Viskazide is a combination product that contains 2 medications (pindolol and hydrochlorothiazide) to treat high blood pressure. Pindolol belongs to a class of medications called beta-blockers and helps to lower blood pressure by decreasing the demands on the heart. Hydrochlorothiazide is a diuretic, or water pill, that helps control blood pressure by getting rid of excess salt and water.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The eventual dose of pindolol - hydrochlorothiazide is determined by treating with each of the ingredients separately (i.e., pindolol and hydrochlorothiazide) and finding the best daily dose for each. The combination medication may then be used at the appropriate dose. The usual adult dose ranges from one pindolol 10 mg - hydrochlorothiazide 25 mg tablet daily to 2 pindolol 10 mg - hydrochlorothiazide 50 mg tablets daily, taken in the morning.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Do not stop taking this medication without first talking with your doctor. Stopping the medication suddenly after you have been taking it for a while may cause unpleasant and potentially harmful effects.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Viskazide 10/25
Each peach, round, compressed tablet, 9 mm diameter, one side slope-faced and bisected with "10/25" embossed on each side of the bisect, reverse side flat-faced with bevelled edge and embossed with "VISKAZIDE" around the circumference and a centered logo, contains pindolol 10 mg and hydrochlorothiazide 25 mg. Nonmedicinal ingredients: D&C Red No. 21 Aluminium Lake, D&C Yellow No. 10 Lake, magnesium stearate, microcrystalline cellulose, pregelatinized starch and silicon dioxide.

Viskazide 10/50
Each orange, round, compressed tablet, 9 mm diameter, one side slope-faced and bisected with "10/50" embossed on each side of the bisect, reverse side flat-faced with bevelled edge and embossed with "VISKAZIDE" around the circumference and a centered logo, contains pindolol 10 mg and hydrochlorothiazide 50 mg. Nonmedicinal ingredients: D&C Red No. 21 Aluminium Lake, D&C Yellow No. 10 Lake, magnesium stearate, microcrystalline cellulose, pregelatinized starch and silicon dioxide.

Pindolol - hydrochlorothiazide should not be taken by anyone who:

• is allergic to pindolol, hydrochlorothiazide, sulfonamides (sulfa drugs), or any of the ingredients of the medication
• is in cardiogenic shock
• is scheduled to have surgery using certain types of anesthetics (e.g., ether)
• is unable to expel urine
• has a serious heart block
• has a severely slow heart rate
• has a very enlarged heart
• has asthma or other obstructive respiratory diseases
• has congestive heart failure
• has right ventricular failure secondary to pulmonary hypertension (excessive blood pressure in the lungs)

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

More common:

• decreased sexual ability
• dizziness or lightheadedness
• drowsiness (mild)
• trouble sleeping

Less common:

• anxiety or nervousness
• constipation
• diarrhea
• increased sensitivity of skin to sunlight (e.g., skin rash, itching, redness or other discolouration of skin, or severe sunburn)
• loss of appetite
• numbness or tingling of fingers and toes
• stomach discomfort or upset
• stuffy nose

Rare:

• changes in taste sensation
• dry, sore eyes
• itching of skin
• nightmares and vivid dreams

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Less common:

• cold hands and feet
• difficulty breathing or wheezing
• mental depression
• slow heartbeat (especially less than 50 beats per minute)
• swelling of ankles, feet, or lower legs

Rare:

• black, tarry stools
• blood in urine or stools
• chest pain
• dark urine
• fever, chills, cough, or sore throat
• hallucinations
• joint pain
• lower back or side pain
• pinpoint-sized red spots on skin
• red, scaling, or crusted skin
• skin rash or hives
• stomach pain (severe) with nausea and vomiting
• unusual bleeding or bruising
• yellow eyes or skin

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Asthma: Patients with asthma and certain other breathing problems should not receive pindolol.

Cholesterol: Increases in cholesterol and triglyceride levels may occur when taking hydrochlorothiazide.

Diabetes: The signs of low blood sugar may not be as noticeable when taking pindolol. Hydrochlorothiazide may make it more difficult for people with diabetes to control their blood sugar. People with diabetes who take insulin or other medications that work by reducing blood sugar should be cautious and monitor blood sugar carefully while taking this medication. Dose adjustment of antidiabetic agents, including insulin, may be required.

Drowsiness/reduced alertness: Dizziness or fatigue may occur when starting treatment with this medication. This may impair your ability to drive or operate machinery. Exercise caution with these activities until you find out whether the medication affects you in this way.

Fluid and electrolyte balance: Levels of electrolytes such as potassium, sodium, magnesium, and chloride can be reduced by the use of hydrochlorothiazide. Your doctor will periodically check to see if your electrolytes remain in balance. A potassium supplement may be necessary when taking this medication. Warning signs or symptoms of fluid and electrolyte imbalance include: dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, seizures, confusion, muscle pains or cramps, muscular fatigue, low blood pressure, racing heart beat, and nausea and vomiting.

Hyperthyroidism (high level of thyroid hormones): People with hyperthyroidism should be cautious while taking pindolol as it may reduce the symptoms of this condition, giving a false impression of improvement. Stopping the medication suddenly could worsen this condition.

Lupus: Hydrochlorothiazide may worsen the symptoms of this condition.

Severe allergies: People with allergies severe enough to cause anaphylaxis (a severe allergic reaction where swelling of the face, lips, and throat make it difficult to breathe) should talk to their doctor about what to do if they have an allergic reaction. Pindolol may make it more difficult to treat their allergic reaction with epinephrine.

Skin conditions: Various skin rashes and dry eyes have been reported with use of this medication.

Stopping usage: This medication should not be stopped suddenly by people who have angina. There have been reports of severe worsening of angina and of heart attack or abnormal heart rhythms occurring in people with angina who have stopped this medication abruptly.

Surgery: If you are scheduled for surgery, inform all doctors involved in your care that you are taking a medication that contains pindolol.

Pregnancy: Pindolol - hydrochlorothiazide is not recommended for use by pregnant women.

Breast-feeding: Pindolol - hydrochlorothiazide passes into breast milk. This medication is not recommended for use by breast-feeding mothers.

Children: The safety and effectiveness of using this medication have not been established for children.

There may be an interaction between pindolol - hydrochlorothiazide and any of the following:

alcohol amlodipine anesthetic agents anticholinergics (e.g., atropine, hyoscyamine) asthma medications barbiturates (e.g., phenobarbital) clonidine diabetes medications digoxin diltiazem disopyramide epinephrine felodipine flecainide guanethidine idocaine lithium

mexiletenemonoamine oxidase (MAO) inhibitors (e.g., tranylcypromine, phenelzine) taken within the past 2 weeksnarcotic analgesics (e.g., morphine, codeine) nifedipine nonsteroidal anti-inflammatory drugs (e.g., ibuprofen) norepinephrine other beta-blockers (e.g., propranolol, metoprolol) procainamide propafenone reserpine quinidine salicylates (e.g., ASA, salsalate) tubocurarin verapamil

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.