Rauwolfia Alkaloid

1 What is Rauwolfia Alkaloid?

Brand: Rauwolfia Alkaloid

Generic: Rauwolfia Alkaloid and Thiazide Diuretic Combination

Rauwolfia alkaloid and thiazide diuretic combinations are prescription-only products used in patients with high blood pressure (hypertension).

Unchecked hypertension for a prolonged time causes “extra” workload on the heart and blood vessels, resulting in damages to the blood vessels of the brain, heart, and kidneys. Over time, hypertension can lead to a stroke, heart failure, or kidney failure.

Rauwolfia alkaloids lower your blood pressure by depressing the central nervous mechanisms whereas thiazide diuretics (water pills) work by increasing the rate of urine formation. Both these actions have combined effect in reducing the blood pressure.

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2 What to Know Before Using

If you are about to start Rauwolfia alkaloid, speak with your doctor about what you need to know.

Keep the following factors in mind before using these medicines:

Allergies: Inform your doctor about the allergies you have, such as to this medication, other medications, or to foods, dyes, or preservatives.

Pediatric: Use only after assessing the risks and benefits.

Geriatric: Use only after assessing the risks and benefits.

Pregnancy: Using this combination in pregnancy carries considerable risks to the unborn baby. Therefore, consult your doctor before using if you are pregnant.

Breastfeeding: Both these medicines are secreted into breast milk and known to cause unwanted effects to the baby. Therefore, take proper medical consultations before using this medicine in a nursing mother.

Drug Interactions: Taking two medicines together can be harmful due to possible interactions. In other cases, even if there is a possible interaction between two medicines your doctor may advise you to take them together after adjusting the dose or issuing precautions. Inform you doctor about your intake of any other prescription or nonprescription medicine.

Other Interactions: Taking your medicine together with certain foods or items such as alcohol or tobacco may cause undesirable interactions. Talk to your doctor to know if using this medicine with food, alcohol, or tobacco is safe. 

Inform your doctor if you have any other medical conditions, including:

3 Proper Usage

To use Rauwolfia alkaloid properly, you must follow all instructions given by your doctor. Do not get disheartened if your doctor prescribes you such medicines for a lifetime.

Remember that hypertension is a chronic disease. The key to controlling this often insidious condition is a combination of medicine, low-sodium diet, and weight management.

Serious health conditions that may arise from uncontrolled hypertension include heart failure, blood vessel disease, stroke, or kidney disease.

At the beginning of the treatment, you may feel excessive tiredness and have to run to the bathroom more frequently (due to water pills). To not let the urinary urges affect your sleep:

  • If a single daily dose is recommended, take it after breakfast.
  • If more than a single daily dose are recommended, take your last dose before 6 pm. Talk to your doctor to determine the best dosing schedule.

You can take this medicine with your meals to reduce symptoms of an upset stomach.

Dosing: For best results, follow your doctor to know what amount of medicine you should take in a single dose.

The doses of a medicine can differ according to the conditions for which it is being prescribed, your age and your overall health status. Remember your doses can differ. Consult your doctor if you have anything to ask.

The adult daily doses of tablets, containing combinations of different rauwolfia alkaloids and thiazides, to treat hypertension are listed below. For any combination, the pediatric dose should be determined by your doctor.

  • Deserpidine and hydrochlorothiazide: 1 tablet two times.
  • Deserpidine and methyclothiazide: One-half to 1 tablet.
  • Rauwolfia serpentina and bendroflumethiazide: 1 to 4 tablets.
  • Reserpine and chlorothiazide: 1 or 2 tablets once or two times.
  • Reserpine and chlorthalidone: 1 or 2 tablets.
  • Reserpine and hydrochlorothiazide: 1 tablet one to four times.
  • Reserpine and methyclothiazide: 1 to 4 tablets.

Missed Dose: Take your missed dose once you remember but avoid it if it’s time to take your next dose, and follow your normal dosing schedule. Avoid taking double doses to make up for the missed dose.


  • Store in a closed container at room temperature.
  • Keep away from heat, moisture, and direct light.
  • Do not freeze.
  • Keep away from children.
  • Discard any unused or expired medicines.

4 Precautions to Take

In using Rauwolfia alkaloid, you must be careful and take some precautions as advised by your doctor. Your progress should be regularly monitored to determine if you are responding to the treatment.

Consult your doctor before using any nonprescription medicines for suppressing hunger, asthma, colds, cough, hay fever, or sinus problems, as these medicines may increase your blood pressure.

Make sure any other doctor or dentist you visit knows about your intake of this medicine.

Under your doctor’s suggestion, you may increase potassium intake to supplement the loss caused by this medicine. But do not take any potassium supplement without first consulting your doctor. See your doctor if vomiting or diarrhea occur, which may cause dehydration.

You may feel dizzy or lightheaded while taking this medicine. Therefore, exercise extra caution while driving, using machines or doing any activity that requires alertness.

Any drug –related depressive symptoms should be reported to the doctor and immediate action should be taken. Watch for symptoms like nightmares or sleep problems.

Using this medicine with alcohol and other CNS depressants such as allergy medicine, sleeping pills, cold medicine, prescription pain medicine or narcotics can cause marked sleepiness. So avoid using them together.

Remember this medicine can interfere with blood or urine sugar tests. Talk to your doctor if you are concerned. Your skin may be excessively sensitive to light while using this medicine.

Here are some measures to protect your skin from the sunlight:

  • Do not expose to direct sunlight, during the day from 10:00 a.m. to 3:00 p.m., if possible.
  • Protect your skin from sunlight by wearing a hat, sunglasses or other appropriate clothing.
  • Use a sunscreen with SPF 15 or more, or as required depending upon your skin type.
  • For the lips, you can use a sunblock lipstick with SPF 15 or more.
  • Avoid using a sunlamp, or tanning bed or booth.
  • Consult your doctor if develop a severe reaction from the sun.

You may also have a congested nose. If you are thinking of using a nasal decongestant, talk to your doctor first.

Combat drug-associated dryness of mouth by using a saliva substitute or a sugar-free candy. See your doctor or dentist if dryness does not improve within 14 days.

5 Potential Side Effects

Make sure you meet with your doctor in using Rauwolfia alkaloid to avoid unwanted potential side effects.

Studies on rats and mice have shown that administering a very high dose of rauwolfia alkaloids results in tumors. However, more studies are required to demonstrate the same effect in humans.

Consult your doctor immediately if you have any of the following side effects:

Less common:

  • Anxiety
  • Abnormal dreams
  • Concentration problems
  • Depression
  • Difficulty maintaining sleep in the morning
  • Drowsiness or tendency to faint
  • Erectile dysfunction or decreased sex drive
  • Nervousness
  • Weakness

Seek immediate medical help if you have any of the following side effects:

Less common: 

  • Black, tar-like stools
  • Blood in vomit
  • Breathing difficulty
  • Headache
  • Pain in chest or joint
  • Slowed heartbeat


Seek emergency medical attention if you have symptoms of excessive potassium loss or overdose:

Some other signs and symptoms of overdose include:

  • Dizziness or drowsiness
  • Excessively warm and reddened skin
  • Excessive constriction of pupil
  • Slowed pulse

Mild and non-serious side effects usually go away on their own without requiring medical intervention. You may also ask your doctor to learn more about how you may prevent or reduce the side effects.

Talk to your doctor if the side effects persist or worry you, including:

More common:

See your doctor if you have some symptoms even after completing the course of this medicine.

The side effects of the medicine are not limited to the ones listed above. Call your doctor immediately if you experience any side effects that are uncommon or worry you. To report side effects to the FDA, contact at 1-800-FDA-1088.