Eprosartan and hydrochlorothiazide

Tell your doctor is you are breastfeeding or plan to breastfeed. 

It is not known if eprosartan and hydrochlorothiazide crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with the use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using eprosartan and hydrochlorothiazide. 

• Take eprosartan and hydrochlorothiazide exactly as prescribed. 
• Eprosartan and hydrochlorothiazide comes in a tablet form and is taken by mouth once daily with or without food. 

In the U.S.

• Teveten HCT

Available Dosage Forms:

• Tablet

Therapeutic Class: Angiotensin II Receptor Antagonist/Thiazide Combination

Pharmacologic Class: Eprosartan

Chemical Class: Thiazide

eprosartan and hydrochlorothiazide should not be the first medicine you use to treat your condition. It is meant to be used only after you have tried other medicines that have not worked or have caused unwanted side effects.

In addition to the use of eprosartan and hydrochlorothiazide, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that eprosartan and hydrochlorothiazide will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

You may take eprosartan and hydrochlorothiazide with or without food.

Dosing

The dose of eprosartan and hydrochlorothiazide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of eprosartan and hydrochlorothiazide. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For high blood pressure:
    • Adults—One tablet once a day. Your doctor may increase your dose as needed.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of eprosartan and hydrochlorothiazide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

It is very important that your doctor check your progress at regular visits to make sure eprosartan and hydrochlorothiazide is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using eprosartan and hydrochlorothiazide while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using eprosartan and hydrochlorothiazide, tell your doctor right away.

Dizziness, lightheadedness, or fainting may also occur, especially when you get up from a lying or sitting position or if you have been taking a diuretic (water pill). Make sure you know how you react to eprosartan and hydrochlorothiazide before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning. If you faint, stop using eprosartan and hydrochlorothiazide and call your doctor right away.

Check with your doctor right away if you become sick while taking eprosartan and hydrochlorothiazide, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water or salt which may cause low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

Check with your doctor immediately if blurred vision, difficulty reading, eye pain, or any other change in vision occurs during or after treatment. This could be a sign of a serious eye problem. Your doctor may want an eye doctor to check your eyes.

eprosartan and hydrochlorothiazide may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests, or if you have any questions, check with your doctor.

Ask your doctor before you use medicines, supplements, or salt substitutes that contain potassium without first checking with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

• Tell all of your health care providers that you take eprosartan and hydrochlorothiazide. This includes your doctors, nurses, pharmacists, and dentists.
• Avoid driving and doing other tasks or actions that call for you to be alert until you see how this medicine affects you.
• To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
• If you have high blood sugar (diabetes), eprosartan and hydrochlorothiazide may sometimes raise blood sugar. Talk with your doctor about how to keep your blood sugar under control.
• Have your blood pressure checked often. Talk with your doctor.
• Have your blood work checked. Talk with your doctor.
• This medicine may affect certain lab tests. Tell all of your health care providers and lab workers that you take this medicine.
• It may take a few weeks to see the full effect.
• If you are taking a salt substitute that has potassium, potassium-sparing diuretics, or potassium, talk with your doctor.
• If you are on a low-salt or salt-free diet, talk with your doctor.
• Talk with your doctor before using OTC products that may raise blood pressure. These include cough or cold drugs, diet pills, stimulants, ibuprofen or like products, and some natural products or aids.
• Talk with your doctor before you drink alcohol or use other drugs and natural products that slow your actions.
• Be careful in hot weather or while being active. Drink lots of fluids to stop fluid loss.
• Tell your doctor if you have too much sweat, fluid loss, throwing up, or loose stools. This may lead to low blood pressure.
• If you take cholestyramine or colestipol, talk with your pharmacist about how to take them with eprosartan and hydrochlorothiazide.
• Watch for gout attacks.
• If you have lupus, this medicine can make your lupus active or get worse. Tell your doctor right away if you get any new or worse signs.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Dizziness.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

No dosage adjustment necessary; use with caution.

Blood pressure; serum electrolytes, BUN, creatinine; weight, I & O reports daily to determine fluid loss

[U.S. Boxed Warning]: Drugs that act on the renin-angiotensin system can cause injury and death to the developing fetus. Discontinue as soon as possible once pregnancy is detected. Also see individual agents.

