guanethidine and hydrochlorothiazide Health Article

What other drugs will affect guanethidine and hydrochlorothiazide?

Do not take guanethidine and hydrochlorothiazide if you are taking a monoamine oxidase inhibitor (MAOI), or if you have taken one in the last 14 days. MAOIs, used to treat depression, include isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate).

Before taking this medication, tell your doctor if you are taking any of the following medicines:

• tricyclic antidepressants such as amitriptyline (Elavil, Endep) or doxepin (Sinequan), which may decrease the effects of guanethidine and hydrochlorothiazide;
• other commonly used tricyclic antidepressants, including amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor), and protriptyline (Vivactil);

• digoxin (Lanoxin) or quinidine (Cardioquin, Quinidex, Quinora, Quinaglute), which will increase the risk of experiencing an irregular heartbeat when taken with guanethidine and hydrochlorothiazide;

• barbiturates such as phenobarbital (Luminal, Solfoton), amobarbital (Amytal), and secobarbital (Seconal), which may cause extreme sleepiness or dizziness if taken with guanethidine and hydrochlorothiazide;

• narcotic pain relievers such as codeine (Tylenol #3, Tylenol #4, others), propoxyphene (Darvon, Darvocet, Wygesic), oxycodone (Percodan, Percocet, Tylox), meperidine (Demerol), morphine (MS Contin, Duramorph, others), and others, which also may cause extreme sleepiness or dizziness if taken with guanethidine and hydrochlorothiazide;

• steroid medications such as hydrocortisone (Hydrocortone, Cortef), prednisone (Deltasone, Orasone), prednisolone (Delta Cortef, Prelone), methylprednisolone (Medrol), betamethasone (Celestone), dexamethasone (Decadron, Hexadrol), and others, which may increase the side effects of hydrochlorothiazide;

• prescription and over-the-counter cough, cold, allergy, diet, and sleeping pills, any of which may contain drugs that increase your blood pressure and heart rate and thus decrease the effects of guanethidine;

• the cholesterol-lowering drugs cholestyramine (Questran) and colestipol (Colestid), which may decrease the effects of hydrochlorothiazide if they are used together;

• nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil), ketoprofen (Orudis, Orudis, KT, Oruvail), and naproxen (Naprosyn, Anaprox, Aleve), which may also decrease the effects of hydrochlorothiazide;

• other commonly used NSAIDs, including diclofenac (Cataflam, Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), mefenamic acid (Ponstel), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin);

• oral antidiabetic drugs such as Glipizide (Glucotrol), glyburide (Micronase, Glynase, Diabeta), chlorpropamide (Diabinese), tolazamide (Tolinase) and tolbutamide (Orinase), which may not lower your blood sugar as well during therapy with guanethidine and hydrochlorothiazide (your diabetes therapy may have to be adjusted);

• lithium (Lithobid, Eskalith), which should not be taken with hydrochlorothiazide because serious side effects may result; or

• other drugs that also lower blood pressure, including acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), carteolol (Cartrol), labetalol (Trandate, Normodyne), propranolol (Inderal), pindolol (Visken), timolol (Blocadren), benazepril (Lotensin), enalapril (Vasotec), captopril (Capoten), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), amlodipine (Norvasc), bepridil (Vascor), diltiazem (Cardizem, Dilacor), felodipine (Plendil), isradipine (Dynacirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), and verapamil (Calan, Verelan, Isoptin).

Drugs other than those listed here may also interact with guanethidine and hydrochlorothiazide or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

Your pharmacist has additional information about guanethidine and hydrochlorothiazide written for health professionals that you may read.

What does my medication look like?

Guanethidine and hydrochlorothiazide is available with a prescription under the brand name Esimil. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

guanethidine/hydrochlorothiazide strengths are as follows:

• Esimil 10 mg/25 mg--round, white scored tablets

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.