When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to metoprolol, hydrochlorothiazide, or sulfa drugs.

How to Use This Medicine:
Tablet, Long Acting Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Tablet: Take it with a meal or just after a meal.
• Extended-release tablet: Take it with or without food. Swallow the extended-release tablet whole. Do not crush, break, or chew it.
• Missed dose: If you miss a dose or forget to use your medicine, skip the missed dose. Never take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some foods and medicines can affect how metoprolol/hydrochlorothiazide works. Tell your doctor if you use the following:
  
  • Cholestyramine, cimetidine, clonidine, colestipol, digoxin, diphenhydramine, fluoxetine, hydroxychloroquine, lithium, methyldopa, paroxetine, propafenone, quinidine, reserpine, ritonavir, terbinafine, thioridazine
  • Insulin or diabetes medicine
  • MAO inhibitor (MAOI)
  • NSAID pain or arthritis medicine (such as aspirin, diclofenac, indomethacin, naproxen)
  • Steroid medicine (such as hydrocortisone, methylprednisolone, prednisolone, prednisone)
• Ask your doctor before you use medicines, supplements, or salt substitutes that contain potassium.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart or blood vessel disease, heart rhythm problems (such as bradycardia), glaucoma, gout, diabetes, lupus, an overactive thyroid, pheochromocytoma, trouble urinating, or a history of asthma or lung disease.
• This medicine may cause new or worsening heart failure.
• Do not stop using this medicine suddenly without asking your doctor, or you could develop life-threatening heart problems.
• Tell any doctor or dentist who treats you that you are using this medicine, especially before you have any type of surgery.
• This medicine may cause you to feel dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you are dizzy or lightheaded.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Change in how much or how often you urinate
• Chest pain that may spread, nausea, unusual sweating, fainting
• Confusion, weakness, and muscle twitching
• Dry mouth, increased thirst, or muscle cramps
• Eye pain, vision changes, seeing halos around lights
• Lightheadedness, dizziness, or fainting
• Slow, fast, pounding, or uneven heartbeat
• Sudden and severe stomach pain, nausea, or vomiting
• Swelling in your hands, feet, ankles, or legs, tiredness
• Trouble breathing or wheezing

If you notice these less serious side effects, talk with your doctor:

• Depression
• Diarrhea, constipation, loss of appetite, or stomach upset

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088