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Tenoretic (Atenolol + Chlorthalidone)

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Synonyms: Higroton, Hygroton, Igroton, Isoren, Natriuran, Oradil, Renon, Saluretin, Thalitone, Zambesil

What is the most important information I should know about Tenoretic?

•To reduce nighttime urination, take Tenoretic before 6 p.m. and preferably in the morning.

•Do not stop taking this medication unless your doctor approves. If you stop taking your medication, your condition could become much worse.

What is Tenoretic?

Tenoretic is in a class of drugs called beta-blockers. Tenoretic is used to lower blood pressure, lower heart rate, reduce angina (chest pain), and reduce the risk of a recurrent heart attack.

Tenoretic is a thiazide diuretic (water pill). It helps to lower your blood pressure and decrease edema (swelling) by increasing the amount of salt and water you lose in your urine.

Tenoretic is used to treat high blood pressure (hypertension).

Tenoretic may also be used for purposes other than those listed in this medication guide.

Who should not take Tenoretic?

•Do not take Tenoretic if you have an allergy to sulfa-based drugs such as sulfa antibiotics. You may have an allergic reaction to Tenoretic

•Before taking this medication, tell your doctor if you have

◦asthma;

◦a heart condition such as low blood pressure, heart block, a pacemaker, or heart failure, or any other heart problem;

◦diabetes

◦gout;

◦a collagen vascular disease such as systemic lupus erythematosus;

◦pancreatitis;

◦kidney disease;

◦liver disease;

◦any type of circulatory disease; or

◦thyroid disease.

•You may not be able to take Tenoretic, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

•This drug is in the FDA pregnancy category D. This means that Tenoretic is known to harm an unborn baby. Do not take this medication if you are pregnant.

Tenoretic passes into breast milk and may harm a nursing infant. Do not take Tenoretic without first talking to your doctor if you are breast-feeding a baby.

How should I take Tenoretic?

•Take Tenoretic exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

•Take each dose with a full glass of water.

Tenoretic is usually taken once a day. Follow your doctor's instructions.

•To reduce nighttime urination, take Tenoretic before 6 p.m. and preferably in the morning.

•Do not stop taking this medication unless your doctor approves. If you stop taking your medication, your condition could become much worse.

•Store Tenoretic at room temperature away from moisture and heat.

What happens if I miss a dose?

•Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

•Seek emergency medical attention.

•Symptoms of an Tenoretic overdose include an irregular heartbeat, seizures, confusion, fainting, coma, shortness of breath, and wheezing.

What should I avoid while taking Tenoretic?

•Avoid a diet high in salt. Too much salt will cause your body to retain water and will decrease the effects of Tenoretic.

•Avoid prolonged exposure to sunlight. Tenoretic may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

•Avoid becoming overheated in hot weather. It is easy to become dangerously dehydrated while taking Tenoretic.

•Use caution when driving, operating machinery, performing other hazardous activities. Tenoretic may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Also use caution when rising from a sitting or lying position.

•Use alcohol cautiously. Alcohol may further lower blood pressure and increase drowsiness and dizziness while you are taking Tenoretic.

•Before having surgery, tell your doctor and dentist that you are taking this medication.

What are the possible side effects of Tenoretic?

•If you experience any of the following serious side effects, stop taking Tenoretic and seek emergency medical attention:

◦an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

◦yellow skin or eyes;

◦confusion;

◦unusual fatigue;

◦abnormal bleeding or bruising;

◦slow or irregular heartbeat, chest pain;

◦swelling of feet and lower legs or sudden weight gain;

◦cold or blue feet and hands; or

◦skin rash.

•Other, less serious side effects may be more likely to occur. Continue to take Tenoretic and talk to your doctor if you experience

◦dizziness;

◦headache;

◦fatigue;

◦tingling or numbness in your arms, legs, hands, or feet;

◦excessive urination or increased hunger or thirst;

◦nausea or decreased appetite;

◦diarrhea, constipation, gas, nausea, or vomiting;

◦weak pulse;

◦muscle weakness or cramps;

◦depression or nightmares; or

◦sensitivity to sunlight.

•Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Tenoretic?

•The following medicines may decrease the effectiveness of Tenoretic:

◦cholestyramine (Questran) and colestipol (Colestid);

◦nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil), ketoprofen (Orudis, Orudis KT, Oruvail), and naproxen (Naprosyn, Anaprox, Aleve); and

◦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).

•Larger doses of Tenoretic may be needed if you are taking any of the medicines listed above.

•Before taking Tenoretic, tell your doctor if you are taking any of the medicines listed below:

◦Oral diabetes medications such as glipizide (Glucotrol), glyburide (Micronase, Glynase, Diabeta), chlorpropamide (Diabinese), tolazamide (Tolinase), and tolbutamide (Orinase) may not be as effective in lowering your blood sugar when you are taking Tenoretic. Your diabetes therapy may have to be adjusted.

◦Lithium (Lithane, Lithobid, Eskalith, others) generally should not be taken with Tenoretic because dangerous side effects may result.

◦other drugs that lower blood pressure must be used very cautiously. Very low blood pressure can result. Some drugs commonly used to lower blood pressure include acebutolol (Sectral), Tenoretic (Tenormin), bisoprolol (Zebeta), carteolol (Cartrol), labetalol (Trandate, Normodyne), propranolol (Inderal), pindolol (Visken), timolol (Blocadren), benazepril (Lotensin), enalapril (Vasotec), captopril (Capoten), fosinopril (Monopril), 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, Veralan, Isoptin).

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