ADVERSE REACTIONS
Adverse reactions are usually reversible upon reduction of dosage or discontinuation of Ser-Ap-Es. Whenever adverse reactions are moderate or severe, it may be necessary to discontinue the drug.
The following adverse reactions have been observed, but there has not been enough systematic collection of data to support an estimate of their frequency. Consequently the reactions are categorized by organ system and are listed in decreasing order of severity and not frequency.
Reserpine
The following have been observed with rauwolfia preparations:
Digestive: Vomiting, diarrhea, nausea, anorexia, dryness of mouth, hypersecretion.
Cardiovascular: Arrhythmias (particularly when used concurrently with digitalis or quinidine), syncope, angina-like symptoms, bradycardia, edema.
Respiratory: Dyspnea, epistaxis, nasal congestion.
Neurologic: Rare parkinsonian syndrome and other extrapyramidal tract symptoms; dizziness; headache; paradoxical anxiety; depression; nervousness, nightmares; dull sensorium; drowsiness.
Musculoskeletal: Muscular aches.
Genitourinary: Pseudolactation, impotence, dysuria, gynecomastia, decreased libido, breast engorgement
Metabolic: Weight gain.
Special Senses: Deafness, optic atrophy, glaucoma, uveitis, conjunctival injection.
Hypersensitive Reactions: Purpura, rash, pruritus.
Hydralazine
Digestive: Hepatitis, paralytic ileus, vomiting, diarrhea, nausea, constipation, anorexia.
Cardiovascular: Angina pectoris, hypotension, paradoxical pressor response, tachycardia, palpitations, edema, flushing.
Respiratory: Dyspnea, nasal congestion.
Neurologic: Psychotic reactions characterized by depression, disorientation, or anxiety; peripheral neuritis, evidenced by paresthesia, numbness, and tingling; tremors; dizziness, headache.
Musculoskeletal: Muscle cramps, arthralgia.
Genitourinary: Difficulty in urination.
Hematologic : Blood dyscrasias, consisting of reduction in hemoglobin and red cell count, leukopenia, agranulocytosis; lymphadenopathy; splenomegaly, eosinophilia.
Special Senses: Conjunctivitis, lacrimation.
Hypersensitive Reactions: Purpura, fever, urticaria, rash, pruritus, chills.
Hydrochlorothiazide
Digestive: Pancreatitis, jaundice (intrahepatic cholestatic), sialadenitis, vomiting, diarrhea, cramping, nausea, gastric irritation, constipation, anorexia.
Cardiovascular: Orthostatic hypotension (may be potentiated by alcohol, barbiturates, or narcotics).
Neurologic: Vertigo, dizziness, transient blurred vision, headache, paresthesia, xanthopsia, weakness, restlessness.
Musculoskeletal: Muscle spasm.
Hematologic : Aplastic anemia, agranulocytosis, leukopenia, thrombocytopenia.
Metabolic: Hyperglycemia, glycosuria, hyperuricemia.
Hypersensitive Reactions: Necrotizing angiitis, Stevens-Johnson syndrome, respiratory distress including pneumonitis and pulmonary edema, purpura, urticaria, rash, photosensitivity.
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