Applies to eprosartan / hydrochlorothiazide: oral tablet

Along with its needed effects, eprosartan / hydrochlorothiazide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking eprosartan / hydrochlorothiazide:

• Abdominal or stomach pain
• ankle, knee, or great toe joint pain
• arm, back, or jaw pain
• bladder pain
• bloating or swelling of the face, arms, hands, lower legs, or feet
• bloody or cloudy urine
• blurred vision
• chest pain or discomfort
• chest tightness or heaviness
• confusion
• convulsions
• decreased urine output
• difficulty breathing
• difficult, burning, or painful urination
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• dry mouth
• fast, pounding, or irregular heartbeat or pulse
• feeling of warmth
• fever
• flushed or dry skin
• frequent urination
• fruit-like breath odor
• headache
• increased hunger
• increased thirst
• increased volume of pale, dilute urine
• itching of the skin
• joint stiffness or swelling
• loss of appetite
• loss of bladder control
• loss of consciousness
• lower back or side pain
• muscle pain or cramps
• nausea or vomiting
• nervousness
• numbness and tingling of the face, fingers, or toes
• pale, bluish-colored, or cold hands or feet
• pinpoint red or purple spots on the skin
• rapid weight gain
• sudden decrease in the amount of urine
• sudden sweating
• unexplained weight loss
• unusual bleeding or bruising
• unusual tiredness or weakness
• unusual weight gain or loss
• weakness or heaviness of the legs

• Back, leg, or stomach pains
• black, tarry stools
• bleeding gums
• blistering, peeling, or loosening of the skin
• bloody or cloudy urine
• chills
• constipation
• cough or hoarseness
• coughing up blood
• darkened urine
• decreased frequency or amount of urine
• diarrhea
• difficulty with swallowing
• drowsiness
• fever with or without chills
• general body swelling
• general feeling of tiredness or weakness
• hives
• indigestion
• irritability
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• nosebleeds
• pains in the stomach, side, or abdomen, possibly radiating to the back
• pale skin
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• red skin lesions, often with a purple center
• red, irritated eyes
• skin rash
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• swollen or painful glands
• thickening of bronchial secretions
• unusual weight loss
• vision changes
• weak pulse
• weight gain
• yellow eyes or skin

Some side effects of eprosartan / hydrochlorothiazide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Acid or sour stomach
• belching
• body aches or pain
• bone pain
• burning feeling in the chest or stomach
• burning or stinging of the skin
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• burning, dry, or itching eyes
• change in hearing
• cold or flu-like symptoms
• congestion
• continuing ringing or buzzing or other unexplained noise in the ears
• cough producing mucus
• depression
• difficulty moving
• ear drainage
• earache
• excess air or gas in the stomach or intestines
• fear or nervousness
• feeling of constant movement of self or surroundings
• feeling unusually cold
• full feeling
• headache, severe and throbbing
• hearing loss
• heartburn
• increased sweating
• irritation in the mouth
• itching ears
• lack or loss of strength
• loose teeth
• loss of voice
• multiple swollen and inflamed skin lesions
• muscle stiffness
• pain, inflammation, or swelling in the calves, shoulders, or hands
• painful cold sores or blisters on the lips, nose, eyes, or genitals
• passing gas
• persistent breath odor or bad taste in your mouth
• rash with flat lesions or small raised lesions on the skin
• redness and swelling of the gums
• redness or swelling of the ears
• redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
• runny or stuffy nose
• sensation of spinning
• shakiness in the legs, arms, hands, or feet
• shivering
• skin rash, encrusted, scaly, and oozing
• sleepiness or unusual drowsiness
• sneezing
• tender, swollen glands in the neck
• tenderness in the stomach area
• toothache
• trembling or shaking of the hands or feet
• trouble sleeping
• voice changes
• weight loss

• Decreased interest in sexual intercourse
• hair loss or thinning of the hair
• hives or welts
• inability to have or keep an erection
• increased sensitivity of the skin to sunlight
• loss in sexual ability, desire, drive, or performance
• muscle spasm
• redness of the skin
• redness or other discoloration of the skin
• severe sunburn
• tenderness of the salivary glands