SIDE EFFECTS: See also Warning and Precautions sections. Dizziness, lightheadedness, blurred vision, or tiredness may occur as your body adjusts to the medication. Nausea/vomiting, stomach pain, and unusual dreams may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Propranolol may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. The hydrochlorothiazide in this product may cause a loss of too much body water (dehydration) and salt/minerals. Tell your doctor right away if you have any of these unlikely but serious symptoms of dehydration or mineral loss: very dry mouth, extreme thirst, muscle cramps, weakness, fast/irregular heartbeat, nausea/vomiting, severe dizziness, confusion, fainting, seizures. Tell your doctor right away if any of these unlikely but serious side effects occur: blue fingers/toes, mental/mood changes (e.g., depression), numbness/tingling of arms/legs, new or worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), very slow heartbeat, decreased sexual ability, increased thirst/urination, decrease in vision, eye pain. Tell your doctor right away if any of these rare but very serious side effects occur: easy bruising/bleeding, signs of infection (e.g., fever, persistent sore throat), aching/swollen joints, yellowing eyes/skin, persistent nausea/vomiting, severe stomach/abdominal pain, dark urine, signs of kidney problems (such as change in the amount of urine). A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you are allergic to propranolol or hydrochlorothiazide; or to other thiazides (e.g., chlorothiazide); or if you have had a serious reaction to other beta blockers (e.g., metoprolol, atenolol); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (e.g., asthma, bronchitis, emphysema), diabetes, heart failure, certain types of heart rhythm problems (sinus bradycardia, Wolff-Parkinson-White syndrome, second- or third-degree atrioventricular block), overactive thyroid (hyperthyroidism), kidney disease, liver disease, blood circulation problems (e.g., Raynaud's disease), a certain type of tumor (pheochromocytoma), mental/mood disorders (e.g., depression), certain muscle/nerve disease (myasthenia gravis), gout, loss of too much body water (dehydration), lupus, certain recent nerve surgery (sympathectomy), severe allergic reactions, untreated mineral imbalance (e.g., low potassium/magnesium, high calcium). Before having surgery, tell your doctor or dentist that you are taking this medication. This drug may make you dizzy or blur your vision. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. Significant loss of body water from too much sweating, vomiting, or diarrhea can also lower your blood pressure and worsen dizziness. Drink plenty of fluids to prevent these effects and dehydration. If you are on restricted fluid intake, consult your doctor for further instructions. Contact your doctor if you are unable to drink fluids or if you have persistent diarrhea/vomiting. This drug may reduce the potassium levels in your blood. Ask your doctor about increasing the amount of potassium in your diet (e.g., bananas, orange juice) or about using a salt substitute containing potassium. A potassium supplement may be prescribed by your doctor. If you have diabetes, this product may mask the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar, such as dizziness and sweating, are unaffected by this drug. This product may also make it harder to control your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet. This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness. Older adults may be more sensitive to the effects of this product, especially dizziness. During pregnancy, this product should be used only when clearly needed. Infants exposed to the medications in this product during pregnancy may have low birth weight, low blood sugar, slow breathing/heartbeat, liver problems, or bleeding problems. Discuss the risks and benefits with your doctor. The medications in this product pass into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: See also How to Use section. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: alpha blockers (e.g., prazosin), aluminum hydroxide, anticholinergics (e.g., atropine, scopolamine), chlorpromazine, cisapride, diazoxide, dofetilide, drugs affecting liver enzymes that remove propranolol from your body (such as cimetidine, St. John's wort, certain SSRI antidepressants including fluoxetine/paroxetine/fluvoxamine, protease inhibitors including ritonavir, rifamycins including rifabutin), other drugs to treat high blood pressure (e.g., clonidine, hydralazine, methyldopa), epinephrine, fingolimod, haloperidol, other heart medications (e.g., digoxin, disopyramide, propafenone, quinidine), lithium, mefloquine, rizatriptan, theophylline, thioridazine, drugs for thyroid disease (e.g., methimazole, propylthiouracil, thyroid supplements including levothyroxine), warfarin. Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen). This medication may interfere with certain laboratory tests (including glaucoma screening test, cardiovascular stress testing using arbutamine, parathyroid test, protein-bound iodide test), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: very slow heartbeat, severe dizziness, fainting, trouble breathing.