Read all of this leaflet carefully before you start taking this medicine

•    Keep this leaflet. You may need to read it again.

•    If you have any further questions, ask your doctor or pharmacist.

•    This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.

•    If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet please tell your doctor or pharmacist.

The information in this leaflet has been divided into the following sections:

1.    What Hygroton is and what it is taken for

2.    Check before you take Hygroton

3.    How to take Hygroton

4.    Possible side effects

5.    How to store Hygroton

6.    Further information

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11. What Hygroton is and what it is taken for_

Hygroton belongs to a group of medicines called thiazide diuretics.

Thiazide diuretics help to reduce the amount of water in your body. They do this by increasing the amount of water that you pass as urine. They are sometimes called water tablets'.

Hygroton is used to:

•    treat high blood pressure (hypertension)

•    treat heart failure

•    help reduce the fluid retention that occurs with some kidney or liver diseases

•    treat diabetes insipidus (a condition in which an individual produces large amounts of dilute urine and is constantly thirsty).

| 2. Check before you take Hygroton_

Do not take Hygroton:

•    if you are allergic (hypersensitive) to chlortalidone, sulphonamides such as sulfamethoxazole or any of the ingredients of Hygroton (see Section 6 Further information)

•    if you are not passing any urine at all

•    if you have severe kidney or liver problems

• if you have low blood levels of potassium which can cause muscle weakness, muscle twitching or abnormal heartbeat

• if you have low blood levels of sodium which can cause tiredness, confusion, muscle twitching, fits or coma

•    if you have high blood levels of calcium which can cause loss of appetite, tiredness or muscle weakness

•    if you have ever had gout or kidney stones

•    if you have Addison’s disease (which is a condition where your adrenal gland is not producing enough steroids)

•    if you are taking lithium.

If any of the above applies to you, or if you are not sure, speak to your doctor or pharmacist before you take Hygroton.

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Take special care with Hygroton

Before you take Hygroton tell your doctor if:

•    you suffer from any other liver or kidney problems

•    you are on a low-salt diet

•    you suffer from diabetes mellitus (increased levels of sugar in the blood) o • you have high cholesterol levels

2    • if you have recently had an anaesthetic

<C • you are elderly.

If any of the above applies to you, or if you are not sure, speak to your doctor or pharmacist before you take Hygroton.

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Taking other medicines

Tell your doctor or pharmacist if you are taking or have recently taken any of the following medicines as they may interfere with Hygroton:

•    other treatments for high blood pressure or heart problems such as:

-    ACE inhibitors (for example, lisinopril)

-    beta blockers (for example propranolol hydrochloride)

-    methyldopa

-    vasodilators (for example bosentan)

-    calcium channel blockers (for example amlodipine)

-    guanethidine

•    corticosteroids such as prednisolone or betamethasone - used to treat allergic and inflammatory diseases and immune reactions

•    cytotoxic agents such as cyclophosphamide or methotrexate - used to treat cancer

•    asthma treatments such as salbutamol or formoterol

•    amphotericin - used to treat infections

•    carbenoxolone - used to treat ulcers

•    insulin and other treatments for diabetes such as chlorpropamide or glibenclamide

•    digoxin - for an irregular heartbeat

•    lithium - used to treat mental illness

•    adrenocorticotropic hormone (ACTH) - used to treat a number of different conditions, including ulcerative colitis, Crohn's disease and rheumatoid arthritis

•    anticholinergics such as atropine sulphate or hyoscine butylbromide for abdominal or stomach spasms or cramps

•    colestyramine - used to reduce cholesterol levels and prevent heart disease

•    amantadine - used to treat Parkinson's disease or viral infections

•    allopurinol - used to treat gout

•    calcium salts or vitamin D - used for replacement therapy

•    non-steroidal anti-inflammatories (NSAlDs) such as aspirin or indometacin - used for pain relief or rheumatism

•    ciclosporin - used to treat rheumatic disease or skin complaints or after a transplant

Please tell your doctor or pharmacist if you are taking or have recently taken/used any other medicines, including medicines obtained without a prescription.

Taking with food and drink

It is best to take Hygroton in the morning with food. Swallow your tablets whole with a drink of water.

You should avoid low salt diets. Taking Hygroton may reduce the amount of salt in your body.

If you are on a low salt diet check with your doctor first before taking Hygroton.

Pregnancy and breast-feeding

Do not take Hygroton if you are pregnant or trying to become pregnant.

Do not take Hygroton if you are breast-feeding because Hygroton passes into breast milk and could harm your baby. Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines

If you feel dizzy when you start taking these tablets, do not drive or work with machinery until these effects have worn off.

| 3. How In take Hygroton tablets_|

Always take Hygroton exactly as your doctor has told you to.

It is important to take your tablets at the right time. You should check with your doctor or pharmacist if you are not sure.

Your doctor will choose a suitable starting dose for your particular condition and monitor your progress. If necessary, this dose can be increased or reduced.

Whilst you are taking Hygroton, your doctor may want to carry out a number of tests from time to time. This is quite usual and nothing to worry about.

It is best to take Hygroton in the morning with food. Swallow your tablets whole with a drink of water.    _

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If you get any of the following tell your doctor or pharmacist immediately as they may tell you to stop taking Hygroton:

•    muscles feel weak or will not work properly

•    irregular heartbeat.

Very common side effects (that affect more than 1 person in 1P):

•    low blood levels of potassium which can cause muscle weakness, muscle twitching or abnormal heartbeat

•    increased blood levels of uric acid

•    increased blood levels of cholesterol.

Common side effects (that affect less than 1 person in 10):

•    low levels of sodium which can cause tiredness, confusion, muscle

CD    twitching, fits or coma

2-    • low levels of magnesium

o' • high blood sugar levels which can cause tiredness, weakness or 3    feeling thirsty

•    nettle rash

•    skin rash

•    low blood pressure which may make you feel dizzy when you stand up

•    dizziness

•    loss of appetite

•    upset stomach

•    impotence in men.

Uncommon side effects (that affect less than 1 person in 100):

•    gout which causes pain and swelling in the joints.

Rare side effects (that affect less than 1 person in 1000):

•    increased calcium in the blood which can cause agitation, sore eyes, abdominal pain

•    sugar in the urine (this would show up when your doctor or nurse tests your urine)

•    worsening of diabetes

•    yellowing of the skin or eyes caused by liver or blood problems (jaundice)

•    increased sensitivity of your skin to sunlight

•    abnormal heartbeat the symptoms of which include palpitations and fainting

•    pins and needles

•    headache    -n

•    feeling or being    sick    cd

•    stomach pain    ^

•    constipation

•    diarrhoea

•    reduction in blood platelets which increases the risk of bruising or bleeding

•    severe reduction in the number of white blood cells which makes infection more likely

•    an abnormally high    amount of eosinophils (type of white blood cell)    —|

in the blood    .§

•    breathing problems

•    problems with your kidneys.

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