Consumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about MODURETIC. It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking MODURETIC against the benefits they expect it will have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine. You may need to read it again.
What MODURETIC is used for
MODURETIC is a combination of two water tablets (or diuretics).
It is used to reduce the amount of fluid in the body for people who have:
swelling of the ankles, feet and legs, which is called oedema
fluid accumulation in the stomach area (which is called ascites) due to liver disease.
MODURETIC helps reduce the amount of fluid in the body, while at the same time, helping to maintain normal potassium levels in the blood. Some other water tablets may lead to low levels of potassium.
MODURETIC also helps lower high blood pressure, which doctors call hypertension.
Everyone has blood pressure. This pressure helps get your blood all around your body. Your blood pressure may be different at different times of the day, depending on how busy or worried you are. You have hypertension (high blood pressure) when your blood pressure stays higher than is needed, even when you are calm and relaxed.
There are usually no symptoms of hypertension. The only way of knowing that you have hypertension is to have your blood pressure checked on a regular basis. If high blood pressure is not treated it can lead to serious health problems. You may feel fine and have no symptoms, but eventually hypertension can cause stroke, heart disease and kidney failure. MODURETIC helps to lower your blood pressure.
MODURETIC works by making your kidneys pass more water and salt, and retain more potassium. This helps reduce high blood pressure and some forms of swelling, while at the same time helping to maintain normal levels of potassium in your blood.
Your doctor may prescribe MODURETIC for another reason. Ask your doctor if you have any questions about why MODURETIC has been prescribed for you.
MODURETIC is not addictive.
Before you take MODURETIC
When you must not take it
Do not take MODURETIC if:
you have an allergy to MODURETIC or any of the ingredients listed at the end of this leaflet
you have an allergy to any sulfonamide or sulfur medicines
One of the active ingredients of MODURETIC, hydrochlorothiazide, is a sulfur-containing medicine (a sulfonamide). Therefore, if you are allergic to sulfur medicines, such as some antibiotics, you are likely to be allergic to MODURETIC. Check with your doctor or pharmacist if you are not sure whether you are allergic to sulfur medicines. Symptoms of an allergic reaction may include skin rash, hives, fever, swelling of the face, lips, mouth, throat or tongue which may cause difficulty breathing or swallowing.
Do not take MODURETIC if:
you are pregnant, or intend to become pregnant
MODURETIC may affect your developing baby if you take it during pregnancy.
you are breast-feeding or intend to breast-feed
Some of the ingredients of MODURETIC can pass into breast milk, and therefore may harm your baby.
you have kidney disease
Do not take MODURETIC if:
your doctor advises you that you have too much potassium in your blood
you are taking medicines which can increase the amount of potassium in the blood or you are eating a potassium-rich diet
MODURETIC helps maintain normal levels of potassium in your blood. If you are taking potassium tablets or supplements, other potassium-conserving medicines, or a potassium-rich diet, your potassium levels may increase too much. Ask your doctor or pharmacist if you are not sure whether you are taking any of these.
Do not take MODURETIC if:
the packaging is torn or shows signs of tampering
the expiry date (EXP) printed on the pack has passed.
If you take this medicine after the expiry date has passed it may not work.
If you are not sure whether you should start taking MODURETIC, talk to your doctor.
Do not give MODURETIC to a child. The safety of MODURETIC in children has not been established.
Before you start to take it
Tell your doctor if:
1. you have any medical conditions, especially the following:
- liver disease
- kidney disease
- heart and lung disease
- high cholesterol
- lupus erythematosus
2. you have any allergies to any other medicines or any other substances, such as foods, preservatives or dyes.
If you have not told your doctor about any of the above, tell them before you take any MODURETIC.
Taking other medicines
Tell your doctor if you are taking any other medicines, including medicines that you buy without a prescription from your pharmacy, supermarket or health food shop. Some medicines and MODURETIC may interfere with each other. These include:
potassium tablets or other potassium-conserving medicines
ACE inhibitors, medicines used to treat high blood pressure
other medicines used to treat high blood pressure
other fluid tablets (diuretics)
digoxin, used to treat heart failure
lithium, used to treat severe mood swings and some types of depression
non-steroidal anti-inflammatory medicines (NSAIDs or Coxibs) used to treat inflammation, pain, arthritis
steroid medicines such as cortisone, prednisone
insulin and tablets used to treat diabetes
cyclosporin and tacrolimus, medicines used to suppress the immune system
barbiturates, used to treat epilepsy, such as phenobarbitone
strong pain killers such as codeine, morphine, dextroproxyphene
cholestyramine and colestipol, used to treat high cholesterol
medicines used to relax muscles before and during surgery
medicines used in emergency situations such as adrenaline
These medicines may be affected by MODURETIC, or may affect how well it works. You may need to take different amounts of your medicine, or you may need to take different medicines.
