Reserpine, hydralazine, and hydrochlorothiazide (patient information)

IMPORTANT WARNING:
Reserpine, hydralazine, and hydrochlorothiazide is no longer available in the U.S. If you are currently taking reserpine, hydralazine, and hydrochlorothiazide, you should call your doctor to discuss switching to another treatment.

Why is this medication prescribed
The combination of reserpine, hydralazine, and hydrochlorothiazide is used to treat high blood pressure. Reserpine and hydralazine work by relaxing the blood vessels so that blood can flow more easily through the body. Hydrochlorothiazide helps to lower blood pressure by eliminating unneeded water and salt from the body.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used
This medication comes as a tablet to take by mouth. It usually is taken twice a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take reserpine, hydralazine, and hydrochlorothiazide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

This medication controls high blood pressure but does cure it. Continue to take reserpine, hydralazine, and hydrochlorothiazide even if you feel well. Do not stop taking reserpine, hydralazine, and hydrochlorothiazide without talking to your doctor. Abruptly stopping this medication may increase blood pressure and cause unwanted side effects.

What special precautions should I follow
Before taking reserpine, hydralazine, and hydrochlorothiazide:


 * tell your doctor and pharmacist if you are allergic to reserpine, hydralazine, hydrochlorothiazide, sulfa drugs, tartrazine (a yellow dye in some medications and processed foods), or any other drugs.
 * tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially amitriptyline (Elavil), aspirin, clomipramine (Anafranil), desipramine (Norpramin), digoxin (Lanoxin), doxepin (Adepin, Sinequan), ephedrine, epinephrine, imipramine (Tofranil), indomethacin (Indocin), MAO inhibitors [phenelzine (Nardil) and tranylcypromine (Parnate)], methylphenidate (Ritalin), metoprolol (Lopressor), nortriptyline (Aventyl, Pamelor), phenylephrine, propranolol (Inderal), protriptyline (Vivactil), quindine (Quinaglute), trimipramine (Surmontil), and vitamins.
 * tell your doctor if you have or have ever had liver or kidney disease, asthma, lupus, gallstones, diabetes, a heart attack, coronary artery disease, rheumatic heart disease, a history of depression, an ulcer, ulcerative colitis, or electric shock therapy.
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking reserpine, hydralazine, and hydrochlorothiazide, call your doctor.
 * if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking this medication.
 * you should know that this medication may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how it affects you.
 * ask your doctor about the safe use of alcohol while you are taking reserpine, hydralazine, and hydrochlorothiazide. Alcohol can make the side effects from this medication worse.

What special dietary instructions should I follow
Your doctor may prescribe a low-salt or low-sodium diet. Follow these directions carefully.

Take reserpine, hydralazine, and hydrochlorothiazide with meals or a snack.

What should I do if I forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Mild side effects
''Reserpine, hydralazine, and hydrochlorothiazide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:''


 * dizziness
 * frequent urination
 * flushing (feeling of warmth)
 * headache
 * loss of appetite
 * upset stomach
 * vomiting
 * diarrhea
 * eye tearing
 * stuffy nose
 * dry mouth
 * decreased sexual ability
 * rash

Severe side effects
If you experience any of the following symptoms, call your doctor immediately:


 * depression
 * nightmares
 * fainting
 * joint pain
 * muscle weakness or cramps
 * unexplained fever
 * yellowing of the skin or eyes
 * numbing or tingling in hands or feet
 * chest pain
 * swollen ankles or leg pain

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know
Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to this medication.

Weigh yourself every day. Call your doctor if you experience rapid weight gain.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

 * Ser-Ap-Es®
 * Serathide®
 * Tri-Hydroserpine®