Reserpine, Hydralazine, and Hydrochlorothiazide (Oral)

This particular combination of medicines has a triple effect - acting on the nerve impulses (Reserpine), allowing the blood vessels to relax (Hydralazine), and lessening levels of water in the patient's body (Hydrochlorothiazide). All three combined can drastically reduce levels of blood pressure.

Overview

Reserpine, Hydralazine, and Hydrochlorothiazide is a popular combination medication used in the treatment of hypertension, or high blood pressure).

Excessive blood pressure increases the heart's workload, as well as that of the arteries. Should the condition continue for an extended period of time, it is possible that the arteries and the heart might not function as they should. This could result in damage to the blood vessels, particularly in the kidneys, the heart, and the brain. The impact of this can include a number of serious and potentially life-threatening conditions, such as renal (kidney) failure, heart failure, or a stroke. Hypertension is also a leading cause of heart attacks. Suitable control of a patient's blood pressure can result in a lower risk of such conditions occurring.

Reserpine, Hydralazine, and Hydrochlorothiazide combination is effective as a consequence of the triple impact of its composite parts.

Reserpine controls impulses in the nerves that move along particular nerve pathways. The resulting effect of this is to cause the blood vessels and the heart to reduce blood pressure in the patient.

Hydralazine relaxes the blood vessels in the body. The resulting effect of this is to increase the flow of blood that passes to the heart, thus reducing the amount of work it has to do.

Hydrochlorothiazide is a water pill, or thiazide diuretic, that increases the production and expulsion of urine from the patient's body. The resulting effect of this is the reduction of water in a patient's body, which consequently aids in the lowering of blood pressure.

Reserpine, Hydralazine, and Hydrochlorothiazide combination is only available via a prescription from your doctor.

Reserpine, Hydralazine, and Hydrochlorothiazide combination is available in the following forms:

  • Tablet

Conditions Treated

Type of Medicine

  • Antihypertensive
  • Thiazide diuretic

Side Effects

There have been suggestions that certain rauwolfia alkaloids (such as those found in reserpine) can increase the chance of contracting breast cancer later in a patient's life. These suggestions have yet to be proven, though studies in mice and rats, who were administered with between 100 and 300 time the recommended dosage for humans, resulted in an increased amount of tumors.

As well as its necessary and anticipated effects, any medication might result in a number of less desired effects. Whilst there's no assurance that all or any of these negative impacts might take place, should any of them present themselves, you may require the attention of a medical professional.

More common

  • a general sensation of weakness, illness, or discomfort

Less common

  • nightmares, sleeplessness early in the morning, or vivid dreams
  • anxiety or nervousness
  • being unable to concentrate, or mental depression
  • weakness, or lacking in energy
  • decrease in sexual interest, or impotence
  • faintness or drowsiness

Symptoms and signs of excessive loss of potassium

  • weak pulse
  • muscle pain or cramps
  • mental or mood changes
  • irregular heartbeat
  • increased thirst
  • dryness to the mouth

Symptoms and signs of excessive loss of sodium

  • unusual weakness or tiredness
  • muscle cramps
  • irritability
  • decrease in mental activity
  • convulsions
  • confusion

Less common

  • swelling of your lymph glands
  • stomach pain or cramps
  • slow heartbeat
  • itching skin, or rash
  • shortness whilst breathing
  • weakness, pain, tingling, or numbness to the feet and hands
  • joint pain
  • irregular heartbeat
  • headache
  • sore throat and fever
  • chest pain
  • blood in your vomit
  • blisters to the skin
  • tarry, black stools

Rare

  • yellow skin or eyes
  • unusual bruising or bleeding
  • shaking and trembling of fingers and hands
  • severe stomach pain accompanied by vomiting and nausea
  • stiffness
  • difficult or painful urination
  • side or lower back pain

Symptoms and signs of an overdose

  • slow pulse
  • pupils shrinking to pinpoints
  • severe vomiting or nausea
  • muscle pain or cramps
  • increase in thirst
  • flushing of the skin
  • dryness in the mouth
  • severe drowsiness or dizziness

Certain side effects can present themselves which do not normally require any kind of medical attention. Effects of this nature often disperse of their own accord once your body has adjusted to your new medication. Furthermore, it is possible that your prescribing doctor can recommend some way of effectively managing at least a few of the side effects. Should any of these following impacts continue to affect you during your treatment, or should any of them become bothersome, be sure to consult your examining doctor.