Your doctor or pharmacist has more information on medicines to be careful with or to avoid while taking MODURETIC.
How to take MODURETIC
How much to take
Take MODURETIC only when prescribed by your doctor. Your doctor will tell you how many tablets you need to take each day.
This depends on your condition and whether you are taking other medicines.
For high blood pressure, the usual dose is one or two tablets a day, taken as a single dose or in divided doses.
For oedema, the usual starting dose is one or two tablets a day.
For the swelling associated with liver disease, the usual starting dose is one tablet a day.
Follow all directions given to you by your doctor and pharmacist carefully. They may differ from the information contained in this leaflet.
If you do not understand the instructions on the box, ask your doctor or pharmacist for help.
Swallow MODURETIC with a glass of water.
When to take it
If you are taking a single dose a day, take it in the morning, for example at breakfast time.
If you are taking more than one dose a day, take the last dose no later than 6 p.m, unless your doctor tells you otherwise. MODURETIC may increase the amount of water (urine) you pass and also the number of times you go to the toilet. By taking the last dose no later than 6 p.m there may be less chance of your sleep being disturbed.
Take your MODURETIC every day at about the same time each day, unless your doctor tells you otherwise. This will help you remember when to take the tablets.
How long to take it
If you have high blood pressure, MODURETIC helps to control this condition but does not cure it. Therefore MODURETIC must be taken every day. Continue taking MODURETIC for as long as your doctor tells you.
If you have oedema or ascites, your doctor will tell you how long to take it.
If you forget to take it
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember, and then go back to taking your tablet(s) as you would normally.
If you are not sure whether to skip the dose, talk to your doctor or pharmacist.
Do not take a double dose to make up for the dose that you missed.
If you have trouble remembering to take your tablets, ask your pharmacist for some hints.
If you take too much (overdose)
Immediately telephone your doctor or Poisons Information Centre (telephone 13 11 26), or go to accident and emergency at your nearest hospital, if you think that you or anyone else may have taken too much MODURETIC. Do this even if there are no signs of discomfort or poisoning. If you take too many tablets, you will probably feel light-headed or dizzy, or you may faint. You may also become very thirsty, confused, have a change in the amount of urine passed or have a fast heart beat.
While you are using MODURETIC
Things you must do
Have your blood pressure checked when your doctor says, to make sure MODURETIC is working.
If you become pregnant while taking MODURETIC, tell your doctor immediately.
If you feel light-headed, dizzy or faint when getting out of bed or standing up, get up slowly. You may feel light-headed or dizzy when you begin to take MODURETIC. This is because your blood pressure is falling suddenly. Standing up slowly, especially when you get up from bed or chairs, will help your body get used to the change in position and blood pressure.
If this problem gets worse or continues, talk to your doctor.
If you have excessive vomiting and/or diarrhoea while taking MODURETIC, or you have any of the following symptoms, tell your doctor:
dry mouth, thirst
weakness, tiredness, drowsiness
muscle pains or cramps
fast heart beat
passing less urine than normal.
You may be dehydrated because you are losing too much water.
If you plan to have surgery (even at the dentist) that needs a general anaesthetic, tell your doctor or dentist that you are taking MODURETIC. Your blood pressure may drop suddenly.
If you are about to be started on any new medicine, tell your doctor and pharmacist that you are taking MODURETIC.
Things to be careful of
Be careful driving or operating machinery until you know how MODURETIC affects you. MODURETIC may cause dizziness or light-headedness in some people, especially after the first few doses or if the dose is increased. Make sure you know how you react to MODURETIC before you drive a car, operate machinery, or do anything else that could be dangerous if you are dizzy or light-headed.
If you drink alcohol, or take strong pain killers or barbiturates, dizziness and light-headedness may be worse.
