Summary

Commonly reported side effects of hydrochlorothiazide/methyldopa include: positive direct coombs test. Continue reading for a comprehensive list of adverse effects.

Applies to hydrochlorothiazide / methyldopa: oral tablet.

Serious side effects

Along with its needed effects, hydrochlorothiazide/methyldopa 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 while taking hydrochlorothiazide / methyldopa:

Rare

• Unexplained fever shortly after starting to take this medicine

Check with your doctor as soon as possible if any of the following side effects occur while taking hydrochlorothiazide / methyldopa:

Signs and symptoms of too much potassium loss

• Dry mouth
• increased thirst
• irregular heartbeats
• muscle cramps or pain
• nausea or vomiting
• unusual tiredness or weakness
• weak pulse

Less common

• Mental depression or anxiety
• nightmares or unusually vivid dreams

Rare

• Cough or hoarseness
• dark or amber urine
• diarrhea or stomach cramps (severe or continuing)
• fever, chills, troubled breathing, and fast heartbeat
• general feeling of discomfort or illness or weakness
• joint pain
• lower back or side pain
• painful or difficult urination
• pale stools
• skin rash, hives, or itching
• stomach pain (severe) with nausea and vomiting
• tiredness or weakness after having taken this medicine for several weeks (continuing)
• yellow eyes or skin

Other side effects

Some side effects of hydrochlorothiazide / methyldopa 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

• Dizziness or light-headedness when getting up from a lying or sitting position
• drowsiness
• dryness of mouth
• headache

Less common

• Decreased sexual ability or interest in sex
• diarrhea
• increased sensitivity of skin to sunlight (skin rash, itching, redness or other discoloration of skin or severe sunburn after exposure to sunlight)
• loss of appetite
• numbness, tingling, pain, or weakness in hands or feet
• slow heartbeat
• stuffy nose
• swelling of breasts or unusual milk production

For Healthcare Professionals

Applies to hydrochlorothiazide / methyldopa: oral tablet.

Cardiovascular

Hydrochlorothiazide:

Frequency not reported: Hypotension, orthostatic hypotension, necrotizing angiitis, vasculitis

Methyldopa:

Frequency not reported: Angina pectoris aggravated, congestive heart failure, prolonged carotid sinus hypersensitivity, orthostatic hypotension, bradycardia, myocarditis, pericarditis, vasculitis^[Ref]

Dermatologic

Hydrochlorothiazide:

Frequency not reported: Cutaneous vasculitis, photosensitivity, urticaria, rash, purpura, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, alopecia

Methyldopa:

Frequency not reported: Toxic epidermal necrolysis, rash^[Ref]

Gastrointestinal

Hydrochlorothiazide:

Frequency not reported: Pancreatitis, diarrhea, vomiting, sialadenitis, cramping, constipation, gastric irritation, nausea

Methyldopa:

Frequency not reported: Pancreatitis, colitis, vomiting, diarrhea, sialadenitis, sore tongue, black tongue, nausea, constipation, distention, flatus, dry mouth^[Ref]

Hematologic

Hydrochlorothiazide:

Frequency not reported: Aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia

Methyldopa:

Frequency not reported: Bone marrow depression, leukopenia, granulocytopenia, thrombocytopenia, hemolytic anemia, Coombs test positive, eosinophilia^[Ref]

Nervous system

Hydrochlorothiazide:

Frequency not reported: Vertigo, paresthesias, dizziness, headache

Methyldopa:

Frequency not reported: Sedation, headache, Parkinsonism, Bell's palsy, mental acuity decreased, involuntary choreoathetotic movements, cerebrovascular insufficiency symptoms, dizziness, lightheadedness, paresthesias^[Ref]

Hepatic

Hydrochlorothiazide:

Frequency not reported: Intrahepatic cholestatic jaundice

Methyldopa:

Frequency not reported: Liver disorders, hepatitis, jaundice, liver function tests abnormal^[Ref]

Other

Hydrochlorothiazide:

Frequency not reported: Weakness, fever

Methyldopa:

Frequency not reported: Asthenia, weakness, edema, drug-related fever, breast enlargement, gynecomastia, lactation^[Ref]

Psychiatric

Hydrochlorothiazide:

Frequency not reported: Restlessness

Methyldopa:

Frequency not reported: Psychic disturbances, nightmares, reversible mild psychoses, depression, libido decreased^[Ref]

Genitourinary

Hydrochlorothiazide:

Frequency not reported: Glycosuria, impotence

Methyldopa:

Frequency not reported: Amenorrhea, impotence^[Ref]

Immunologic

Hydrochlorothiazide:

Frequency not reported: Anaphylactic reactions

Methyldopa:

Frequency not reported: Antinuclear antibody test positive, LE cells, rheumatoid factor^[Ref]

Metabolic

Hydrochlorothiazide:

Frequency not reported: Anorexia, electrolyte imbalance, hyperglycemia, hyperuricemia

Methyldopa:

Frequency not reported: Weight gain^[Ref]

Musculoskeletal

Hydrochlorothiazide:

Frequency not reported: Muscle spasm

Methyldopa:

Frequency not reported: Lupus-like syndrome, arthralgia, myalgia^[Ref]

Renal

Hydrochlorothiazide:

Frequency not reported: Renal failure, renal dysfunction, interstitial nephritis

Methyldopa:

Frequency not reported: BUN increased^[Ref]

Respiratory

Hydrochlorothiazide:

Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema

Methyldopa:

Frequency not reported: Nasal stuffiness^[Ref]

Endocrine

Methyldopa:

Frequency not reported: Hyperprolactinemia^[Ref]

Ocular

Hydrochlorothiazide:

Frequency not reported: Transient blurred vision, xanthopsia^[Ref]