… s chlortalidone component:
• plasma electrolyte should be periodically determined in appropriate intervals to detect possible electrolyte imbalance especially hypokalaemia and hyponatraemia.
• hypokalaemia and hyponatraemia may occur. Measurement of electrolytes is recommended, especially in the older patient, those receiving digitalis preparations for cardiac failure, those taking an abnormal (low in potassium) diet or those suffering from gastrointestinal complaints. Hypokalaemia may predispose to arrhythmias in patients receiving digitalis.
• impaired glucose tolerance may occur and diabetic patients should be aware of the potential for increased glucose levels. Close monitoring of glycaemia is recommended in the initial phase of ther …
Identical in both labels. Surrounding text shown from Wockhardt UK Ltd.
… ed in uncontrolled heart failure (see section 4.3), may be used in patients whose signs of heart failure have been controlled. Similarly, care must be taken with patients with poor cardiac reserve.
Ischaemic Heart disease: especially in patients with ischaemic heart disease, treatment should not be discontinued suddenly. The dosage should be gradually reduced, i.e. over 1-2 weeks, if necessary at the same time initiating replacement therapy, to prevent exacerbation of angina pectoris. In addition, hypertension and arrhythmias may develop. Furthermore, there is a risk of myocardial infarction and sudden death. Patients should be followed during withdrawal, especially those with ischaemic heart disease.
Untreated Congestive Heart disease: beta-blockers should not be used in such patients. The condition should be stabilised first.
First Degree Heart Block: due to its negative effect on conduction …
… clonidine by beta-blocker therapy, the introduction of beta-blockers should be delayed for several days after clonidine administration has stopped. (See also prescribing information for clonidine.)
Class I anti-arrhythmic drugs (e.g. disopyramide) and amiodarone may have a potentiating effect on atrial-conduction time and induce negative inotropic effect.
Concomitant use of sympathomimetic agents, e.g. adrenaline (epinephrine), may counteract the effect of beta-blockers.
Concomitant use with insulin and oral antidiabetic drugs may lead to the intens …
Identical in all 5 labels. Surrounding text shown from Aurobindo Pharma - Milpharm Ltd..
… with anaesthetic drugs may result in attenuation of the reflex tachycardia and increase the risk of hypotension. Anaesthetic agents causing myocardial depression are best avoided (see section 4.4).
Anti-arrhythmics:
Class I anti-arrhythmic drugs (e.g. disopyramide) and amiodarone may have a potentiating effect on atrial-conduction time and induce negative inotropic effect.
Antidiabetics:
Concomitant use wi …
… g clonidine by beta-blocker therapy, the introduction of beta-blockers should be delayed for several days after clonidine administration has stopped (see also prescribing information for clonidine).
Class I anti-arrhythmic drugs (e.g. disopyramide, quinidine) and amiodarone may have a potentiating effect on atrial conduction time and induce negative inotropic effect.
Concomitant use of sympathomimetic agents, e.g. adrenaline, may counteract the effects of beta-blockers.
Concomitant use with insulin and oral antidiabetic drugs may lead to the intensification of …