Clonidine and Chlorthalidone (Systemic)

Brand Names : Combipres

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For clonidine and chlorthalidone, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to clonidine (oral or skin patch form), chlorthalidone, sulfonamides (sulfa drugs), or other thiazide diuretics (water pills). Also tell your health care professional if you are allergic to any other substance, such as foods, preservatives, or dyes.

Pregnancy - Clonidine has not been studied in pregnant women. However, studies in animals have shown that clonidine does not cause birth defects but does cause other harmful effects in the fetus. When chlorthalidone is used during pregnancy, it may cause side effects including jaundice, blood problems, and low potassium in the newborn infant. Be sure you have discussed this with your doctor before taking this medicine.

Breast-feeding - Both clonidine and chlorthalidone pass into breast milk. Chlorthalidone may decrease the flow of breast milk. Therefore, you should avoid use of clonidine and chlorthalidone combination during the first month of breast-feeding.

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

Older adults - Dizziness or lightheadedness and signs of too much potassium loss may be more likely to occur in the elderly, who are more sensitive to the effects of clonidine and chlorthalidone.

Other 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 doctor may want to change the dose, or other precautions may be necessary. When you are taking clonidine and chlorthalidone, it is especially important that your health care professional know if you are taking any of the following:

• Beta-adrenergic blocking agents (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], bisoprolol [e.g., Zebeta], carteolol [e.g., Cartrol], labetalol [e.g., Normodyne], metoprolol [e.g., Lopressor], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal], sotalol [e.g., Betapace, Sotacor], timolol [e.g., Blocadren]) - These medicines may increase the risk of harmful effects when clonidine and chlorthalidone combination treatment is stopped suddenly

• Cholestyramine or
• Colestipol - Use with clonidine and chlorthalidone combination may prevent the chlorthalidone portion of the medicine from working properly; take clonidine and chlorthalidone combination at least 1 hour before or 4 hours after cholestyramine or colestipol

• Digitalis glycosides (heart medicine) - This medicine may cause low potassium in the blood, which may increase the chance of side effects of digitalis glycosides

• Lithium (e.g., Lithane) - Use with clonidine and chlorthalidone combination may cause high blood levels of lithium, which may increase the chance of side effects

• Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil]) - These medicines may decrease the effects of clonidine and chlorthalidone combination on blood pressure

Other medical problems - The presence of other medical problems may affect the use of clonidine and chlorthalidone. Make sure you tell your doctor if you have any other medical problems, especially:

• Diabetes mellitus (sugar diabetes) - This medicine may change the amount of diabetes medicine needed

• Gout - This medicine may increase the amount 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 make these conditions worse

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

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