Bendroflumethiazide

Bendroflumethiazide is not suitable for some people. For example, check with your doctor first if you have Addison's disease or diabetes.

Bendroflumethiazide usually comes as tablets that you take once a day. Follow the instructions that come with your medicine.

Side effects of bendroflumethiazide include feeling thirsty and feeling or being sick. More serious side effects can happen in rare cases.

Bendroflumethiazide is not usually taken while pregnant. Talk to your doctor about more suitable medicines you can have.

It can cause problems to take bendroflumethiazide with some other medicines, such as ibuprofen and medicines for diabetes or heart problems.

Most adults and children, including babies, can take bendroflumethiazide.

Bendroflumethiazide is not suitable for some people. To make sure it's safe for you, tell your doctor before starting to take it if you:

• have ever had an allergic reaction to bendroflumethiazide or any other medicine
• have underactive adrenal glands (Addison's disease)
• have low levels of sodium, potassium or magnesium in your blood
• have high levels of calcium or uric acid in your blood
• have liver problems
• have kidney problems or difficulty peeing
• are being sick (vomiting) or have diarrhoea
• have diabetes
• have gout
• have an inflammatory condition called lupus
• are pregnant, trying to get pregnant or breastfeeding

Always take bendroflumethiazide as a doctor or pharmacist has told you.

Dosage

Bendroflumethiazide comes as tablets.

Your dose of bendroflumethiazide will depend on why you're taking it, your age and how well your kidneys work.

The usual adult dose for high blood pressure is 2.5mg once a day.

For build-up of fluid (oedema), the usual dose is 5mg to 10mg once a day but this may be reduced to a single dose taken 1 to 3 times a week.

Occasionally, your doctor might prescribe bendroflumethiazide to be taken twice a day.

Your dose may be lower if you are over 65 or have kidney problems.

For babies and children, your child's doctor will use your child's weight or age to work out the right dose.

How to take it

You'll usually take bendroflumethiazide once a day, in the morning. If you take it later in the day you may have to wake up in the night to go to the toilet.

If you have to take it twice a day, take it once in the morning and again around midday.

Try to take bendroflumethiazide at the same time every day to help keep it working properly.

Sometimes, your doctor may advise you to take bendroflumethiazide less often. You may only need to take it 2 or 3 times a week, in which case take it on the same days each week.

You can take bendroflumethiazide with or without food.

Swallow the tablets whole with a drink of water. Speak to a pharmacist if you or your child finds it difficult to swallow tablets.

There are things you can do to help cope with these side effects of bendroflumethiazide:

Try to make sure you can get to a toilet easily. Also, take it in the morning or you may need to get up in the night to use the toilet.

Speak to a pharmacist or doctor if you're finding it hard to get to the toilet in time.

It's important not to get dehydrated, but how much you can drink will depend on why you're taking bendroflumethiazide. Check with your doctor how much water you can drink while you're taking this medicine.

Stick to simple meals and do not eat rich or spicy food. If you're being sick, try frequent small sips of water to avoid dehydration. Speak to your doctor if your symptoms continue.

If you take the combined contraceptive pill or progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Drink plenty of water or other fluids. Speak to a pharmacist if you are peeing less than usual or have dark yellow and strong-smelling pee, as you could be at risk of dehydration.

Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take the combined contraceptive pill or progestogen-only pill and have severe, watery diarrhoea or any diarrhoea that lasts more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Eat when you would usually expect to be hungry. If it helps, eat smaller meals but more often than usual. Snack when you're hungry and choose nutritious snacks that are high in calories and protein, such as dried fruit and nuts.

Get more fibre into your diet by eating fresh fruit, vegetables and cereals, and drink plenty of water. Try to exercise more regularly, for example, by going for a daily walk or run. If this does not help, talk to your pharmacist or doctor.

If you get sudden severe pain in any joint, such as your big toe, wrists, elbows or knees and the skin over the joint is hot, swollen and red, this could be a sign of gout. The redness may be less noticeable on brown or black skin.

Speak to your doctor if you have these symptoms.

These could be signs of low blood pressure (hypotension).

If you feel dizzy or faint, stop what you're doing. Try sitting or lying down until you feel better, and then get up slowly. A drink of water may also help. Do not drive, ride a bike or operate machinery if you are affected.

Speak to your doctor if this keeps happening.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Bendroflumethiazide is not normally used during pregnancy as other medicines are more suitable for treating high blood pressure.

If you're trying to get pregnant or are already pregnant, talk to your doctor about whether bendroflumethiazide is right for you. They may recommend switching to a different medicine for high blood pressure.

If your baby is healthy, you can take bendroflumethiazide if you need to while you're breastfeeding. However, other medicines might be better. Talk to your doctor or pharmacist first, and they'll help you to decide.

It's not known how much bendroflumethiazide gets into breast milk, but it's only likely to be low levels. It's unlikely to cause any side effects in your baby. However, if you take bendroflumethiazide for a long time, or at very high doses, it might reduce the amount of breast milk you make.

It's very rare for breastfed babies to have side effects from medicines you're taking. But it's important to keep monitoring your baby if you're taking any medicine while breastfeeding.

Contact your healthcare professional or call 111 as soon as possible if you notice that your baby:

• is not feeding as well as usual or not putting on weight as you would expect
• has signs they may be becoming dehydrated, such as tiredness, dark yellow pee or fewer wet nappies
• is vomiting (being sick), or has diarrhoea or constipation
• is being irritable
• has a skin rash

If your baby has any symptoms that are not listed, or if you're worried about them, you can also call 111 or contact any healthcare professional.

Carry on taking the medicine, and keep breastfeeding as usual until you've got advice about your baby's symptoms.

Some medicines can affect the way bendroflumethiazide works and increase the chances of you having side effects.

Tell your doctor or pharmacist before starting to take bendroflumethiazide if you take any other medicines, including:

• other medicines that lower blood pressure
• allopurinol, a medicine to treat gout
• non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or aspirin for pain relief
• insulin or any other medicine used to treat diabetes
• ciclosporin, a medicine used for preventing transplant rejection or to treat other medical conditions such as psoriasis or rheumatoid arthritis
• medicines used to treat heart problems, such as amiodarone, digoxin, disopyramide, flecainide or sotalol
• medicines to treat sickness or nausea (antiemetics), such as domperidone, metoclopramide or prochlorperazine
• certain antidepressants, such as amitriptyline, citalopram or venlafaxine
• medicines for other mental health problems, such as chlorpromazine, pimozide or trifluoperazine
• other diuretics (medicines that help your body get rid of extra fluid)
• steroids, such as prednisolone or hydrocortisone
• some medicines used for asthma, including inhalers such as formoterol, salbutamol or salmeterol
• carbamazepine, a medicine for epilepsy
• medicines to treat calcium or vitamin D deficiency, including alfacalcidol or calcitriol

These are not all the medicines that may cause problems if you take them with bendroflumethiazide. For a full list, see the leaflet inside your medicine packet.

Taking bendroflumethiazide with everyday painkillers

Some painkillers, especially ones that dissolve in water (soluble), can contain a lot of sodium, which is found in salt. Too much sodium can stop medicines for high blood pressure working properly.

Medicines that contain a lot of sodium include:

• soluble paracetamol
• soluble co-codamol

Speak to a pharmacist or doctor to find out if these medicines are safe for you to take with bendroflumethiazide.