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pindolol - hydrochlorothiazide
How does this medication work? What will it do for me?
Viskazide is a combination product that contains 2 medications: pindolol and hydrochlorothiazide. It is used to treat high blood pressure. Pindolol belongs to a class of medications called beta-blockers that helps to lower blood pressure by decreasing the demands on the heart. Hydrochlorothiazide is a diuretic, or water pill, which helps control blood pressure by getting rid of excess salt and water.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
10 mg/25 mg
Each peach, round, compressed tablet, 9 mm diameter, one side slope-faced and bisected with "10/25" embossed on each side of the bisect, reverse side flat-faced with bevelled-edge and embossed with "VISKAZIDE" around the circumference and a logo centered, contains 10 mg of pindolol and 25 mg of hydrochlorothiazide. Nonmedicinal ingredients: D&C Red No. 21 Aluminium Lake, D&C Yellow No. 10 Lake, magnesium stearate, microcrystalline cellulose, pregelatinized starch, and silicon dioxide.
10 mg/50 mg
Each orange, round, compressed tablet, 9 mm diameter, one side slope-faced and bisected with "10/50" embossed on each side of the bisect, reverse side flat-faced with bevelled-edge and embossed with "VISKAZIDE" around the circumference and a logo centered, contains 10 mg of pindolol and 50 mg of hydrochlorothiazide. Nonmedicinal ingredients: D&C Red No. 21 Aluminium Lake, D&C Yellow No. 10 Lake, magnesium stearate, microcrystalline cellulose, pregelatinized starch, and silicon dioxide.
How should I use this medication?
The eventual dose of pindolol – hydrochlorothiazide is determined by treating with each of the ingredients separately (i.e., pindolol and hydrochlorothiazide) and finding the best daily dose for each. The combination medication may then be used at the appropriate dose.
The usual adult dose of pindolol – hydrochlorothiazide ranges from 1 tablet daily of 10 mg pindolol and 25 mg hydrochlorothiazide to 2 tablets of 10 mg pindolol and 50 mg hydrochlorothiazide, taken in the morning.
Do not stop taking this medication without first talking with your doctor. Stopping the medication suddenly after you have been taking it for a while may cause unpleasant and potentially harmful effects.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication in its original package at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not take this medication if you:
- are allergic to pindolol, hydrochlorothiazide, or any ingredients of the medication
- are allergic to sulfonamides (sulfa drugs)
- are in cardiogenic shock
- are scheduled to have surgery using certain types of anesthetics (e.g., ether)
- are unable to produce urine or are unable to urinate
- have serious heart block (second- and third-degree AV block) or sick sinus syndrome
- have a severely slow heart rate
- have a very enlarged heart
- have asthma or other obstructive respiratory diseases
- have congestive heart failure
- have right ventricular failure secondary to pulmonary hypertension (excessive blood pressure in the lungs)
- have Prinzmetal’s angina
- have untreated pheochromocytoma (a tumour of the adrenal gland)
- have severe blockages in the arteries away from the heart
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- decreased interest in sexual activity
- excessive sweating
- fatigue or weakness
- increased sensitivity of skin to sunlight (e.g., skin rash, itching, redness or other discoloration of skin, or severe sunburn)
- loss of appetite
- muscle cramps or pain
- numbness or tingling of fingers and toes
- sleep disturbances
- stomach discomfort or upset
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- chest pain
- cold hands and feet
- difficulty breathing or wheezing
- electrolyte imbalance (e.g., weakness, drowsiness, muscle pain or cramps, irregular heartbeat)
- flare-up of psoriasis (e.g., pinpoint-sized red spots on skin, red, scaling, or crusted skin)
- increased frequency of infections (e.g., fever, chills, cough, or sore throat)
- joint pain
- non-melanoma skin cancer (e.g., slowly changing discoloured patch on the skin; red, pink lumps on the skin; flat, scaly patches)
- racing or pounding heartbeat
- signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
- signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
- signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
- signs of heart failure (e.g., shortness of breath, fatigue, swelling in legs, ankles, feet)
- signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine, change of urine colour)
- signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss,
- slow heartbeat (especially less than 50 beats per minute)
- swelling of ankles, feet, or lower legs
- symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
- symptoms of low blood pressure (e.g., dizziness, lightheadedness upon rising from sitting or lying position)
- vision problems, eye pain
Stop taking the medication and seek immediate medical attention if any of the following occur:
- signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
- signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
- signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergic reaction: Some people who are allergic to sulfonamide medications also experience allergic reactions to hydrochlorothiazide. Before you take this medication, inform your doctor about any previous adverse reactions you have had to medications, especially to sulfonamide antibiotics or diabetes medications. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.