More common

  • stuffy nose
  • vomiting or nausea
  • lack of appetite
  • dizziness, particularly if rising from a seated or prone position
  • diarrhea

Less common

  • irritated or watering eyes
  • swelling of lower legs and feet
  • increased skin sensitivity to sunlight
  • reddening or flushing of the skin

Once you stop taking Reserpine, Hydralazine, and Hydrochlorothiazide combination you might still experience certain side effects which will require attention. Throughout this time, you ought to consult with your prescribing doctor should any of the negative effects begin to concern you.

Some side effects (ones not listed above) can also present themselves amongst some patients. Should you become aware of any other negative effects, be sure to consult your examining professional.

Dosage

The dosage of reserpine, hydralazine, and hydrochlorothiazide combination will likely differ between different patients. You must follow your prescribing doctor's directions, or follow the instructions printed on the medication's label. The information that follows only includes average dosage amounts of this combination drug. Should you be prescribed a dose that is either higher or lower than those listed here, you shouldn't alter it, unless specifically advised to do so by your examining physician.

The quantity of reserpine, hydralazine, and hydrochlorothiazide combination you need to take will be dependent upon how strong the medicine is. Additionally, the amount of dosages to be taken per day, the time to elapse between each dose, and the duration of your course of treatment will depend upon the condition you are treating with the drug.

For oral dosage tablets:

For high blood pressure:

Adults:

One or two tablets, taken three times throughout the day

Children:

The use and dosage will be decided upon by your prescribing doctor.

If, for some reason, you should miss a dosage of reserpine, hydralazine, and hydrochlorothiazide combination, you ought to take it at the earliest opportunity. That said, should it almost be time for you to take your next dosage, you ought to skip the dosage you have missed, and return to the regular dosing schedule. On no account should you double your doses.

Interactions

Whilst some drugs shouldn't be taken with one another under any circumstances, in some cases a pair of differing medications can be utilised concurrently, even if known interactions are likely to occur. In such cases, your examining doctor might wish to amend the dosage, or they might consider other precautions are necessary when prescribing both types of drug. When you have been prescribed reserpine, hydralazine, and hydrochlorothiazide combination, it is vitally important that you make your doctor aware if you currently take any drugs listed below. These interactions are listed based upon their likely significance, and the list might not be exhaustive.

Using Reserpine, Hydralazine, and Hydrochlorothiazide combination with any drygs listed here is not to be recommended. Your examining doctor may choose to not treat you using this particular medication, or may choose to amend one or more of your other drugs.

  • Tranylcypromine
  • Toloxatone
  • Tetrabenazine
  • Selegiline
  • Rasagiline
  • Procarbazine
  • Phenelzine
  • Pargyline
  • Nialamide
  • Moclobemide
  • Linezolid
  • Lazabemide
  • Isocarboxazid
  • Iproniazid
  • Furazolidone
  • Dofetilide
  • Clorgyline
  • Brofaromine

Using Reserpine, Hydralazine, and Hydrochlorothiazide combination concurrently with one or more of the drugs listed below would not normally be recommended. However, such a course of treatment might be necessary under certain circumstances. Should your examining doctor prescribe both medicines at the same time, they might choose to alter your dosage, or the frequency at which you take one or other of these medications.

