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How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while having treatment with this one, to ensure that the combination is safe.

This medicine reduces the ability of the body to remove the medicine lithium. As this can increase the blood level of lithium and the risk of its side effects, this medicine should not be taken by people taking lithium.

Colestyramine and colestipol can reduce the absorption of cyclopenthiazide from the gut. if you have been prescribed either of these medicines you should not take them within two hours of taking this medicine.

This medicine decreases blood pressure. If it is used in combination with other medicines that lower blood pressure, either as a side effect, or to treat high blood pressure (antihypertensives), the combination might make you feel dizzy or faint. Your doctor may need to adjust your doses. Other medicines that decrease blood pressure include the following:

ACE inhibitors such as enalapril

alpha-blockers such as prazosin

beta-blockers such as propranolol

calcium-channel blockers such as verapamil, nifedipine

clonidine

nitrates, eg glyceryl trinitrate

tricyclic or MAOI antidepressants

certain antipsychotics

alprostadil

baclofen

benzodiazepines.

If you are due to start treatment with an ACE inhibitor, eg captopril, your doctor may ask you to stop taking this medicine, or reduce your dose for a few days beforehand, in order to avoid your blood pressure falling too low with the first dose of the ACE inhibitor.

Amiloride can increase the amount of potassium in the blood. If this medicine is taken with any of the following, which can also raise potassium in the blood, the combination could cause the amount of potassium in the blood to rise too high (hyperkalaemia):

ACE inhibitors, eg captopril

angiotensin II receptor antagonists, eg losartan

ciclosporin

non-steroidal anti-inflammatory drugs (NSAIDs), eg indometacin

other potassium-sparing diuretics, eg spironolactone, triamterene

potassium supplements (do not take with this medicine)

potassium salts, eg potassium citrate (do not take with this medicine)

potassium-containing salt substitutes, eg lo-salt (do not take with this medicine)

tacrolimus.

Cyclopenthiazide can decrease the amount of potassium in the blood. If this medicine is taken with any of the following medicines, which can also lower potassium in the blood, the combination could cause the amount of potassium in the blood to fall too low (hypokalaemia):

acetazolamide

amphotericin

corticosteroids, such as hydrocortisone and prednisolone

beta 2 agonists, eg salbutamol, terbutaline

other diuretics, eg bendroflumethiazide, furosemide

theophylline.

If the level of potassium in your blood falls during treatment, this can increase the risk of adverse effects from digoxin or medicines for abnormal heart rhythms, eg amiodarone.

There may be an increased risk of side effects on the kidneys if this medicine is used in combination with the following medicines:

ACE inhibitors, eg captopril

certain antibiotics, eg aminoglycosides such as gentamicin

other diuretics

non-steroidal anti-inflammatory drugs (NSAIDs), eg indometacin.

Diuretics can increase blood glucose levels and people with diabetes may therefore need increases in their dose of insulin or antidiabetic tablets. If you have diabetes you should monitor your blood sugar levels.

There may be an increased risk of a rise in the level of calcium in the blood (hypercalcaemia) if calcium or vitamin D supplements, or antacids containing calcium, eg calcium carbonate, are taken in combination with cyclopenthiazide. You should avoid taking large amounts of these medicines while you are taking this medicine, unless otherwise directed by your doctor.

There may be an increased risk of allergic reactions to allopurinol in people taking thiazide diuretics such as cyclopenthiazide, particularly if they also have any kidney problems.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain both these diuretics.

Navidrex contains just cyclopenthiazide.

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