Moexipril and hydrochlorothiazide (Oral)

Moexipril and hydrochlorothiazide combination is used to treat high blood pressure (hypertension). High blood pressure increases the workload of the heart and arteries. If it lasts for a long time, the heart and arteries may not work properly. This can harm the blood vessels in the brain, heart, and kidneys, leading to a stroke, heart failure, or kidney failure. Lowering blood pressure lowers the risk of strokes and heart attacks.

Moexipril is an angiotensin converting enzyme (ACE) inhibitor. It works by blocking a substance in the body that makes blood vessels tighten. This allows moexipril to relax the blood vessels. This lowers blood pressure and improves the supply of blood and oxygen to the heart.

Hydrochlorothiazide is a thiazide diuretic (water pill). It decreases the amount of water in the body by increasing urine flow, which helps lower blood pressure.

This medicine is available only with your doctor's prescription.

It is very important for your doctor to check your progress at regular visits to ensure this medicine is working correctly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to prevent pregnancy. If you think you have become pregnant while using this medicine, tell your doctor immediately.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of the face, arms, legs, eyes, lips, tongue, or throat while using this medicine.

Call your doctor right away if you have severe stomach pain (with or without nausea or vomiting). This could be a symptom of intestinal angioedema.

Dizziness, lightheadedness, or fainting may also happen, especially when you get up from lying down or sitting, or if you have been taking a diuretic (water pill). Make sure you know how you react to the medicine before you drive, use machines, or do other activities that could be dangerous if you are dizzy or not alert. If you feel dizzy, lie down to avoid fainting. Then sit for a few moments before standing to prevent the dizziness from returning. If you faint, stop using this medicine and call your doctor immediately.

Check with your doctor right away if you become sick while taking this medicine, especially with severe or ongoing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water or salt and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

Tell your doctor immediately if you have a fever, chills, or sore throat. These may be signs of an infection from low white blood cells.

This medicine may affect blood sugar levels. If you notice a change in your blood or urine sugar test results, or if you have any questions, check with your doctor.

Check with your doctor right away if you have any symptoms of liver problems, such as dark-colored urine or pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, or yellow skin or eyes.

Check with your doctor immediately if you experience blurred vision, difficulty reading, eye pain, or any other change in vision during or after treatment. Your doctor may want an eye doctor to examine your eyes.

Hyperkalemia (high potassium in the blood) may occur while using this medicine. Check with your doctor right away if you have symptoms like abdominal or stomach pain, confusion, difficulty breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in your hands, feet, or lips, shortness of breath, or weakness or heaviness in your legs. Do not use supplements or salt substitutes containing potassium without first checking with your doctor.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.

Black patients may be less sensitive to the blood pressure-lowering effects of this medicine. Additionally, the risk of a serious allergic reaction involving swelling of the face, mouth, hands, or feet may be increased.

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

In deciding to use a medicine, the risks of using the medication must be weighed against the beneficial it will do. This is a decision you and your clinician will make. For this medicine, the following should be considered:

Allergies

Inform your physician if you have ever had any unusual or allergic reaction to this drug or any other medications. As well inform your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of moexipril and hydrochlorothiazide combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific issues that would limit the usefulness of moexipril and hydrochlorothiazide combination in the elderly. Nevertheless, elderly patients are more likely to have age-related kidney issues, which may require caution and a dose adjustment for patients receiving moexipril and hydrochlorothiazide combination.

Breast Feeding

There are no adequate studies in women for determining infant chance when using this medication during breastfeeding. Weigh the potential benefits against the potential chances before using this medicine while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your physician may want to change the dose, or other precautions may be necessary. When you are using this medication, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medication with any of the following medications is not recommended. Your doctor may decide not to treat you with this drug or change some of the other medicines you take.

• Aliskiren
• Dofetilide
• Sacubitril

Using this drug with any of the following medicines is typically not advised, but may be required in some cases. If both medications are prescribed together, your doctor may change the dose or how frequently you use one or both of the medications.

• Acarbose
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Albiglutide
• Albuterol
• Alogliptin
• Alteplase, Recombinant
• Amiloride
• Amphetamine
• Amtolmetin Guacil
• Arsenic Trioxide
• Aspirin
• Azathioprine
• Azilsartan
• Azilsartan Medoxomil
• Benzphetamine
• Bromfenac
• Bromocriptine
• Bufexamac
• Buprenorphine
• Canagliflozin
• Candesartan
• Canrenoate
• Celecoxib
• Chlorpropamide
• Choline Salicylate
• Clonixin
• Codeine
• Dapagliflozin
• Deslanoside
• Desmopressin
• Dexibuprofen
• Dexketoprofen
• Dextroamphetamine
• Diclofenac
• Diflunisal
• Digitalis
• Digitoxin
• Digoxin
• Dipyrone
• Droperidol
• Droxicam
• Dulaglutide
• Empagliflozin
• Eplerenone
• Eprosartan
• Etodolac
• Etofenamate
• Etoricoxib
• Everolimus
• Exenatide
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Flecainide
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Formoterol
• Furosemide
• Glimepiride
• Glipizide
• Glyburide
• Ibuprofen
• Indomethacin
• Insulin
• Insulin Aspart, Recombinant
• Insulin Bovine
• Insulin Degludec
• Insulin Detemir
• Insulin Glulisine
• Irbesartan
• Ketanserin
• Ketoprofen
• Ketorolac
• Levomethadyl
• Linagliptin
• Liraglutide
• Lisdexamfetamine
• Lithium
• Lixisenatide
• Lornoxicam
• Losartan
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Melphalan
• Mercaptopurine
• Methamphetamine
• Methotrexate
• Metildigoxin
• Miglitol
• Morniflumate
• Nabumetone
• Naproxen
• Nateglinide
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Olmesartan
• Ouabain
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Phenylbutazone
• Piketoprofen
• Pioglitazone
• Piroxicam
• Porfimer
• Potassium
• Potassium Citrate
• Potassium Phosphate
• Pramlintide
• Proglumetacin
• Propyphenazone
• Proquazone
• Proscillaridin
• Repaglinide
• Rofecoxib
• Rosiglitazone
• Salicylic Acid
• Salsalate
• Saxagliptin
• Sirolimus
• Sitagliptin
• Sodium Salicylate
• Sotalol
• Spironolactone
• Sulindac
• Tacrolimus
• Tapentadol
• Telmisartan
• Tenoxicam
• Tiaprofenic Acid
• Tolazamide
• Tolbutamide
• Tolfenamic Acid
• Tolmetin
• Topiramate
• Triamterene
• Trimethoprim
• Valdecoxib
• Valsartan
• Vildagliptin