  • Valdecoxib
  • Tolmetin
  • Tolfenamic Acid
  • Tiaprofenic Acid
  • Tenoxicam
  • Sulindac
  • Sotalol
  • Sodium Salicylate
  • Salsalate
  • Salicylic Acid
  • Rofecoxib
  • Proscillaridin
  • Proquazone
  • Propyphenazone
  • Proglumetacin
  • Piroxicam
  • Piketoprofen
  • Phenytoin
  • Phenylbutazone
  • Parecoxib
  • Oxyphenbutazone
  • Oxaprozin
  • Ouabain
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Niflumic Acid
  • Nepafenac
  • Naproxen
  • Nabumetone
  • Morniflumate
  • Metildigoxin
  • Methotrexate
  • Meloxicam
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Loxoprofen
  • Lornoxicam
  • Lithium
  • Levomethadyl
  • Ketorolac
  • Ketoprofen
  • Ketanserin
  • Iobenguane I 123
  • Indomethacin
  • Ibuprofen
  • Fosphenytoin
  • Flurbiprofen
  • Flufenamic Acid
  • Floctafenine
  • Flecainide
  • Feprazone
  • Fepradinol
  • Fenoprofen
  • Felbinac
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Droxicam
  • Droperidol
  • Dipyrone
  • Digoxin
  • Digitoxin
  • Digitalis
  • Diflunisal
  • Diclofenac
  • Dexketoprofen
  • Dexibuprofen
  • Deslanoside
  • Cyclophosphamide
  • Colchicine
  • Clonixin
  • Choline Salicylate
  • Celecoxib
  • Bufexamac
  • Bromfenac
  • Aspirin
  • Arsenic Trioxide
  • Amtolmetin Guacil
  • Amphetamine
  • Acetyldigoxin
  • Acemetacin
  • Aceclofenac

Using reserpine, hydralazine, and hydrochlorothiazide combination in tandem with the following drugs can result in a higher chance of certain negative impacts, but utilizing both of the drugs at the same time could be the most effective form of treatment for you. If prescribing both medications together, your examining doctor might amend your dosage of either or all of the drugs.

  • Yohimbine
  • Topiramate
  • Licorice
  • Gossypol
  • Ginkgo
  • Cholestyramine
  • Carbamazepine
  • Bepridil

Using Reserpine, Hydralazine, and Hydrochlorothiazide combination with the following could increase the chance of some certain side effects, though it might well be unavoidable under certain conditions. Speak to your examining doctor, should you have any concerns.

  • Food
  • Enteral nutrition

Warnings

Inform your doctor, should you have suffered an allergic reaction when taking reserpine, hydralazine, and hydrochlorothiazide combination in the past, or when taking any kind of medication.

It is not expected that reserpine, hydralazine, and hydrochlorothiazide combination will result in different effects amongst children than amongst adults.

It is not expected that reserpine, hydralazine, and hydrochlorothiazide combination will result in different effects amongst the elderly.

No adequate studies have been conducted to determine if reserpine, hydralazine, and hydrochlorothiazide combination will result in different effects amongst pregnant women.

Studies suggest that reserpine, hydralazine, and hydrochlorothiazide combination only poses minimal risk to nursing infants during breastfeeding.

Many patients suffering from hypertension may not even notice the signs or symptoms of the condition. Indeed, many sufferers might feel perfectly normal. It is essential that you use your reserpine, hydralazine, and hydrochlorothiazide combination exactly as your prescribing doctor recommends, and that any appointments you might have with the doctor are kept to, even should you feel fine.

It is important to remember that reserpine, hydralazine, and hydrochlorothiazide combination is not a cure for hypertension, merely a way to help you control it. As such, you must continue taking its specifically as your doctor instructs if you wish your blood pressure to be reduced and kept down. You might be required to take medication for your hypertension over the rest of your life. Should you not control it as advised by your prescribing doctor, hypertension can result in severe medical conditions, including kidney disease, stroke, blood vessel disease, and heart failure.

Reserpine, Hydralazine, and Hydrochlorothiazide combination can cause an unusual sensation of tiredness at the start of your course of treatment. You might also notice increased amounts of urine being produced, or at a greater frequency. These effects are likely to subside once you have been taking your medication for a little while. To prevent your increased need for urination affecting how well you sleep:

  • If you only need to take one dose per day, be sure to take it first thing in a morning, after your breakfast.
  • If you need to take over one dose per day, be sure that your last dosage is taken no later than six o'clock in the evening unless your prescribing doctor directs otherwise.

It is always best that you plan your dosage on a schedule which will affect your daily activities and your sleep pattern to the least degree. If you need advice on the best times of day to take your reserpine, hydralazine, and hydrochlorothiazide combination, consult with your prescribing doctor.

