Clorpres (Oral)

Clonidine and chlorthalidone combinations are used to treat high blood pressure (hypertension).

High blood pressure increases the workload on the heart and arteries. If it lasts for a long time, it can cause the heart and arteries to work poorly. This may harm the blood vessels in the brain, heart, and kidneys, leading to a stroke, heart failure, or kidney failure. Hypertension may also raise the risk of heart attacks. Controlling blood pressure can help reduce the chances of these problems.

Clonidine works by managing nerve impulses along specific nerve pathways in the body. This helps relax blood vessels, allowing blood to flow through them more easily. The chlorthalidone in this combination is a diuretic (water pill) that helps lower the amount of water in the body by increasing urine flow.

The clonidine and chlorthalidone combination is available only with your doctor's prescription.

It is important for your doctor to check your progress at regular visits to ensure that this medicine is working as it should.

Talk to your doctor before stopping this medicine. Your doctor may want you to slowly reduce the amount you are taking before stopping completely.

Make sure you have enough medicine to last through weekends, holidays, or vacations. You should not miss any doses. You may want to ask your doctor for another written prescription to carry with you. This way, you can have it filled if you run out of medicine while away from home.

Before any type of surgery (including dental surgery) or emergency treatment, make sure the doctor or dentist knows that you are taking this medicine.

Do not take other medicines unless your doctor has discussed them with you. This includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus issues, as they may increase your blood pressure.

This medicine will enhance the effects of alcohol and other central nervous system (CNS) depressants (medicines that slow down the nervous system, which may cause drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of these while using this medicine.

This medicine may make some people feel drowsy or less alert than usual. This is more likely when you first start taking it or when you increase your dose. Be aware of how this medicine affects you before driving, using machines, or doing anything else that could be dangerous if you are not alert.

Dizziness, lightheadedness, or fainting may happen, especially when you stand up from lying down or sitting. Getting up slowly may help, but if the problem continues or worsens, talk to your doctor.

Dizziness, lightheadedness, or fainting is also more likely if you drink alcohol, stand for long periods, exercise, or if it is hot outside. Drinking alcohol may make drowsiness worse. While taking this medicine, be careful to limit your alcohol intake. Also, be cautious during exercise or in hot weather, or if you need to stand for a long time.

This medicine may cause a loss of potassium from your body.

• To help prevent this, your doctor may suggest that you eat or drink foods high in potassium (like orange or other citrus fruit juices), take a potassium supplement, or take another medicine to help prevent potassium loss.
• It is very important to follow these instructions. Do not change your diet on your own, especially if you are on a special diet (like for diabetes) or taking a potassium supplement or a medicine to reduce potassium loss. Extra potassium may not be needed and, in some cases, too much potassium could be harmful.

Check with your doctor if you become ill and have severe or ongoing vomiting or diarrhea. These issues may lead to losing more water and potassium.

For patients with diabetes:

• The chlorthalidone in this medicine may raise blood sugar levels. While taking this medicine, be sure to test your blood sugar (glucose) level or test for sugar in your urine.

This medicine may make your skin more sensitive to sunlight than usual. Even brief exposure to sunlight may cause a skin rash, itching, redness, or other skin discoloration, or severe sunburn. When you start taking this medicine:

• Stay out of direct sunlight, especially from 10:00 a.m. to 3:00 p.m., if possible.
• Wear protective clothing, including a hat, and sunglasses.
• Use a sunscreen with a skin protection factor (SPF) of at least 15. Some patients may need a product with a higher SPF, especially if they have fair skin. If you have questions about this, talk to your health care professional.
• Use a lip balm with an SPF of at least 15 to protect your lips.
• Do not use a sunlamp or tanning bed or booth.

If you have a severe reaction to the sun, talk to your doctor.

This medicine may cause dryness of the mouth. For temporary relief, you can use sugarless candy or gum, melt ice in your mouth, or use a saliva substitute. However, if your mouth remains dry for more than 2 weeks, check with your doctor or dentist. Ongoing dryness may increase the risk of dental problems, including tooth decay, gum disease, and fungal infections.

In deciding to use a medicine, the risks of taking it must be balanced with the benefits it will provide. This is a decision you and your doctor will make together. For this medicine, consider the following:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also inform your healthcare professional about any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on this medicine have only been done in adult patients, and there is no specific information comparing the use of clonidine and chlorthalidone combination in children to other age groups. However, children may be more sensitive than adults to clonidine. Clonidine overdose has been reported when children accidentally took this medicine.

Geriatric

Dizziness or lightheadedness and signs of too much potassium loss may happen more often in older adults, who are more sensitive to the effects of clonidine and chlorthalidone.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction might happen. In these cases, your doctor may want to adjust the dose, or other precautions may be needed. When taking this medicine, it is especially important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions have been selected based on their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may change the dose or frequency of one or both medicines.

