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If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional: The most common adverse reactions were tiredness, dizziness, depression, shortness of breath, bradycardia, hypotension, diarrhea, pruritus, and rash.[Ref] Very common (10% or more): Heart failure (up to 27.5%), hypotension (systolic blood pressure less than 90 mm Hg) (up to 27.4%), bradycardia (heart rate less than 40 beats per minute) (up to 15.9%), Common (1% to 10%): Cold extremities, arterial insufficiency, palpitation, first degree heart block (P-R interval 0.26 seconds or greater), second or third degree heart block, postural disorders Uncommon (0.1% to 1%): Cardiogenic shock in patients with acute myocardial infarction Rare (0.01% to 0.1%): Disturbances of cardiac conduction, cardiac arrhythmia Very rare (less succinate than 0.01%): Intermittent claudication increased Frequency not reported: Claudication[Ref] Common (1% to 10%): Diarrhea, nausea, dry mouth, gastric pain, constipation, flatulence, heartburn, abdominal pain, vomiting Frequency not reported: Retroperitoneal fibrosis[Ref] Common (1% to 10%): Tiredness, peripheral edema, accident and/or injury, death, fatigue Uncommon (0.1% to 1%): Edema, precordial pain Frequency not reported: Lactic dehydrogenase elevated Postmarketing reports: Chest pain[Ref] Common (1% to 10%): Dizziness, vertigo, stroke, headache Uncommon (0.1% to 1%): Paresthesia, somnolence, impaired concentration Rare (0.01% to 0.1%): Alertness decreased Very rare (less than 0.01%): Amnesia/memory impairment, tinnitus, taste disturbance Frequency not reported: Short-term memory loss Postmarketing reports: Syncope[Ref] Common (1% to 10%): Shortness of breath, wheezing, dyspnea Rare (less than 0.1%): Rhinitis[Ref] Common (1% to 10%): Pruritus, rash Uncommon (0.1% to 1%): Sweating increased Rare (0.01% to 0.1%): Loss of hair Very rare (less than 0.01%): Photosensitivity reactions, psoriasis aggravated, gangrene in patients with preexisting severe peripheral circulatory disorders, hyperhidrosis, alopecia[Ref] Common (1% to 10%): Depression Uncommon (0.1% to 1%): Insomnia, nightmare Rare (0.01% to 0.1%): Nervousness, anxiety Very rare (less than 0.01%): Confusion, hallucination, personality disorder, disturbances of libido Frequency not reported: Sleep disturbance[Ref] Uncommon (0.1% to 1%): Muscle cramps Very rare (less than 0.01%): Arthralgia, arthritis Frequency not reported: Musculoskeletal pain[Ref] Uncommon (0.1% to 1%): Weight gain Frequency not reported: Unstable diabetes Postmarketing reports: Blood triglycerides increased, high density lipoprotein (HDL) decreased[Ref] Rare (less than 0.1%): Visual disturbance, dry and/or irritated eyes, conjunctivitis Frequency not reported: Blurred vision[Ref] Rare (0.01% to 0.1%): Liver function test abnormalities Very rare (less than 0.01%): Hepatitis Frequency not reported: Transaminase elevated, alkaline phosphatase elevated Postmarketing reports: Jaundice, non-specific hepatic dysfunction[Ref] Rare (0.01% to 0.1%): Impotence/sexual dysfunction Very rare (less than 0.01%): Peyronie's disease[Ref] Rare (less than 0.1%): Positive antinuclear antibodies[Ref] Very rare (less than 0.01%): Thrombocytopenia Frequency not reported: Agranulocytosis[Ref] 1. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. Effect Reduced serum p H; increased urine p H Dazamide®, Diamox® Therapeutics A heterocyclic sulfonamide used to manage respiratory acidosis by inhibiting renal carbonic anhydrase, which ↑ renal excretion of Na , K , and bicarbonate, and ↓ ammonia excretion; acetazolamide is also used to ↓ fluid retention in CHF, control 2º glaucoma and preoperatively in acute angle-closure glaucoma, epilepsy Effect ↓ Serum p H; ↑ urine p H Therapeutic range 10–15 µg/m L Toxic range ≥ 20 µg/m L A drug that inhibits the enzyme carbonic anhydrase in the kidney tubules, thus acting as a diuretic. 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