It is advisable that you get into a habit of using your medication at the same times every day, in order to assist you in remembering to take it.

If reserpine, hydralazine, and hydrochlorothiazide combination starts to upset your stomach, remember that it can be taken alongside meals, or with a glass of milk. If your upset stomach (including stomach cramps or pains, vomiting, and nausea) persists, be sure to consult your prescribing doctor.

It is vital that you have regular visits with your consulting doctor so that they might check out your progress, and determine that your course of reserpine, hydralazine, and hydrochlorothiazide combination is working as it should.

You should not take any other medication whilst on reserpine, hydralazine, and hydrochlorothiazide combination, unless you have first discussed their use with your prescribing doctor. This particularly includes non-prescription, over-the-counter drugs that are taken to aid with sinus problems, hayfever, coughs, colds, asthma, or controlling your appetite, as many of them are known to increase levels of blood pressure in a patient.

Before you undergo any type of surgery (which includes dental surgery), and before you undergo any type of emergency treatment, you must ensure that the dentist or doctor in charge of the procedure is aware that you are currently taking reserpine, hydralazine, and hydrochlorothiazide combination.

Reserpine, Hydralazine, and Hydrochlorothiazide combination can cause certain to exhibit headaches, or cause them to feel drowsy or dizzy. Be sure you're aware of your own reaction to the drug before choosing to drive, or use machinery, or take part in any other activity that would prove dangerous should you not be fully alert, or should you be dizzy.

Reserpine, Hydralazine, and Hydrochlorothiazide combination can exacerbate the effects caused by alcohol and some other CNS depressants (that is, medications that act by slowing down a patient's nervous system, which can possibly result in drowsiness). This includes hay fever medication (antihistamines), anesthetics (which includes dental anesthetics), muscle relaxants, medicine for treating seizures, barbiturates, prescription narcotics or pain medication, or sleeping medication. Before you take any of these whilst on your course of reserpine, hydralazine, and hydrochlorothiazide combination, be sure to speak to your prescribing doctor.

Reserpine, hydralazine, and hydrochlorothiazide combination can result in a reduction in the levels of potassium in your body. Your doctor may offer recommendations to prevent this occurrence, including the following:

  • consume foods and drinks that boast a high level of potassium (this can include citrus fruits like oranges, either as solid food, or in juice form).
  • take a supplement of potassium
  • take some other form of medication in order to curtail the potassium loss before it starts.
  • It is vital that you follow the above directions. It is equally important that you not alter your diet without seeking medical advice on the matter. This is an even more pressing consideration should your already be on a specialized diet (for instance, if you are on a diabetic diet), or should you be taking some kind of potassium supplement, or other medication for reducing potassium loss. Additional potassium might not be required and, under certain circumstances, excess potassium may be harmful.

Consult with your prescribing doctor should you start to feel sick, or should you present with continuing or severe diarrhea, vomiting, or nausea, since these conditions can result in you losing additional potassium and water.

For patients with diabetes:

  • Reserpine, hydralazine, and hydrochlorothiazide combination can result in increased levels of sugar in the blood. Whilst taking this medication you should be particularly vigilant while testing for levels of sugar in your expelled urine. Should you have queries or concerns on this matter, you ought to consult your prescribing doctor for advice.

Some patients prescribed reserpine, hydralazine, and hydrochlorothiazide combination can experience increased sensitivity to sunlight compared to normal. Being exposed to sunlight for even brief periods can result in changes to vision, discoloration, itching, reddening, or rashes on the skin, or severe sunburn. When you first start to take this combination drug:

  • Avoid direct sunlight where possible, particularly between 10 o'clock in the morning and 3 o'clock in the afternoon.
  • Wear clothing that will protect you from the sun, including sunglasses and a hat.
  • Apply sun protection with an SPF (skin protection factor) of 15 or more. Certain patients might need to apply a sunblock that has a higher skin protection factor, should they have a particularly fair complexion. Should you have any concerns or queries on this, you ought to discuss the matter with your prescribing doctor.
  • Do not utilize a tanning booth, tanning bed, or a sunlamp.
  • If you suffer from a severe reaction to the sun, be sure to check with a doctor.

