Metoprolol and Hydrochlorothiazide (Oral)

As a diuretic and a beta-blocker, the Metoprolol and Hydrochlorothiazide combination can be an effective form of treatment for some patients suffering from hypertension.


Metoprolol and Hydrochlorothiazide is a drug combination that is given to patients suffering from hypertension (high blood pressure). If you do suffer from this then it is important that you seek suitable medical treatment. If left untreated, hypertension can lead to some very severe medical problems such as heart attacks, kidney failure, or strokes. This is because the high blood pressure increases the workload that your arteries and heart need to perform. Over time, this causes them to no longer be able to function properly, thus causing the aforementioned complications. However, by controlling your blood pressure, you can help prevent these from occurring.

The Metoprolol component of this drug combination is a beta-blocker. This means it can work by affecting the responses sent to certain nerve impulses in parts of your body. This includes the heart. As such, it can cause your heart to beat slower and decrease your blood pressure. By lowering your blood pressure, it allows more oxygen and blood to flow to your heart.

Hydrochlorothiazide is known as a water pill (or diuretic). This means that it can reduce the amount of water in your body by increasing your flow of urine. In turn, this also helps to lower your blood pressure.

Be aware that the Metoprolol and Hydrochlorothiazide combination is only available via a prescription from your doctor. It is only suitable for certain patients, and your doctor will need to first assess your suitability. Instead of this, they may find it more appropriate to prescribe an alternative form of hypertension medication.

Conditions treated

Type of medication

  • Tablet

Side effects

As well as having its intended effect of treating hypertension, it is possible that this drug combination will cause you to experience unwanted side effects, Some patients may suffer from multiple side effects, whereas others may experience none. These side effects can range in their severity and their need for medical assistance. Below is a list of the serious side effects that may occur. If you experience any of these whilst taking the Metoprolol and Hydrochlorothiazide combination drug, you should inform your doctor immediately.

More common

Less common

  • Tightness in your chest

If you experience any of the following signs of an overdose, seek emergency medical assistance.

  • Heaviness or weakness of the legs

Instead of these more serious side effects, you make experience less worrying ones that do not necessarily require medical attention. In fact, you may find that they pass over time as your treatment progresses and your body adjusts to the medicine. Below is a list of such side effects. However, if you do experience any of the following and find them worrying or lingering, you may still contact your doctor for advice.

More common

  • Sleepiness

Less common

  • Inability to keep or have an erection

You may experience other side effects not listed here. If this is the case, you can discuss them with your doctor.


The final dose of this medication will be different for each individual patient. It will depend on your age, weight, and height, any other medical conditions you suffer from and any corresponding medication you take to treat those conditions. Your doctor will also consider the strength of the medication, the duration of your treatment and your reaction to the first dose. Do not change your dose without speaking with your doctor first. To do so could increase your risk of certain side effects or reduce this drug combination's effectiveness in your treatment.

Oral dosage (extended-release tablets) for the treatment of high blood pressure:

Adults: Initially, one tablet daily. Your healthcare team can adjust your dose as necessary.

Children: The final dose and use must be determined by your doctor.

For oral dosage form (tablets):

Adults: 1 or 2 tablets each day, given as either one single dose or divided into different doses. Your healthcare team can adjust your doses as necessary.

Children: The final use and dose will be determined by your doctor.

Missed Dose

If you miss a dose of this drug combination, you need to take it as soon as you have remembered. That is unless it's close to the time of your next dose. In this circumstance, you should skip the dose you have missed and return to your original dosing schedule. Don't double doses.

Proper Use

This medication should not be the 1st medication that you use to treat your condition. It's meant to only be used after you have tried other medication that has caused unwanted side effects or has not been successful in treatment.

In addition to the use of this medication, you may also use other ways to treat your high blood pressure, including changes in the types of food you eat, especially foods high in salt, or weight control. Your doctor will let you know which of these are the most important treatment plans for you.

You should discuss with your doctor before you change your diet.

Many patients who suffer from high blood pressure will not notice any indication of a problem. In fact, most people feel well. It's extremely important that you take your medication exactly as directed and that you keep your appointments with your healthcare team even if you feel okay.

The use of this medication cannot cure your high blood pressure, but it can help control it. You must continue to take it as you have been directed to do so if you expect it to lower your blood pressure and ensure it stays down. Some patients may be required to take high blood pressure medication for the rest of their lives. If high blood pressure is left untreated, it can cause serious issues such as blood vessel disease, heart failure, kidney disease or stroke.

Take the tablet alongside a meal or just after you have eaten. Ensure that you swallow the extended-release tablet whole. Don't chew, crush, or break it. You can take this medication alongside the consumption of food.


Interactions can occur with this medication. These interactions can reduce the effectiveness of the drug in treatment or produce severe side effects. To help limit these interactions occurring, you should give your doctor a complete list of all the current and past medications you have used, including any other medical conditions you suffer from. Your list needs to include all prescription and nonprescription drugs, all vitamin supplements and herbal remedies. When possible, your doctor will avoid treating you with medications that will cause interactions, but in some circumstances, it may be necessary.

The use of this medication alongside any of the following is not recommended. Your doctor may avoid treating you with this drug altogether or alter some of the other medications you are using.