Breathing problems: In general, people who have asthma and certain other breathing problems or chronic lung disease should use pindolol cautiously, as it can cause breathing difficulty. Low doses of this medication may be taken with caution by those with asthma who do not respond to or cannot tolerate alternative treatment. If you have breathing problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Cholesterol: Increases in cholesterol and triglyceride levels may occur when taking hydrochlorothiazide. Your doctor may want you to have regular blood tests to monitor your cholesterol levels while you are taking this medication. If you have increased cholesterol or triglyceride levels, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Diabetes: The signs of low blood sugar may not be as noticeable when taking pindolol. Hydrochlorothiazide may make it more difficult for people with diabetes to control their blood sugar. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. It may be necessary to monitor your blood glucose levels more often when you are taking this medication. Dose adjustment of diabetes medications, including insulin, may be necessary.
Drowsiness/reduced alertness: Dizziness or fatigue may occur when starting treatment with this medication and may impair your ability to drive or operate machinery. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how you are affected by this medication.
Fluid and electrolyte balance: Levels of electrolytes such as potassium, sodium, magnesium, and chloride can be reduced by the use of hydrochlorothiazide. Your doctor will periodically check to see if your electrolytes remain in balance. A potassium supplement may be necessary when taking this medication. Warning signs or symptoms of fluid and electrolyte imbalance include dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, seizures, confusion, muscle pains or cramps, muscular fatigue, low blood pressure, racing heartbeat, and nausea and vomiting.
Gout: Hydrochlorothiazide may increase the level of uric acid in the body. If you develop painful, warm, and swollen joints or difficulty with urination, contact your doctor as soon as possible.
If you have a history of gout, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Heart failure: Beta-blockers, such as pindolol, can worsen existing heart failure. If you have a history of heart failure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Hyperthyroidism (high level of thyroid hormones): People with hyperthyroidism should be cautious while taking pindolol as it may reduce the symptoms of this condition, giving a false impression of improvement. Stopping the medication suddenly could worsen this condition.
Kidney function: Hydrochlorothiazide may cause decreased kidney function, particularly if you already have reduced kidney function. If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Lupus: Hydrochlorothiazide may worsen the symptoms of this condition. If you have lupus, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Severe allergies: If you experience allergies severe enough to cause anaphylaxis (a severe allergic reaction where swelling of the face, lips, and throat make it difficult to breathe), talk to your doctor about what to do if you have an allergic reaction. Pindolol may make it more difficult to treat the allergic reaction with epinephrine.
Skin cancer: Recent reviews have connected long-term use of hydrochlorothiazide with an increased risk of developing non-melanoma skin cancer. Talk to your doctor about any concerns you may have.
Skin conditions: Various skin rashes and dry eyes have been reported with use of other beta-blockers. Flare-ups of psoriasis have been reported by people who take pindolol – hydrochlorothiazide.
Stopping usage: This medication should not be stopped suddenly by people who have angina. There have been reports of severe worsening of angina and of heart attack or abnormal heart rhythms occurring in people with angina who have stopped this medication abruptly.
Surgery: If you are scheduled for surgery, inform all doctors involved in your care that you are taking a medication that contains pindolol.
Vision changes: Hydrochlorothiazide occasionally causes vision changes including increased eye pressure (glaucoma) and myopia (nearsightedness). If you experience any eye symptoms, such as pain or change in vision, contact your doctor as soon as possible.
Pregnancy: Pindolol – hydrochlorothiazide should not be taken by pregnant women. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking pindolol – hydrochlorothiazide, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.
What other drugs could interact with this medication?
There may be an interaction between pindolol – hydrochlorothiazide and any of the following:
- alpha-agonists (e.g., clonidine, methyldopa)
- alpha-blockers (e.g., alfuzosin, doxazosin, tamsulosin)
- amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
- anesthetic agents
- angiotensin converting enzyme inhibitors (ACEIs; captopril, ramipril)
- angiotensin receptor blockers (ARBs; e.g., candesartan, irbesartan, losartan)
- antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
- antimalarial medications (e.g., chloroquine, hydroxychloroquine, primaquine)
- antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- barbiturates (e.g., butalbital, phenobarbital)
- beta-2 agonists (e.g., salbutamol, formoterol, terbutaline)
- calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
- calcium supplements (e.g., calcium carbonate, calcium citrate)
- diabetes medications (e.g., chlorpropamide, glyburide, insulin, metformin, rosiglitazone)
- diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
- ergot alkaloids (e.g., dihydroergotamine, ergonovine, ergotamine, methylergonovine)
- grass pollen allergen extract
- inhaled corticosteroids (e.g., budesonide, ciclesonide, fluticasone)
- monoamine oxidase (MAO) inhibitors (e.g., tranylcypromine, phenelzine) taken within the past 2 weeks
- multivitamin supplements
- narcotic analgesics (e.g., morphine, codeine)
- nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
- nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., diclofenac, ibuprofen, naproxen)
- oral corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
- other beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
- phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
- salicylates (e.g., ASA, salsalate)
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
- sodium phosphates
- sulfonylureas (e.g., gliclazide, glyburide, tolbutamide)
- theophyllines (e.g., aminophylline, oxtriphylline, theophylline)
- tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
- vitamin D analogues (e.g., alfacalcidol, calcitriol, cholecalciferol)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Viskazide