Reserpine

This prescription-only tablet for hypertension (high blood pressure) consists of three medicines namely reserpine, hydralazine, and hydrochlorothiazide.

Unchecked hypertension for a prolonged time causes “extra” workload on the heart and blood vessels, resulting in damages to the blood vessels of the brain, heart, and kidneys.

Over time, hypertension can lead to a stroke, heart failure, or kidney failure.

Reserpine lowers your blood pressure by depressing the central nervous mechanisms whereas hydralazine dilates blood vessels allowing more blood to flow through them.

Hydrochlorothiazide, a type of diuretic (water pill), works by increasing the rate of urine formation. All these actions have combined effect in reducing the blood pressure.

Before using reserpine, you must know all about the risks and complications associated with it.

Keep the following factors in mind before using these medicines:

Allergies: Inform your doctor about the allergies you have, such as to this medication, other medications, or to foods, dyes, or preservatives.

Pediatric: Use only after assessing the risks and benefits.

Geriatric: Use only after assessing the risks and benefits.

Pregnancy: It falls under pregnancy category C for all trimesters, meaning that due to lack of sufficient studies, it’s not clear if this medication is safe for use in pregnancy.

Breastfeeding: Use only after assessing the risks and benefits.

Drug Interactions: Taking two medicines together can be harmful due to possible interactions. In other cases, even if there is a possible interaction between two medicines your doctor may advise you to take them together after adjusting the dose or issuing precautions.

Here is a list of the medicines which in general are not recommended to be used with this medicine.

Inform your doctor if you are using any of these medicines:

• Brofaromine
• Dofetilide
• Furazolidone
• Iproniazid
• Isocarboxazid
• Lazabemide
• Linezolid
• Moclobemide
• Nialamide
• Pargyline
• Phenelzine
• Procarbazine
• Selegiline
• Tetrabenazine
• Toloxatone
• Tranylcypromine

Though usually not recommended, your doctor may decide, after adjusting dose or frequency of one or both medicines, to use this medicine with any of the following medicines:

• Acetyldigoxin
• Amphetamine
• Arsenic Trioxide
• Colchicine
• Cyclophosphamide
• Deslanoside
• Digitalis
• Droperidol
• Flecainide
• Fosphenytoin
• Iobenguane
• I 123
• Ketanserin
• Levomethadyl
• Lithium
• Methotrexate
• Metildigoxin
• Ouabain
• Phenytoin
• Proscillaridin
• Sotalol

Rarely and only when absolutely needed, this medicine may be used with the following medicines even if using them together may put you at risk of certain side effects.

In such cases, you may have to take the adjusted dose or change the frequency of intake.

• Aceclofenac
• Acemetacin
• Alacepril
• Amtolmetin Guacil
• Aspirin
• Benazepril
• Bepridil
• Captopril
• Carbamazepine
• Celecoxib
• Cholestyramine
• Choline Salicylate
• Clonixin
• Dexibuprofen
• Diflunisal
• Dipyrone
• Droxicam
• Enalapril
• Enalaprilat
• Etodolac
• Etofenamate
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Ginkgo
• Gossypol
• Indomethacin
• Meclofenamate
• Mefenamic Acid
• Morniflumate
• Nabumetone
• Naproxen
• Nepafenac
• Niflumic Acid
• Nimesulide
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Phenylbutazone
• Piketoprofen
• Proglumetacin
• Propionic Acid
• Propyphenazone
• Proquazone
• Quinapril
• Salsalate
• Sulindac
• Tiaprofenic Acid
• Tolfenamic Acid
• Tolmetin
• Topiramate
• Yohimbine
• Zofenopril

Other Interactions: Taking your medicine together with certain foods or items such as alcohol or tobacco may cause undesirable interactions.

Talk to your doctor to know if using this medicine with food, alcohol, or tobacco is safe. Using this medicine with any of the following is not generally recommended.

• Enteral Nutrition
• Food

Inform your doctor if you have any other medical conditions, including:

• Allergies or other breathing related troubles such as asthma
• Type II diabetes
• Gallstones
• Stomach ulcer
• Ulcerative colitis
• Seizures
• Past occurrence of gout, lupus erythematosus or depression
• Heart problems
• Kidney or liver problems
• Pancreatitis (inflamed pancreas)
• Parkinson's disease
• Pheochromocytoma
• A recent stroke

To use reserpine properly, you must follow all instructions given by your doctor. Remember that hypertension is a chronic disease. The key to controlling this often insidious condition is a combination of medicine, low-sodium diet, and weight management.

Do not get disheartened if your doctor prescribes you such medicines for a lifetime. Serious health conditions that may arise from uncontrolled hypertension include heart failure, blood vessel disease, stroke, or kidney disease.

Follow your doctor’s instructions while taking any medicine including this one. This medicine may cause you to have an unusual feeling of tiredness when you begin to take it.

At the beginning of the treatment, you may feel excessive tiredness and have to run to the bathroom more frequently (due to water pills). To not let the urinary urges affect your sleep,

• If a single daily dose is recommended, take it after breakfast.
• If more than a single daily dose are recommended, take your last dose before 6 pm. Talk to your doctor to determine the best dosing schedule.

