RAUWOLFIA & THIAZIDE DIURETICS

Brand & Generic Names

Demi-Regroton	RAUWOLFIA SERPENTINA &
DESERPIDINE &	BENDROFLUMETHIAZIDE
HYDROCHLOROTHIAZIDE	Rauzide
DESERPIDINE &	Regroton
METHYCLOTHIAZIDE	Renese-R
Diupres	RESERPINE & CHLOROTHIAZIDE
Diurese R	RESERPINE &
Diurigen with Reserpine	CHLORTHALIDONE
Diutensen-R	RESERPINE &
Dureticyl	HYDROCHLOROTHIAZIDE
Enduronyl	RESERPINE &
Enduronyl Forte	HYDROFLUMETHIAZIDE
Hydropine	RESERPINE &
Hydropres	METHYLCLOTHIAZIDE
Hydrosine	RESERPINE & POLYTHIAZIDE
Hydrotensin	RESERPINE & QUINETHAZONE
Mallopres	RESERPINE &
Metatensin	TRICHLORMETHIAZIDE
Naquival	Salazide
Oreticyl	Salutensin
Oreticyl Forte	Salutensin-Demi

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Antihypertensive, diuretic, tranquilizer

Uses

• Controls, but doesn't cure, high blood pressure.
• Reduces fluid retention (edema).

Dosage & Usage Information

How to take:
Tablet--Swallow with liquid. If you can't swallow whole, crumble tablet and take with liquid or food.

When to take:
At the same time each day.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Forces sodium and water excretion, reducing body fluid.
Reduced body fluid and relaxed arteries lower blood pressure.
Interferes with nerve impulses and relaxes blood vessel muscles, reducing blood pressure.
Suppresses brain centers that control emotion.

Time lapse before drug works:
3 weeks continual use required to determine effectiveness.

Don't take with:
Any other prescription or non-prescription drugs without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Cramps; weakness; drowsiness; pinpoint pupils; slow, weak pulse; slow, shallow breathing; diarrhea; flush; low body temperature; coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Irregular heartbeat, Discontinue. Seek weak pulse, hives, emergency treatment. black stool, bloody vomit.

Common:

Lethargy, drowsiness, tremor, depression, red eyes, runny nose, diarrhea, dry mouth.

Infrequent:

• Blurred vision, abdominal pain, nausea, vomiting, irregular heartbeat, joint pain.
• Dizziness, mood change, headache, dry mouth, weakness, tiredness, weight gain or loss, foot and leg swelling.

Rare:

• Sore throat, fever, mouth sores; jaundice; unexplained bleeding or bruising.
• Rash, painful or difficult urination, tremor, impotence, nightmares.

Warnings & Precautions

Don't take if:

• You are allergic to any thiazide diuretic drug or any rauwolfia alkaloid.
• You are depressed.
• You have active peptic ulcer or ulcerative colitis.

Before you start, consult your doctor:

• If you are allergic to any sulfa drug.
• If you have gout, liver, pancreas or kidney disorder, epilepsy.
• If you have had peptic ulcer, ulcerative colitis or gallstones.
• If you have been depressed.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons, especially dizziness and excessive potassium loss.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
Not recommended.

Prolonged use:

• You may need medicine to treat high blood pressure for the rest of your life.
• Causes cancer in laboratory animals. Consult your doctor if you have family or personal history of cancer.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check blood pressure.

Skin & sunlight:
May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.

Discontinuing:
Don't discontinue without consulting doctor. Dose may require gradual reduction if you have taken drug for a long time. Doses of other drugs may also require adjustment.

Others:

• Hot weather and fever may cause dehydration and drop in blood pressure. Dose may require temporary adjustment. Weigh daily and report any unexpected weight decreases to your doctor.
• May cause rise in uric acid, leading to gout.
• May cause blood-sugar rise in diabetics.
• Consult your doctor if you do isometric exercises. These raise blood pressure. Drug may intensify blood pressure rise.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Anticoagulants*,	Unpredictable increased or decreased
oral	effect of anticoagulant.
Anticonvulsants*	Serious change in seizure pattern.
Antidepressants,	Dangerous drop in blood pressure.
tricyclic (TCA)*	Avoid combination unless under
	medical supervision.
Antihistamines*	Increased antihistamine effect.
Antihypertensives*	Increased effect of rauwolfia.
Aspirin	Decreased aspirin effect.
Barbiturates*	Increased hydrochlorothiazide
	effect.
Beta-adrenergic	Increased effect of rauwolfia
blockers*	alkaloids. Excessive sedation.
Carteolol	Increased antihypertensive effect.
Cholestyramine	Decreased hydrocholorothiazide
	effect.
Cortisone drugs*	Excessive potassium loss that
	causes dangerous heart rhythms.
Digitalis	Excessive potassium loss that
preparations*	causes dangerous heart
	rhythms.
Diuretics, thiazide*	Increased effect of other thiazide
	diuretics.
Dronabinol	Increased effect of both drugs.
	Avoid.
Indapamide	Increased diuretic effect.
Levodopa	Decreased levodopa effect.
Lisinopril	Increased antihypertensive effect.
	Dosage of each may require
	adjustment.
Lithium	Increased effect of lithium.
MAO inhibitors*	Increased hydrochlorothiazide
	effect. Severe depression.
Mind-altering drugs*	Excessive sedation.
Nicardipine	Blood pressure drop. Dosages may
	require adjustment.
Nitrates*	Excessive blood pressure drop.
Oxprenolol	Increased antihypertensive effect.
	Dosages of both drugs may require
	adjustments.
Pergolide	Decreased pergolide effect.
Potassium	Decreased potassium effect.
Probenecid	Decreased probenecid effect.
Sotalol	Decreased antihypertensive effect.
Terazosin	Decreases effectiveness of
	terazosin.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Increased intoxication.
	Dangerous blood pressure drop.
	Avoid.
Carbonated drinks.	Decreased rauwolfia effect.
Cocaine:	Increased risk of heart block and
	high blood pressure.
Spicy foods.	Possible digestive upset.
Licorice.	Excessive potassium loss that
	causes dangerous heart rhythms.
Marijuana:	Occasional use--Mild drowsiness.
	Daily use--Moderate drowsiness, low
	blood pressure, depression.
Tobacco:	No proven problems.