Using this medicine with any of the following medicines may cause an increased chance of certain adverse effects, but using both drugs may be the best therapy for you. If both medications are prescribed together, your doctor may change the dose or how frequently you use one or both of the medications.

• Aceclofenac
• Acemetacin
• Aminolevulinic Acid
• Amtolmetin Guacil
• Bepridil
• Bromfenac
• Bufexamac
• Bumetanide
• Bupivacaine
• Bupivacaine Liposome
• Capsaicin
• Carbamazepine
• Celecoxib
• Cholestyramine
• Choline Salicylate
• Clonixin
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Diflunisal
• Dipyrone
• Droxicam
• Ethacrynic Acid
• Etodolac
• Etofenamate
• Etoricoxib
• Etozolin
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Ginkgo
• Gold Sodium Thiomalate
• Gossypol
• Ibuprofen
• Indomethacin
• Ketoprofen
• Ketorolac
• Licorice
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Morniflumate
• Nabumetone
• Naproxen
• Nepafenac
• Nesiritide
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Phenylbutazone
• Piketoprofen
• Piretanide
• Piroxicam
• Pranoprofen
• Proglumetacin
• Propionic Acid
• Propyphenazone
• Proquazone
• Rofecoxib
• Salicylic Acid
• Salsalate
• Sodium Salicylate
• Sulindac
• Tenoxicam
• Tiaprofenic Acid
• Tolfenamic Acid
• Tolmetin
• Torsemide
• Valdecoxib

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain drugs may also cause interactions to occur. Discuss with your healthcare professional the use of your medication with food, alcohol, or tobacco.

Other Medical Issues

The presence of other medical issues may affect the use of this drug. Make sure you inform your physician if you have any other medical issues, especially:

• Angioedema (swelling of the face, lips, tongue, throat, arms, or legs), history of—May increase the chance of this condition occurring again.

• Anuria (not capable to pass urine) or
• Diabetic patients who are also using aliskiren (Tekturna®) or
• Sulfa drug allergy (e.g., sulfamethoxazole, Bactrim®, Septra®)—Should not be used in patients with these conditions.

• Asthma, history of—May raise likelihood of having an allergic reaction.

• Collagen vascular disease (an autoimmune disease) together with kidney disease—Increased risk of blood problems.

• Congestive heart failure or
• Dehydration or
• Diarrhea or
• Heart or blood vessel disease or
• Hyponatremia (low sodium in the blood) or
• Kidney disease—These conditions may cause the blood pressure to fall too low with this drug.

• Diabetes or
• Kidney problems—Increased chance of potassium levels in the body becoming too high.

• Edema (swelling or fluid in the body) or
• Electrolyte imbalance (e.g., low levels of magnesium, potassium, salt or sodium in the body) or
• Fluid imbalance (due to excessive perspiration, vomiting, diarrhea) or
• Glaucoma, secondary angle closure or
• Gout or
• Heart disease (e.g., ischemic heart disease, aortic stenosis, cerebrovascular disease) or
• Hypercalcemia (high calcium in the blood) or
• Hypercholesterolemia (high cholesterol in the blood) or
• Liver disease or
• Myopia, acute (changes in the eyeball causing vision issues) or
• Systemic lupus erythematosus (SLE)—Use with caution. May make these conditions worse.

Along with its necessary effects, a medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they might need medical attention.

Check with your doctor right away if any of the following side effects happen:

Less common

• Blurred vision
• confusion
• decreased urination
• dizziness, faintness, or lightheadedness when standing up suddenly from a lying or sitting position
• dry mouth
• fast, slow, or irregular heartbeat
• muscle cramps or pain
• numbness, tingling, pain, or weakness in the hands or feet
• rapid breathing
• seizures
• sunken eyes
• sweating
• thirst
• trembling
• unusual tiredness or weakness
• weakness and heaviness of the legs
• wrinkled 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. Your health care professional may also have ways to prevent or lessen some of these side effects. Check with your health care professional if any of the following side effects continue, are bothersome, or if you have any questions about them:

Less common

• Dry cough

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.

• Uniretic

Pharmacologic Class: Diuretic

Chemical Class: Thiazide

This medicine should not be the first medicine you use to treat your condition. It is meant to be used only after you have tried other medicines that have not worked or have caused unwanted side effects.

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these 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.

It is best to take this medicine on an empty stomach, at least 1 hour before meals.

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 or 2 tablets once 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.

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.

Ask your healthcare professional how you should dispose of any medicine you do not use.