You can take this medicine with your meals to reduce symptoms of an upset stomach.

Dosing: For best results, follow your doctor to know what amount of medicine you should take in a single dose.

The doses of a medicine can differ according to the conditions for which it is being prescribed, your age and your overall health status. Remember your doses can differ.

Consult your doctor if you have anything to ask. The doses of tablets to treat hypertensions are:

• Adults: 1 or 2 tablets 3 times a day.
• Children: Your doctor will decide the use and dose.

Missed Dose: Take your missed dose once you remember but avoid it if it’s time to take your next dose, and follow your normal dosing schedule. Avoid taking double doses to make up for the missed dose.

Storage:

• Store in a closed container at room temperature.
• Keep away from heat, moisture, and direct light.
• Do not freeze.
• Keep away from children.
• Discard any unused or expired medicines.

Before using reserpine, there are some precautions you must take. Your progress should be regularly monitored to determine if you are responding to the treatment.

Consult your doctor before using any nonprescription medicines for suppressing hunger, asthma, colds, cough, hay fever, or sinus problems, as these medicines may increase your blood pressure.

Make sure any other doctor or dentist you visit knows about your intake of this medicine.

You may feel dizzy or lightheaded while taking this medicine. Therefore, exercise extra caution while driving, using machines or doing any activity that requires alertness.

Any drug–related depressive symptoms should be reported to the doctor and immediate action should be taken. Watch for symptoms like nightmares or sleep problems.

Avoid taking alcohol and other CNS depressants such as allergy medicine, sleeping pills, cold medicine, prescription pain medicine or narcotics together with this medicine.

Under your doctor’s suggestion, you may increase potassium intake to supplement the loss caused by this medicine. But do not take any potassium supplement without first consulting your doctor. See your doctor if vomiting or diarrhea occur, which may cause dehydration.

Remember this medicine can interfere with blood or urine sugar tests. Talk to your doctor if you are concerned.

Your skin may be excessively sensitive to light while using this medicine. Here are some measures to protect your skin from the sunlight:

• Do not expose to direct sunlight, during the day from 10:00 a.m. to 3:00 p.m., if possible.
• Protect your skin from sunlight by wearing a hat, sunglasses or other appropriate clothing.
• Use a sunscreen with SPF 15 or more, or as required depending upon your skin type.
• For the lips, you can use a sunblock lipstick with SPF 15 or more.
• Avoid using a sunlamp, or tanning bed or booth.
• Consult your doctor if develop a severe reaction from the sun.

You may also have a congested nose. If you are thinking of using a nasal decongestant, talk to your doctor first.

Combat drug-associated dryness of mouth by using a saliva substitute or a sugar-free candy. See your doctor or dentist if dryness does not improve within 14 days.

Make sure you meet with your doctor in using reserpine to avoid unwanted potential side effects.

Studies on rats and mice have shown that administering a very high dose of reserpine results in tumors. However, more studies are required to demonstrate the same effect in humans.

Consult your doctor if you have any of the following side effects:

More common: 

• Generalized weakness or feeling ill

Less common:

• Abnormal dreams
• Anxiety
• Concentration problems
• Depression
• Difficulty maintaining sleep in the morning
• Drowsiness or tendency to faint
• Erectile dysfunction or decreased sex drive
• Nervousness
• Weakness

Signs and symptoms of Excessive Potassium Loss:

• Abnormal heart rhythm
• Altered mood
• Dry mouth
• Excessive thirst
• Feeble pulse
• Muscle cramps or pain

Signs and symptoms of Excessive Sodium Loss:

• Confusion
• Excessive tiredness or weakness
• Irritability
• Mental sluggishness
• Muscle cramps
• Seizures

Less common: 

• Abnormal heart rhythm
• Black, tar-like stools
• Blood in vomit
• Breathing difficulty
• Fever and headache
• Headache
• Numb or tingling sensations in the extremities
• Pain in , stomach, chest, throat, or joint
• Skin blisters or rashes
• Slowed heartbeat
• Swollen lymph glands

Rare:

• Abnormal bleeding or bruising
• Lower back or side pain
• Pain while urinating
• Severe stomach pain accompanied by nausea and vomiting
• Tremors in the hands and fingers
• Yellowish eyes or skin

Seek emergency medical attention if you have any of the following Signs and Symptoms of Overdose:

• Dizziness or drowsiness (severe)
• Dry mouth
• Excessively warm and reddened skin
• Excessive constriction of pupil
• Excessive thirst
• Muscle cramps or pain
• Severe nausea or vomiting
• Slowed pulse

Mild and non-serious side effects usually go away on their own without requiring medical intervention. You may also ask your doctor to learn more about how you may prevent or reduce the side effects.

Talk to your doctor if the side effects persist or worry you. See your doctor if you have some symptoms even after completing the course of this medicine.

The side effects of the medicine are not limited to the ones listed above. Call your doctor immediately if you experience any side effects that are uncommon or worry you. To report side effects to the FDA, contact at 1-800-FDA-1088.