  • Dofetilide

The use of this medication alongside any of the following medications is not typically recommended, however in some cases it may be necessary. If you are prescribed both medications, your doctor may alter the dose or frequency in which you use either medication.

  • Bromfenac

The use of this medication alongside any of the following drugs could increase your risk of some side effects. However, sometimes the use of both drugs may be the best treatment plan for you. If you are given both medications together, your doctor may change the dose or frequency in which you take either or both medications.

  • Propoxyphene

Other Interactions

Certain medications should not be used at or around the time of consuming food or some types of food since interactions can occur. Using tobacco or alcohol with specific medications can also cause interactions to occur.

Discuss with your doctor about the use of this drug combination with food, alcohol or tobacco.

Other Medical Problems

The presence of other medical conditions could affect the use of this medication. Ensure you let your doctor know if you have any other medical conditions, especially:


Before they are able to prescribe you with this medicine, your doctor will need to first assess your condition to decide whether it is the most appropriate course of treatment for you. They may find it more suitable to prescribe you with an alternative form of hypertension treatment. As a part of this examination, they will need you to inform them of any allergies you suffer from. This includes any allergies to dyes, animals, foods, or preservatives.

As of writing, no safety and efficacy have yet been established for the use of this medicine in pediatric patients. This is because no suitable studies have taken place into the effects it has on younger patients compared to adults. Your doctor is best placed to advise you if there are any increased risks to your child of them taking this medicine.

The suitable studies that have so far taken place in older patients have not highlighted any geriatric-specific problems that would make this drug any less useful in elderly patients. Do be aware however that older patients are more likely to suffer from age-related heart, liver, or kidney problems. If applicable, it may mean that greater caution may need to be exercised when taking this drug combination. The dose taken may need to be adjusted.

As of writing, it is unclear as to whether suitable studies have taken place on pregnant women using this medicine. As such, it is unclear as to whether pregnant women or their unborn child are at greater risk of this medicine. Your doctor can advise on these risks.

There are currently no suitable studies that have taken place on breastfeeding women using the Metoprolol and Hydrochlorothiazide combination. Your doctor can advise you of any increased risks to you or your infant child of receiving this medicine. Together, you can weigh these risks against the benefits it offers.

Your doctor will need to see you at regular appointments whilst you are receiving treatment via this drug combination. It is important that you attend all of these so they can check for any unwanted effects and make suitable adjustments to your prescription. You may be required to have urine or blood tests at these appointments.

Some patients may experience heart failure as a result of taking this drug. If you experience any of the following symptoms at any time, contact your doctor immediately:

  • Dilated neck veins

You may experience changes in your blood sugar levels as a result of taking Metoprolol and Hydrochlorothiazide combination. As well as this, it may cover up certain signs of having low blood sugar levels, such as a having a rapid heart rate. If you notice this problem or any changes in your urine or blood tests, you can discuss this with your doctor.

You should ensure that any doctors or dentists that treat you are aware you are taking this drug combination. Before having medical tests or surgery, you may be required to stop taking it up to 7 days before.

You should not drive or perform any other dangerous tasks until you know fully how this drug affects you. Some people can become less alert than usual as a result of taking it.

You should first check with your doctor if you wish to stop taking this medicine. They may require you to stop taking it slowly rather than all at once. If you do stop it suddenly, it can be dangerous as it can make other conditions worse.

If you start having any of the following symptoms, you should inform your doctor right away. They could be signs of a mineral imbalance or dehydration.

  • A dry mouth

If you experience eye pain, difficulty reading, blurred vision, or other changes to your vision whilst taking this drug, you should tell your doctor immediately. They may occur after your treatment as well. They can be signs of an eye problem that is serious. They may need you to have your eyes checked by an ophthalmologist.

You should not take any other drugs at the same time as this one unless they have first been discussed with your doctor. This refers to all prescription and nonprescription drugs. In particular, those for sinus problems, asthma, colds, cough, appetite control, or hay fever. This is because these medicines can increase your blood pressure.


You should store this medicine at room temperature and keep it in a sealed container. Keep it away from direct light, heat, and moisture and never allow it to freeze. Also, keep it stored safely away from children. If you have any medicine left after your treatment, or if any goes out of date, then you should dispose of it safely and sensibly. Your pharmacist or doctor can advise you on how to do this.


When used as directed, this drug combination is successful in the treatment of high blood pressure (hypertension). However, due to a large number of interactions possible, it's important that you give your doctor a full and complete list of all the medications you are currently taking. The safety and efficacy of this drug have not been established for the use in children. It is unknown whether this drug can affect pregnant women or those who are breastfeeding. You should let your doctor know if you are currently pregnant or breastfeeding. You should continue to monitor your progress whilst on this medication and attend all appointments.

It's important you always take your medication, even if you feel normal. Most people who suffer from high blood pressure feel fine. You should let your doctor know if your condition does not improve as you may need to alter your dosage. You will also need to make changes to your diet and weight alongside using this medication and some patients are required to take high blood pressure medication for life. Do not share this medication with anyone else. If you require any further information about the practical uses of this drug combination or you have any more questions, then contact your local healthcare professional or doctor for further instructions.