When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to propranolol, hydrochlorothiazide, sulfa drugs (such as sulfamethoxazole, Bactrim®, Septra®), or certain blood pressure medicines (such as atenolol, metoprolol, Tenormin®). You should not use this medicine if you are not able to form urine (anuria), or if you have asthma or certain heart problems. Talk with your doctor about what these heart problems are.

How to Use This Medicine:
Capsule, Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• This medicine 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.
• Carefully follow your doctor's instructions about any special diet. Be sure to drink plenty of fluids if you exercise, sweat more than usual, or have diarrhea or vomiting. Check with your doctor right away if you continue to experience diarrhea or vomiting.

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

• Make sure your doctor knows if you are also using amiodarone (Cordarone®), clonidine (Catapres®, Combipres®), deserpidine (Dureticyl®, Harmonyl®), digoxin (Lanoxin®), epinephrine (Epi-Pen®), fentanyl (Actiq®, Duragesic®), haloperidol (Haldol®), ketanserin (Sufrexal®), lithium (Eskalith®, Lithobid®), reserpine (Ser-ap-es®), thioridazine (Mellaril®), verapamil (Calan®, Covera®, Isoptin®), pain or arthritis medicine (such as aspirin, diclofenac, ibuprofen, Advil®, Aleve®, Motrin®, or Orudis®), or a steroid medicine (such as cortisone, prednisone, Azmacort®, Flonase®, or Medrol®).
• Tell your doctor if you are also using aluminum hydroxide gel (Amphojel®), antipyrine, chlorpromazine (Thorazine®), cimetidine (Tagamet®), insulin, lidocaine (Xylocaine®), norepinephrine, phenobarbitone, phenytoin (Dilantin®), rifampin (Rifadin®, Rimactane®), theophylline (Theo-Dur®), thyroxine, or tubocurarine.
• Do not use medicines, supplements, or salt substitutes that contain potassium without checking first with your doctor.
• Do not drink alcohol while you are using this medicine.
• 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:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, blood vessel disorders, chest pain (angina), congestive heart failure, circulation problems, or a history of mineral imbalance (such as high or low calcium, magnesium, potassium, or sodium in the blood). Tell your doctor if you have diabetes, gout, lung problems, lupus, overactive thyroid, or Wolff-Parkinson-White syndrome.
• This medicine 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.
• This medicine may cause serious allergic reactions including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, lips, tongue, or throat while you are using this medicine.
• This medicine may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort; dilated neck veins; extreme fatigue; irregular breathing; an irregular heartbeat; shortness of breath; swelling of the face, fingers, feet, or lower legs; weight gain; or wheezing.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests.
• Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin; red skin lesions; severe acne or skin rash; sores or ulcers on the skin; or fever or chills while you are using this medicine.
• Check with your doctor right away if you start having dry mouth, increased thirst, muscle cramps, nausea or vomiting, unusual tiredness or weakness, severe drowsiness or dizziness, seizures, a decrease in urine, or a fast heartbeat while you are using this medicine. These may be symptoms of dehydration or mineral imbalance.
• Stop using this medicine and check with your doctor immediately if blurred vision, difficulty in 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 will want you to have your eyes checked by an eye doctor.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• If you stop using this medicine, your blood pressure may go up. High blood pressure usually has no symptoms. Even if you feel well, do not stop using the medicine without asking your doctor.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments. Blood and urine tests may be needed to check for unwanted effects.

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, or red skin rash.
• Blurred vision or changes in vision.
• Change in how much or how often you urinate.
• Chest pain (may be related to your disease and not a side effect).
• Confusion, body weakness, or muscle twitching.
• Dry mouth, increased thirst, muscle cramps, nausea, or vomiting.
• Fast, slow, or uneven heartbeat.
• Lightheadedness, dizziness, or fainting.
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
• Seizures.
• Shortness of breath, cold sweat, and bluish-colored skin.
• Swelling in your hands, ankles, or feet.
• Unusual tiredness or weakness.
• Yellowing of your skin or the whites of your eyes.

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

• Diarrhea or constipation.
• Loss of appetite.
• Mild skin rash.

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