• Acarbose
• Acebutolol
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Albiglutide
• Albuterol
• Alogliptin
• Amitriptyline
• Amoxapine
• Amtolmetin Guacil
• Arsenic Trioxide
• Aspirin
• Atenolol
• Bepridil
• Betaxolol
• Bevantolol
• Bisoprolol
• Bromfenac
• Bromocriptine
• Bufexamac
• Buprenorphine
• Canagliflozin
• Carteolol
• Celecoxib
• Celiprolol
• Ceritinib
• Chlorpropamide
• Choline Salicylate
• Clomipramine
• Clonixin
• Codeine
• Crizotinib
• Dapagliflozin
• Desipramine
• Deslanoside
• Desmopressin
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Diflunisal
• Digitalis
• Digitoxin
• Digoxin
• Dilevalol
• Diltiazem
• Dipyrone
• Dofetilide
• Dothiepin
• Doxepin
• Droperidol
• Droxicam
• Dulaglutide
• Empagliflozin
• Esmolol
• Etodolac
• Etofenamate
• Etoricoxib
• Exenatide
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Flecainide
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Formoterol
• Glimepiride
• Glipizide
• Glyburide
• Ibuprofen
• Imipramine
• Indomethacin
• Insulin
• Insulin Aspart, Recombinant
• Insulin Bovine
• Insulin Degludec
• Insulin Detemir
• Insulin Glulisine
• Iobenguane I 131
• Ketanserin
• Ketoprofen
• Ketorolac
• Levobunolol
• Levomethadyl
• Linagliptin
• Liraglutide
• Lithium
• Lixisenatide
• Lofepramine
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Macimorelin
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Methotrexate
• Metildigoxin
• Metipranolol
• Metoprolol
• Miglitol
• Mirtazapine
• Morniflumate
• Nabumetone
• Nadolol
• Naproxen
• Nateglinide
• Nebivolol
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Nortriptyline
• Oxaprozin
• Oxprenolol
• Oxyphenbutazone
• Parecoxib
• Penbutolol
• Phenylbutazone
• Piketoprofen
• Pindolol
• Pioglitazone
• Piroxicam
• Pramlintide
• Proglumetacin
• Propranolol
• Propyphenazone
• Proquazone
• Protriptyline
• Repaglinide
• Rofecoxib
• Rosiglitazone
• Salicylic Acid
• Salsalate
• Saxagliptin
• Sitagliptin
• Sodium Salicylate
• Sotalol
• Sulindac
• Tapentadol
• Tenoxicam
• Tertatolol
• Tiaprofenic Acid
• Timolol
• Tolazamide
• Tolbutamide
• Tolfenamic Acid
• Tolmetin
• Trimipramine
• Valdecoxib
• Verapamil
• Vildagliptin

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or frequency of one or both medicines.

• Aminolevulinic Acid
• Cyclosporine
• Fluphenazine
• Gossypol
• Licorice
• Mepivacaine
• Naloxone
• Semaglutide
• Warfarin
• Yohimbine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around mealtime or with certain types of food because interactions may occur. Using alcohol or tobacco with certain medicines may also lead to interactions. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may affect the use of this medicine. Make sure to tell your doctor if you have any other medical issues, especially:

• Type 2 diabetes mellitus—This medicine may change how much diabetes medicine is needed

• Gout—This medicine may raise the level of uric acid in the blood, which can lead to gout

• Heart or blood vessel disease or
• Lupus erythematosus (history of) or
• Mental depression (history of) or
• Pancreatitis (inflammation of the pancreas) or
• Raynaud's syndrome—This medicine may worsen these conditions

• Kidney disease—Effects of this medicine may be increased because of slower removal from the body. If kidney disease is severe, the chlorthalidone part of this medicine may not work

• Liver disease—If this medicine causes too much loss of water from the body, liver disease can get much worse

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Signs and symptoms of overdose

• Difficulty in breathing
• dizziness (extreme) or faintness
• feeling cold
• pinpoint pupils of eyes
• slow heartbeat
• unusual tiredness or weakness (extreme)

Check with your doctor as soon as possible if any of the following side effects occur:

Signs and symptoms of too much potassium loss

• Dryness of mouth
• increased thirst
• irregular heartbeat
• mood or mental changes
• muscle cramps or pain
• nausea or vomiting
• weak pulse

Signs and symptoms of too much sodium loss

• Confusion
• convulsions (seizures)
• decreased mental activity
• irritability
• muscle cramps
• unusual tiredness or weakness

Less common

• Mental depression
• swelling of feet and lower legs

Rare

• Black, tarry stools
• blood in urine or stools
• cough or hoarseness
• fever or chills
• joint pain
• lower back or side pain
• paleness or cold feeling in fingertips and toes
• pinpoint red spots on skin
• skin rash or hives
• stomach pain (severe) with nausea and vomiting
• unusual bleeding or bruising
• vivid dreams or nightmares
• yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Constipation
• dizziness
• drowsiness
• dryness of mouth
• unusual tiredness or weakness

Less common

• Decreased sexual ability
• diarrhea
• dizziness or lightheadedness when getting up from a lying or sitting position
• dry, itching, or burning eyes
• increased sensitivity of skin to sunlight
• loss of appetite
• nausea or vomiting
• nervousness
• upset stomach

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

• Anxiety or tenseness
• chest pain
• fast or pounding heartbeat
• headache
• increased salivation
• nausea
• nervousness
• restlessness
• shaking or trembling of hands and fingers
• stomach cramps
• sweating
• trouble in sleeping
• vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Clorpres

Available Dosage Forms:

• Tablet

Therapeutic Class: Alpha-Adrenergic Agonist/Thiazide Combination

Pharmacologic Class: Clonidine

Chemical Class: Thiazide Related

This medicine may cause you to have an unusual feeling of tiredness when you begin to take it. You may also notice an increase in the amount of urine or in your frequency of urination. After taking the medicine for a while, these effects should lessen. It is best to plan your doses according to a schedule that will least affect your personal activities and sleep. Ask your health care professional to help you plan the best time to take this medicine.

In addition to the use of the medicine your doctor has prescribed, appropriate treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which factors are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

To help you remember to take your medicine, try to get into the habit of taking it at the same time each day.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets): For high blood pressure: Adults—1 tablet one or two times a day. Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss two or more doses in a row, check with your doctor right away. If your body goes without this medicine for too long, your blood pressure may go up to a dangerously high level and some unpleasant effects may occur.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.