Moducren®

(hydrochlorothiazide, amiloride hydrochloride, and timolol maleate, MSD)

PLEASE READ BOTH SIDES OF THIS LEAFLET CAREFULLY BEFORE YOU START TO TAKE YOUR TABLETS.

Keep this leaflet. You may want to read it again.

What is in your tablets?
Active ingredients
There are three active ingredients in Moducren: Hydrochlorothiazide EP, amiloride hydrochloride EP, and timolol maleate EP.
Moducren Tablets are only available in one strength. Each tablet contains 25 mg hydrochlorothiazide EP, 2.5 mg amiloride hydrochloride EP, and 10 mg timolol maleate EP.
Moducren Tablets are available in packs of 14, 28 or 1 00 tablets.

Other ingredients
Indigo carmine E132, industrial methylated spirit 740P BP, magnesium stearate EP, microcrystalline cellulose EP, pregelatinised maize starch BP, purified water BP.
How do your tablets work ?
The active ingredients in your tablets are hydrochlorothiazide, amiloride hydrochloride, and timolol maleate: the first and second ingredients belong to a group of medicines known as 'diuretics', the third belongs to a group of medicines known as beta-blockers. These medicines act together to lower your blood pressure.

Who makes your tablets?
Your tablets are made by Merck Sharp & Dohme Limited, Shotton Lane, Cramlington, Northumberland, for Merck Sharp & Dohme Limited, Hoddesdon, Hertfordshire, UK, who hold the Product Licence in the UK and Product Authorisation in Ireland.

Why do you need to take these tablets?
Your doctor has prescribed Moducren for you because you have high blood pressure. Although you may not feel unwell, high blood pressure can increase your risk of heart disease or stroke, if left untreated.

Are there patients who should not take these tablets?
Yes; do not take the tablets if:
1.	You are or think you may be pregnant.
2.	You are planning to become pregnant.
3.	You are breast-feeding.
4.	You have asthma or other lung disease, such as bronchitis or emphysema.
5.	You have a problem with your heart, such as heart failure.
6.	You have a high level of a naturally occurring chemical called potassium in your blood; or you are currently taking medicines which make your body retain this chemical, such as potassium supplements or some types of water tablets. Your doctor will know which medicines these are.
7.	You have kidney or liver problems.
8.	You are a diabetic or have been diagnosed as subject to spontaneous hypoglycaemia.
9.	You are allergic to any of the ingredients.
10.	You are allergic to any sulphonamide-derived drugs. (Ask your doctor if you are not sure which ones these are.)
If you think any of these apply to you, do not take the tablets, go and talk to your doctor first and follow his advice.

Use in children: Safety and effectiveness in children have not been established.

What else should you know about taking your tablets?
You should check with your doctor before taking 'Moducren' if:
-	You have angina or have had a heart attack in the past.	-	You are taking medicines for a heart condition, such as 'Digoxin'.
-	You have a condition known as 'systemic lupus erythematosus'.
-	You have gout.

Your doctor may have asked you to change your diet slightly, to avoid eating foods which contain a lot of potassium. These foods include milk, bananas, raisins, prunes. Your doctor will know which foods you should avoid. Your doctor may also need to carry out simple blood tests while you are taking Moducren, to monitor the level of potassium in your blood.
In addition, if you are planning to have an operation, or undergo an emergency operation (including at the dentist), you should tell the doctor treating you that you are or have been taking Moducren Tablets.

What about alcohol?
Your doctor may have told you that you should always keep your alcohol intake to a minimum because it may affect the activity of Moducren and cause a decrease in blood pressure accompanied by a feeling of dizziness or lightheadedness when standing up quickly.
If you are concerned about how much alcohol you can drink while you are taking Moducren, discuss this with your doctor.

Can you take Moducren with other medicines?
Moducren can occasionally interfere with a few other medicines that you may be taking, so it is important that you tell your doctor about all the medicines you are taking, including those obtained without a doctor's prescription .
If you are taking any of the following medicines you should talk to your doctor before taking Moducren:
-	Medicines for diabetes.
-	Other medicines to treat high blood pressure or a heart condition (such as Digoxin).
-	Medicines known as 'non-steroidal anti-inflammatory drugs' (NSAIDs), such as aspirin, ibuprofen.
-	Steroids or a medicine called ACTH.
-	Sympathomimetics, such as adrenaline.
-	A medicine called lithium (a drug used to treat a certain kind of depression). 
-	Certain muscle relaxants.
-	Barbiturates or narcotics.

How should you take Moducren?
You should take your tablets exactly as advised by your doctor or pharmacist. The number of tablets you take each day will depend upon your condition and whether you are taking other medicines. For most people this is either 1 or 2 tablets taken once a day, usually swallowed with a glass of water.
Take Moducren exactly as your doctor has instructed. It is very important to continue taking Moducren for as long as your doctor prescribes. Do not take more tablets than the prescribed dose.

What if you forget to take a tablet or take too many?
If you miss a dose, just carry on with the next one as normal. Do not take an extra one to make up.
In case of an overdose, contact your doctor immediately so that medical attention may be given promptly.

What unwanted effects could your tablets have?
Like all medicines, Moducren may occasionally cause side effects in some patients. These may include the following: Dizziness; tiredness; headache; a slow pulse rate; cold feeling in your fingers or toes; light-headedness due to a drop in blood pressure, fainting, angina; irregular heart beats; wheezing; difficulty in breathing; stomach upsets (such as nausea, indigestion, constipation, diarrhoea, vomiting, stomach pain); jaundice; lack or loss of appetite; thirst and a dry mouth; sore mouth; impotence; tingling sensations; rash; dry eyes; sweating; shaking; muscle cramps; changes in your vision; disturbed sleep; depression, nervousness, vertigo (spinning sensation); reduced bone marrow activity; changes in the levels of blood and urine chemicals (such as sodium, potassium, chloride and magnesium [your doctor can tell you more about these]) .	

Tell your doctor or pharmacist promptly about any of these or any unusual symptoms.

How should your tablets be kept?
Keep your tablets out of the reach of children. Keep them out of direct sunlight and in a dry place.
Do not put them into another container as they might get mixed up. If you have any tablets left over when your doctor tells you to stop taking them, then return them to your doctor or pharmacist.
Do not take them past the expiry date which is clearly marked on the pack.	Remember, this medicine is for you. Do not share it with anyone else. It may not suit them.

How can you obtain more information about Moducren?
This leaflet gives you only some of the most important patient information about Moducren. If you have any questions after you have read it, ask your doctor or pharmacist, who will give you further information.

® denotes registered trademark of Merck & Co., Inc., Whitehouse Station, NJ, USA.