Do not take Moduretic tablets:

• if you are allergic to hydrochlorothiazide and amiloride hydrochloride or any of the other ingredients of this medicine (listed in section 6)
• if you have diabetes (a high blood sugar level)
• if you have been told by your doctor you have high levels of urea, creatinine, potassium or calcium in your blood
• if you are allergic to a type of antibiotic called sulfonamides, such as sulfamethoxazole
• if you are allergic to acetazolamide which is a diuretic used to remove fluid from the body and to treat high pressure in the eye (glaucoma), heart problems and sometimes fits or epilepsy
• if you are allergic to any other ‘thiazide’ water tablet (diuretic)
• if you are taking potassium sparing water tablets (diuretics) such as eplerenone, spironolactone or triamterene
• if you are taking a potassium supplement or medicine containing potassium or you eat potassium-rich foods
• if you suffer from kidney or liver disease
• if you have Addison’s disease

Do not take Moduretic if any of the above applies to you. If you are not sure talk to your doctor or pharmacist before taking Moduretic.

Warnings and precautions

Talk to your doctor or pharmacist before taking Moduretic if:

• you experience a decrease in vision or eye pain. These could be symptoms of fluid accumulation in the vascular layer of the eye (choroidal effusion) or an increase of pressure in your eye and can happen within hours to a week of taking Moduretic. This can lead to permanent vision loss, if not treated. If you earlier have had a penicillin or sulfonamide allergy, you can be at higher risk of developing this
• you have been told by your doctor you have high levels of uric acid, cholesterol or triglycerides (a type of cholesterol) in your blood
• you are taking digitalis such as digoxin – used for heart failure and abnormal heart beat
• you are being given fluids by a tube inserted into one of your veins
• you have recently suffered from severe vomiting or diarrhoea
• you have Systemic Lupus Erythematosus
• you are elderly
• you have gout
• you have had skin cancer or if you develop an unexpected skin lesion during the treatment. Treatment with hydrochlorothiazide, particularly long term use with high doses, may increase the risk of some types of skin and lip cancer (non-melanoma skin cancer). Protect your skin from sun exposure and UV rays while taking Moduretic.

If you are not sure talk to your doctor or pharmacist before taking Moduretic.

Children and adolescents

Do not give this medicine to children under 18 years of age as limited data is available.

Other medicines and Moduretic

Tell your doctor or pharmacist if you are taking or have recently taken or might take any other medicines, including medicines obtained without a prescription. This includes herbal medicines. This is because Moduretic can affect the way some other medicines work. Also some other medicines can affect the way Moduretic works.

It is important to tell your doctor or pharmacist if you take:

• angiotensin converting enzyme inhibitors (ACE inhibitors) such as enalapril used to treat high blood pressure or heart problems
• angiotensin II receptor antagonists such as losartan – used to treat high blood pressure or diabetics with kidney damage
• other medicines for high blood pressure
• medicines for diabetes such as insulin or chlorpropamide
• lithium – used for depression
• non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen – used to reduce high temperature (fever), pain or for arthritis
• barbiturates – used to help you sleep or to reduce anxiety
• painkillers such as codeine, dihydrocodeine, dextropropoxyphene, diamorphine, morphine, pentazocine and pethidine
• cholestyramine and colestipol – used to treat high cholesterol (hyperlipidaemia)
• steroids – used to treat lots of different conditions such as rheumatism, arthritis, allergic conditions, skin problems, asthma or a type of blood disorder
• ACTH to test whether your adrenal glands are working properly
• medicines injected for allergic reactions such as adrenaline (also known as epinephrine)
• tacrolimus – used after a liver or kidney transplant to prevent rejection
• ciclosporin – used for rheumatoid arthritis or to prevent rejection after a transplant
• ‘non-depolarising’ muscle relaxants such as tubocurarine
• Trilostane – used to treat breast cancer or overactive adrenal glands (such as in Conn’s syndrome, Cushing’s syndrome).

In addition, if you are going to have an operation, make sure the doctor treating you knows you are taking Moduretic.

If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before taking Moduretic.

Tests while you are taking Moduretic

When you are on this medication it may affect some tests on blood or urine samples. Please remind your doctor you are taking Moduretic if he or she wants you to have any tests.

If you have diabetes or your doctor suspects you have diabetes, you may need to have some tests before receiving treatment with Moduretic.

Moduretic with food, drink and alcohol

Your doctor may have asked you to change your diet slightly and not to eat certain foods which contain a lot of potassium. These foods include milk, bananas, raisins and prunes. Your doctor will tell you what food you should not eat. If you are unsure about what food you should avoid, ask your doctor before taking Moduretic tablets.

Your doctor may have told you that you should keep alcohol intake to a minimum while you are taking Moduretic. Alcohol may increase the effects of Moduretic so that you feel dizzy or light-headed when you stand up quickly.

Pregnancy and breast-feeding

Pregnancy

You must tell your doctor if you are pregnant, think you may be pregnant or are planning to have a baby. Usually, your doctor will advise you to take another medicine instead of Moduretic, as Moduretic is not recommended during pregnancy. This is because Moduretic crosses the placenta and its use after the third month of pregnancy may cause potentially harmful foetal and neonatal effects.

Breastfeeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. Moduretic is not recommended for mothers who are breast feeding.

Driving and using machines

This medicine may make you feel tired or dizzy. Do not drive or operate machinery until you have discussed this with your doctor or you know if you are affected.

Moduretic contains lactose

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

Moduretic contains sunset yellow colouring (E110), which may cause allergic reactions.

How to store Moduretic

Keep this medicine out of the sight and reach of children.

Do not use the medicine after the expiry date which is stated on the carton after ‘EXP’. The expiry date refers to the last day of that month.

Store below 25°C. Protect from moisture.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.