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Lisinopril/ hydrochlorothiazide

Generic Name: lisinopril/hydrochlorothiazide (lye-SIN-oh-pril/HYE-droe-KLOR-oh-THYE-a-zide)
Brand Name: Examples include Prinzide and Zestoretic

Lisinopril/hydrochlorothiazide may cause injury or death to the fetus if taken during pregnancy. If you think you may be pregnant, contact your doctor right away. If you are planning to become pregnant, talk with your doctor about other treatment options.


Lisinopril/ hydrochlorothiazide is used for:

Treating high blood pressure.

Lisinopril/hydrochlorothiazide is an angiotensin-converting enzyme (ACE) inhibitor and thiazide diuretic combination. It works by removing excess fluid from the body and causing blood vessels to relax or widen.

Do NOT use lisinopril/ hydrochlorothiazide if:

  • you are allergic to any ingredient in lisinopril/hydrochlorothiazide, any other sulfonamide medicine (eg, sulfamethoxazole, glyburide, probenecid), or another ACE inhibitor (eg, captopril)
  • you have a history of angioedema (swelling of the face, lips, throat, or tongue; difficulty swallowing or breathing; or unusual hoarseness), including angioedema caused by treatment with an ACE inhibitor
  • you are unable to urinate
  • you are pregnant
  • you are also taking aliskiren and you have either diabetes or kidney problems
  • you are taking dofetilide or ketanserin

Contact your doctor or health care provider right away if any of these apply to you.

Before using lisinopril/ hydrochlorothiazide:

Some medical conditions may interact with lisinopril/hydrochlorothiazide. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are able to become pregnant
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have liver problems, blood vessel problems (eg, stroke), heart problems (eg, congestive heart failure, aortic stenosis), diabetes, or high cholesterol
  • if you have a history of kidney problems (eg, renal artery stenosis), you are on dialysis or apheresis, or you have had a kidney transplant
  • if you have gout or electrolyte imbalances (eg, high or low potassium levels, low blood sodium levels), or you are on a low-salt (sodium) diet
  • if you are dehydrated, drink alcohol, or have low blood volume or low blood pressure
  • if you have a collagen vascular disorder (eg, lupus, scleroderma), bone marrow problems, or severe immune system problems
  • if you have a history of allergies or asthma, or if you are receiving treatments to reduce sensitivity to bee or wasp stings
  • if you are scheduled to have surgery or receive anesthesia
  • if you have recently had a certain type of nerve surgery (sympathectomy)
  • if you have never taken another medicine for high blood pressure

Some MEDICINES MAY INTERACT with lisinopril/hydrochlorothiazide. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Digoxin, dofetilide, or ketanserin because the risk of irregular heartbeat may be increased
  • Everolimus or sirolimus because the risk of angioedema may be increased
  • Eplerenone, potassium preparations, potassium-sparing diuretics (eg, triamterene), salt substitutes containing potassium, or trimethoprim because the risk of high blood potassium levels may be increased
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, celecoxib, ibuprofen, indomethacin) because they may decrease lisinopril/hydrochlorothiazide's effectiveness and the risk of serious kidney problems may be increased
  • Adrenocorticotropic hormone (ACTH), barbiturates (eg, phenobarbital), corticosteroids (eg, prednisone), dextran sulfate, diazoxide, diuretics (eg, furosemide), narcotic pain medicine (eg, codeine), or other medicines for high blood pressure because the risk of low blood pressure may be increased
  • Aliskiren or angiotensin receptor blockers (ARBs) (eg, losartan) because the risk of certain side effects (eg, kidney problems, high blood potassium levels, low blood pressure) may be increased
  • Certain gold-containing medicines (eg, sodium aurothiomalate) because flushing, nausea, vomiting, and low blood pressure may occur
  • Cholestyramine, colestipol, or salicylates (eg, aspirin) because they may decrease lisinopril/hydrochlorothiazide's effectiveness
  • Lithium or thiopurines (eg, azathioprine) because the risk of their side effects may be increased by lisinopril/hydrochlorothiazide
  • Insulin or other diabetes medicines (eg, glyburide) because their effectiveness may be decreased by lisinopril/hydrochlorothiazide

This may not be a complete list of all interactions that may occur. Ask your health care provider if lisinopril/hydrochlorothiazide may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use lisinopril/ hydrochlorothiazide:

Use lisinopril/hydrochlorothiazide as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take lisinopril/hydrochlorothiazide by mouth with or without food.
  • If you take cholestyramine or colestipol, ask your doctor or pharmacist how to take it with lisinopril/hydrochlorothiazide.
  • Take lisinopril/hydrochlorothiazide on a regular schedule to get the most benefit from it.
  • Taking lisinopril/hydrochlorothiazide at the same time each day will help you remember to take it.
  • Continue to use lisinopril/hydrochlorothiazide even if you feel well. Do not miss any doses.
  • If you miss a dose of lisinopril/hydrochlorothiazide, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use lisinopril/hydrochlorothiazide.