Talk to your doctor about foods or drinks that have a high potassium content. MODURETIC helps to maintain normal potassium levels in your body. However, if you eat foods or have drinks that are high in potassium this may lead to an increase of potassium in your body. Too much potassium can be harmful, therefore it is important to discuss your diet with your doctor.
Tell your doctor if you are being treated for diabetes. MODURETIC may change how well your diabetes is controlled. Your doses of diabetic medicines, including insulin, may need to change.
Things that would be helpful for your blood pressure
Some self help measures suggested below may help your blood pressure. Talk to your doctor or pharmacist about these measures and for more information.
Alcohol -your doctor may advise you to limit your alcohol intake.
Diet - eat a healthy diet which includes plenty of fresh vegetables, fruit, bread, cereals and fish. Also eat less fat and sugar.
Exercise - regular exercise helps to reduce blood pressure. Try regular walking, swimming, cycling or games such as tennis and golf. Before starting any exercise, ask your doctor about the best kind of programme for you.
Salt - your doctor may advise you to watch the amount of salt in your diet. To reduce your salt intake you should avoid using salt in cooking or at the table.
Smoking - your doctor may advise you to stop smoking or at least cut down.
Weight - your doctor may suggest losing some weight to help lower your blood pressure. Some people may need a dietician's help to lose weight.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking MODURETIC. MODURETIC helps most people, but it may have unwanted side-effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if you notice any of the following and they worry you:
nausea, vomiting, loss of appetite
diarrhoea, constipation, stomach pain, wind
dizziness or lightheadedness
transient blurred vision or yellow vision
These are some of the more common side effects of MODURETIC.
Tell your doctor immediately if you notice any of the following:
severe dizziness, spinning sensation
signs of frequent infections such as fever, severe chills, sore throat or mouth ulcers
bruising or bleeding more easily than normal, nose bleeds
tiredness, headaches, being short of breath when exercising, looking pale
yellowing of the skin and/or eyes, also called jaundice
numbness or tingling in the hands or feet
skin rash, itchiness
changes in the way your heart beats
These may be serious side effects. You may need urgent medical attention.
Serious side effects are rare.
If any of the following happen, stop taking MODURETIC and tell your doctor immediately or go to accident and emergency at your nearest hospital:
swelling of the face, lips, mouth, throat or tongue which may cause difficulty swallowing or breathing
shortness of breath
pinkish, itchy swellings on the skin, also called hives or nettlerash
severe skin reaction which starts with painful red areas, then large blisters and ends with peeling of layers of skin. This is accompanied by fever and chills, aching muscles and generally feeling unwell
vomiting blood or material that looks like coffee grounds
bleeding from the back passage, black, sticky bowel motions (stools) or bloody diarrhoea
chest pain or tightness
These are serious side effects. You may need urgent medical attention or hospitalisation. These side effects are rare.
Other side effects not listed above may also occur in some patients. Tell your doctor if you notice any other effects.
Do not be alarmed by this list of possible side effects. You may not experience any of them.
After using MODURETIC
Keep your tablets in the blister pack until it is time to take them. If you take the tablets out of the box or blister pack they may not keep well.
Keep MODURETIC in a cool dry place where the temperature stays below 30 °C.
Do not store it or any other medicine in the bathroom or near a sink.
Do not leave it in the car or on window sills. Heat and dampness can destroy some medicines.
Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
If your doctor tells you to stop taking the tablets, or the tablets have passed their expiry date, ask your pharmacist what to do with any that are left over.
What it looks like
MODURETIC is a peach, diamond-shaped tablet with MSD 917 marked on one side.
A pack contains 50 tablets.
MODURETIC contains hydrochlorothiazide 50 mg and amiloride hydrochloride 5 mg per tablet.
calcium hydrogen phosphate
pregelatinised maize starch
sunset yellow FCF CI15985
MODURETIC does not contain sucrose, gluten, tartrazine or any other azo dyes.
MODURETIC is made in Australia by:
Merck Sharp & Dohme (Australia) Pty Limited
A.B.N. 14 000 173 508
54-68 Ferndell Street
South Granville NSW 2142
This leaflet was prepared in April 2008.
Australian Registration Number:
AUST R 10499
® Registered Trademark of Merck & Co., Inc. Whitehouse Station, N.J., U.S.A.