Reserpine, hydralazine, and hydrochlorothiazide combination often results in nasal stuffiness. That said, it is not advised that you take any form of nasal decongestant medication without checking with a medical professional first.

Reserpine, hydralazine, and hydrochlorothiazide combination can result in dryness in the mouth. You can attain some temporary relief by using a saliva substitute, melting pieces of ice in the mouth, or taking sugarless candy or gum to promote saliva production. However, should the condition carry for longer than two weeks, you should consult your dentist or prescribing doctor. A continuing dryness in the mouth can increase the risk of developing a dental disease, such as fungal infections, gum disease, and tooth decay.

Certain medical conditions can have an effect on how reserpine, hydralazine, and hydrochlorothiazide combination is used. If you suffer from any other illnesses, particularly if it is one or more of those listed beneath, ensure that you inform your prescribing doctor.

Resperine should not be prescribed to people suffering from the following conditions, as it has been shown to cause breathing problems.

  • breathing problems (including asthma) or allergies

Hydrochlorothiazide should be prescribed with care to people suffering from the following conditions, as its use can alter the dosage of diabetes medication required.

  • Diabetes mellitus - Type 2

Reserpine should be prescribed with caution to people suffering from the following conditions, as it has been shown to increase stomach activity, which can worsen the condition.

Hydrochlorothiazide should be prescribed with caution to people suffering from the following conditions, as it has been demonstrated to increase levels of uric acid in a patient's blood, which may result in gout

  • History of gout

Resperine should be prescribed with caution amongst patients suffering from the following conditions, as it has been shown to cause issues with heart rhythm, as well as slowing down a patient's heartbeat.

  • Heart disease

Hydralazine and hydrochlorothiazide should be prescribed with caution amongst patients who suffer from the following conditions. The known impacts of hydralazine can be increased, as they are removed more slowly from the body. In severe cases, hydrochlorothiazide might not work at all.

  • Kidney disease

Hydrochlorothiazide should be prescribed with caution to people suffering from the following conditions, as it induces the loss of water from a patient's body, which can worsen the condition.

Hydrochlorothiazide should be prescribed with caution to people suffering from the following conditions, as it has been shown to worsen the condition.

  • History of lupus erythematosus

Reserpine should be prescribed with caution to people suffering from the following conditions, as it has been shown to cause mental depression.

  • History of mental depression

Reserpine should be prescribed with caution to people suffering from the following conditions, as it has been shown to result in effects that mirror those exhibited by sufferers of the disease.

The overall impact of reserpine, hydralazine, and hydrochlorothiazide combination is to reduce a patient's blood pressure. Therefore, it should be prescribed with caution among patient's suffering from the following conditions, as a lowered level of blood pressure can possibly worsen the condition.

Storage

Store any reserpine, hydralazine, and hydrochlorothiazide combination away from moisture, as well as heat, and direct light, inside a closed container. Be sure you keep it from freezing.

Reserpine, hydralazine, and hydrochlorothiazide combination must always kept away from children.

You should not keep hold of any reserpine, hydralazine, and hydrochlorothiazide combination that is no longer required, or out of date.

Summary

Reserpine, hydralazine, and hydrochlorothiazide combination is commonly prescribed for the treatment of hypertension (or, high blood pressure).

This combination has a triple effect, affecting nerve impulses, relaxing blood vessels, and reducing the water in the patient's body. The three effects combined can cause a drastic reduction in a patient's blood pressure.

Excessive blood pressure affects the arteries and the heart and, if left unchecked, can result in damage to the kidneys, heart, and brain, potentially causing serious medical conditions such as renal failure, heart failure, or strokes. Additionally, hypertension is a known contributor to the likelihood of having a heart attack.

Reserpine effects the nerves in the heart and the blood vessels, reducing blood pressure. Hydralazine relaxes the blood vessels in the body, increasing the flow of blood that passes to the heart, and reducing the work it needs to do. Hydrochlorothiazide is a diuretic, or water pill, promotes the expulsion of urine from the patient's body, to reduction bodily water and lower blood pressure.

 

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Last Reviewed:
February 01, 2018
Last Updated:
January 27, 2018