Generic name: Clonidine/chlorthalidone - Oral
Brand name(s): Combipres
This product is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.This product contains 2 medications: clonidine and chlorthalidone. Clonidine belongs to a class of drugs (central alpha agonists) that act in the brain to lower blood pressure. It works by relaxing blood vessels so blood can flow more easily. Chlorthalidone is a "water pill" (diuretic) and causes your body to get rid of extra salt and water. This effect may increase the amount of urine you make when you first start the medication. It also helps to relax the blood vessels so that blood can flow more easily.These medications are used together when 1 drug alone is not controlling your blood pressure. Your doctor may direct you to start taking the individual medications first, and then switch you over to this combination product if this is the best dose combination for you.
How to use
Take this medication by mouth with or without food as directed by your doctor, usually once or twice daily. It is best to avoid taking this medication within 4 hours of your bedtime to avoid having to get up to urinate. Consult your doctor or pharmacist if you have questions about your dosing schedule.The dosage is based on your medical condition and response to treatment.If you also take certain drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take this product at least 2 hours before or at least 4 hours after these medications.Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time(s) each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.Do not stop taking this medication without consulting your doctor. You may experience symptoms such as nervousness, agitation, shaking, and headache. A rapid rise in blood pressure may also occur if the drug is suddenly stopped. The risk is greater if you have used this drug for a long time or in high doses, or if you are also taking a beta blocker (such as atenolol). There have also been rare reports of severe, possibly fatal reactions (such as stroke) from stopping this drug too quickly. Therefore, it is important that you do not run out of this medication or miss any doses. Tell your doctor or pharmacist immediately if you are unable to take the medication (for example, due to vomiting). To prevent any reactions while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms immediately.When used for a long time, this medication may not work as well and may require different dosing or an additional medication. Talk with your doctor if this medication stops working well (such as your blood pressure readings remain high or increase).
Before taking this product, tell your doctor or pharmacist if you are allergic to clonidine or chlorthalidone (including having a rash while using clonidine patches); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, heart rhythm problems (such as slow heartbeat, second- or third-degree atrioventricular block), gout, lupus, untreated mineral imbalance (such as low potassium).This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages.Too much sweating, diarrhea, or vomiting may cause loss of too much body water (dehydration) and increase your risk of dizziness or lightheadedness. Report prolonged diarrhea or vomiting to your doctor. Be sure to drink enough fluids to prevent dehydration unless your doctor directs you otherwise.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).If you have diabetes, this product may affect your blood sugar levels. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor immediately if you have symptoms of high blood sugar such as increased thirst and urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.This medication may reduce the potassium levels in your blood. Ask your doctor about adding potassium to your diet. Your doctor may prescribe a potassium supplement.This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors.Contact lens wearers may need to use wetting eye drops since this medication can cause dry eyes.Older adults may be more sensitive to the side effects of this product, especially dizziness.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.
See also How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: cisapride, lithium.Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products, diet aids, or NSAIDs such as ibuprofen, naproxen) because they may contain ingredients that could cause drowsiness or increase your blood pressure. Ask your pharmacist for more details.This product may interfere with certain laboratory tests (including parathyroid test, protein-bound iodide test), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.
Dizziness, lightheadedness, drowsiness, dry mouth, or constipation may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.To relieve dry mouth, suck (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.The chlorthalidone in this product may cause a loss of too much body water (dehydration) and salt/minerals. Tell your doctor right away if you have any symptoms of dehydration or mineral loss, including: extreme thirst, very dry mouth, muscle cramps, weakness, fast/irregular heartbeat, confusion.Tell your doctor right away if you have any serious side effects, including: fainting, slow heartbeat, mental/mood changes (such as irritability, depression), toe/joint pain, change in the amount of urine (not including the normal increase in urine when you first start this drug).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. If you miss 2 or more doses in a row, contact your doctor right away.
If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness/drowsiness, fainting, slow/irregular heartbeat, slow/shallow breathing, seizures.
Do not share this medication with others.Lifestyle changes that may help this medication work better include stress reduction programs, exercise, and dietary changes. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.Laboratory and/or medical tests (including kidney function, blood mineral levels such as potassium) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.Check your blood pressure and pulse (heart rate) regularly while taking this medication. Learn how to monitor your own blood pressure and pulse at home, and share the results with your doctor.
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.