination of two medications called Hydrochlorothiazide and Methyldopa.
What really happens with this medicine?
Simply put, this is a combination of two medications that are used to control high blood pressure.
1. Hydrochlorothiazide: This is a type of medication that we usually call a "water pill." In medical terms, it is a "diuretic." It works by removing excess water and salt from the body through urine. This reduces the pressure inside the blood vessels.
2. Methyldopa: This medication works by affecting your brain and nervous system. It relaxes blood vessels, reducing the resistance to blood flow. This also helps control blood pressure.
When these two medications are combined, better results can be achieved in controlling high blood pressure.
Things you need to tell your doctor before starting medication
Before prescribing this medication, it is very important that your doctor knows your complete health history. Be sure to tell him/her about any of the conditions listed below.
| Your health condition | Why should you inform? |
|---|---|
| Liver or kidney disease | Since these medications are eliminated from the body through these organs, if their effectiveness is impaired, the dosage of the medication may need to be changed. |
| Diabetes | This medicine may slightly increase blood sugar levels, so it may affect diabetes control. |
| Gout | Hydrochlorothiazide, which is contained in the medication, can increase uric acid levels and aggravate gout. |
| Anemia | Methyldopa can sometimes affect red blood cells. |
| Immune system diseases (e.g. lupus) | There is a small chance that this medication will worsen such conditions. |
| Allergic to sulfa drugs, other medications, or foods. | Hydrochlorothiazide is a sulfa drug, so it can cause allergies. |
| If you are pregnant, trying to get pregnant, or breastfeeding. | It is essential to talk to your doctor about the safety of this medication during these times. |
| If you have taken an MAOI medication within the past 14 days. | These are medications for depression. Taking them together can be very dangerous. |
How should I use this medicine?
- This medicine is an oral tablet. Take it every day, at the prescribed time, as prescribed by your doctor.
- If you experience stomach upset, take it with a meal.
- Do not stop taking the medication suddenly without medical advice. Your blood pressure may suddenly increase.
- Children may need special care when taking this medicine. Talk to your doctor about this.
Important: If you have even the slightest suspicion that you have taken more medicine than you think, go to the nearest hospital ETU (Emergency Treatment Unit) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital .
This medicine is prescribed for you only. Never give your medicine to anyone else , even if they think they have the same illness as you.
What if I miss a dose of medication?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose.
Other things that may interact with this medicine
It's very important to tell your doctor about all the medications you take, not just prescription medications, but over-the-counter medications, vitamins, traditional medicines, and everything else you use. Because some things can interact with these medications.
| Things that should never be taken together | |
|---|---|
| MAOI type medication | (Example: Carbex, Eldepryl, Marplan, Nardil, Parnate). Taking these together can cause a dangerous increase in blood pressure. |
| Things to use with caution and possible interactions | |
| Alcohol | It can alter the effects of the medication and increase dizziness and drowsiness. |
| Painkillers (NSAIDS) | (Ex: Ibuprofen, Naproxen). These can reduce the effectiveness of blood pressure medication. |
| Iron salts | Iron prevents the body from absorbing methyldopa (this is explained below). |
| Other blood pressure medications and diuretics | The pressure can be too low. If the doctor is aware of it, there is no problem. |
| Lithium | Lithium levels in the body can become dangerously high. |
| Barbiturates, anesthetics used during surgery, steroids | These can also interact with this medicine. |
Things to keep in mind when taking medication
Drowsiness and dizziness
You may feel drowsy or dizzy when you first start taking this medicine. Avoid driving or operating machinery until you know how this medicine affects you. Especially if you are elderly, stand up slowly when you get up from a sitting position or out of bed. This can make you dizzy and fall. Avoid drinking alcohol, as it can make this condition worse.
Body water content
If you have persistent diarrhea, vomiting, or excessive sweating, you may lose a lot of water from your body and become dehydrated. In this case, it may be dangerous to use this medicine. Ask your doctor what to do in such a situation.
Skin and sunlight
This medicine may make your skin more sensitive to sunlight. This means you may burn and redden more easily. So stay out of the sun as much as possible. If you do go out, wear clothing that covers your skin, wear sunglasses, and use sunscreen. Also talk to your doctor about your risk of skin cancer while taking this medicine.
Be especially careful if you take iron pills.
This is very important if you are taking iron pills for something like anemia. Iron prevents the body from absorbing the Methyldopa component in this medicine. Therefore, do not take iron pills and this blood pressure medicine at the same time. The best way is to take the iron pill 2 hours before or 6 hours after taking the blood pressure medicine.
What side effects might I experience?
Like any medicine, this can cause some side effects, although not everyone gets them.
| Side effects that you should report to your doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, severe itching, swelling of the face, lips or tongue. |
| Difficulty breathing, chest pain | These can be serious symptoms. |
| Yellowing of the eyes, yellowing of the skin, dark-colored urine, light-colored stools | These could be symptoms of a liver problem. |
| Severe dizziness, vision changes, eye pain | It can be a symptom of increased pressure, especially in the eyes. |
| Unexplained bruising, bleeding, fever, body aches | Blood cells may have been affected. |
| Swelling of the legs or ankles, decreased urine output | These could be symptoms of a kidney or heart problem. |
| Side effects that should be reported to the doctor if they persist or are bothersome | |
| Dry mouth | Get relief by chewing sugar-free gum, candy, or drinking water. |
| Drowsiness, diarrhea | These may decrease as the body gets used to the medication. |
| Depressed mood | It is important to inform the doctor about this. |
| Change in sexual desire or activity | This is also a common side effect. |
| Breast enlargement or milk secretion in both men and women | This may be due to the effects of methyldopa. |
Take-Home Message
- This is a combination of two medications that are given to control high blood pressure.
- Take your medicine at the same time every day, exactly as your doctor tells you. Don't stop taking it at your own discretion.
- Tell your doctor about all other medications you take and any other illnesses you have.
- When taking the medication, be aware of things like drowsiness, dizziness, and sensitivity to sunlight.
- If you experience any serious side effects, such as a severe allergic reaction, chest pain, or yellowing of the eyes and skin, seek medical advice immediately.
- If you are taking iron pills, do not take them with this medicine. Keep a gap of several hours between them.
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