Important safety information:

  • Lisinopril/hydrochlorothiazide may cause dizziness, light-headedness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use lisinopril/hydrochlorothiazide with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Lisinopril/hydrochlorothiazide may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Lisinopril/hydrochlorothiazide may cause a serious side effect called angioedema. Black patients may be at greater risk of developing this side effect. Contact your doctor at once if you develop swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness.
  • Lisinopril/hydrochlorothiazide contains a sulfonamide called hydrochlorothiazide, which can cause certain eye problems (myopia, angle-closure glaucoma). Your risk may be increased if you are allergic to sulfonamide medicines (eg, sulfamethoxazole) or to penicillin antibiotics (eg, amoxicillin). Untreated angle-closure glaucoma can lead to permanent vision loss. If these eye problems occur, symptoms usually occur within hours to weeks of starting lisinopril/hydrochlorothiazide. Contact your doctor immediately if you experience symptoms such as vision changes (eg, decreased vision clearness) or eye pain.
  • Check with your doctor before you use a salt substitute or a product that has potassium in it.
  • Drink plenty of fluids while taking lisinopril/hydrochlorothiazide and avoid engaging in activities that cause excessive sweating. Dehydration, excessive sweating, vomiting, or diarrhea may lead to a fall in blood pressure. Contact your health care provider at once if any of these occur.
  • Lisinopril/hydrochlorothiazide may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.
  • Diabetes patients - Lisinopril/hydrochlorothiazide may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • A persistent, unproductive cough may occur. Tell your doctor if this occurs. If caused by lisinopril/hydrochlorothiazide, recovery is usually rapid when the medicine is stopped.
  • Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
  • Tell your doctor or dentist that you take lisinopril/hydrochlorothiazide before you receive any medical or dental care, emergency care, or surgery.
  • Lisinopril/hydrochlorothiazide may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to lisinopril/hydrochlorothiazide. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Lisinopril/hydrochlorothiazide may interfere with certain lab tests, including parathyroid function. Be sure your doctor and lab personnel know you are taking lisinopril/hydrochlorothiazide.
  • Lab tests, including blood electrolytes, blood pressure, complete blood cell counts, and kidney and liver function, may be performed while you use lisinopril/hydrochlorothiazide. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use lisinopril/hydrochlorothiazide with caution in the ELDERLY; they may be more sensitive to its effects.
  • Lisinopril/hydrochlorothiazide should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Lisinopril/hydrochlorothiazide may cause birth defects and fetal or newborn death if you take it while you are pregnant. Do not become pregnant while you take lisinopril/hydrochlorothiazide. If you think you may be pregnant, contact your doctor right away. Lisinopril/hydrochlorothiazide is found in breast milk. Do not breast-feed while taking lisinopril/hydrochlorothiazide.

Possible side effects of lisinopril/ hydrochlorothiazide:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Dizziness; headache; light-headedness; nonproductive cough; tiredness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); blurred vision or other vision changes (eg, decreased vision clearness); change in the amount of urine produced; chest pain or discomfort; dark urine; difficult or painful urination; drowsiness; dry mouth; eye pain; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; joint pain, stiffness, or swelling; loss of appetite; mood or mental changes (eg, depression); muscle cramps, pain, or weakness; numbness, burning, or tingling; numbness of an arm or leg; one-sided weakness; pale stools; persistent or unusual nausea or vomiting; red, swollen, blistered, or peeling skin; restlessness; severe or persistent cough; severe or persistent headache, dizziness, or light-headedness; shortness of breath; slurred speech; stomach pain (with or without nausea or vomiting); sudden, unusual weight loss or gain; symptoms of high blood sugar (eg, fast breathing; flushing; fruit-like breath odor; increase in thirst, hunger, or urination); symptoms of low blood sodium (eg, confusion, mental or mood changes, seizures, sluggishness); trouble swallowing; unusual bruising or bleeding; unusual thirst, weakness, or tiredness; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; severe dizziness or light-headedness; symptoms of blood electrolyte problems (eg, confusion; irregular heartbeat; mental or mood changes; muscle cramps, pain, or weakness; seizures; sluggishness); symptoms of dehydration (eg, drowsiness; dry eyes; fast heartbeat; nausea; restlessness; unusual thirst, tiredness, or weakness; vomiting).

Proper storage of lisinopril/hydrochlorothiazide:

Store lisinopril/hydrochlorothiazide at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in bathroom. Keep lisinopril/hydrochlorothiazide out of the reach of children and away from pets.

General information:

  • If you have any questions about lisinopril/hydrochlorothiazide, please talk with your doctor, pharmacist, or other health care provider.
  • Lisinopril/hydrochlorothiazide is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take lisinopril/hydrochlorothiazide or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about lisinopril/hydrochlorothiazide. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to lisinopril/hydrochlorothiazide. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using lisinopril/hydrochlorothiazide.

Issue Date: April 2, 2014
Database Edition 14.2.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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