Consumer Drug Information

Zestoretic

Generic Name: Lisinopril/Hydrochlorothiazide (lye-SIN-oh-pril/hye-droe-klor-oh-thye-a-zide)
Brand Name: Examples include Prinzide and Zestoretic

Zestoretic may cause injury or death to the fetus if taken after the third month of pregnancy. If you think you may be pregnant, contact your doctor right away.

Zestoretic is used for:

Lowering high blood pressure.

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

Do NOT use Zestoretic if:

you are allergic to any ingredient in Zestoretic or any other sulfonamide medicine (eg, sulfamethoxazole, glyburide, probenecid)
you have a history of angioedema (swelling of the face, lips, throat, or tongue)
you have a history of kidney artery narrowing
you are unable to urinate
you are taking dofetilide or ketanserin
you are in your second or third trimester of pregnancy

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

Before using Zestoretic :

Some medical conditions may interact with Zestoretic . 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 taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
if you have allergies to medicines, foods, or other substances
if you are able to become pregnant
if you have impaired liver function, diabetes, bone marrow suppression, blood vessel problems of the brain (eg, stroke), gout, high blood potassium levels, low blood sodium levels, heart disease, scleroderma, severe immune system problems, or lupus, or you are on a sodium restricted diet
if you have a history of allergies or asthma
if you are scheduled to have major surgery or to receive anesthesia
if you have a history of kidney artery narrowing, decreased kidney function, you are on dialysis, or you have had a kidney transplant

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

Celecoxib or salicylates (eg, aspirin) because they may decrease Zestoretic 's effectiveness
ACE inhibitors (eg, enalapril), indomethacin, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), or thiazide diuretics (eg, hydrochlorothiazide) because side effects, such as increased risk for kidney dysfunction, may occur
Barbiturates (eg, phenobarbital), dextran sulfate, diazoxide, or narcotic pain medicine (eg, codeine) because side effects, such as increased risk for low blood pressure, may occur
Corticosteroids (eg, prednisone), digitalis glycosides (eg, digoxin), dofetilide, ketanserin, lithium, muscle relaxants (eg, methocarbamol), potassium preparations, potassium-sparing diuretics (eg, triamterene), or thiopurines (eg, azathiopurine) because the risk of their side effects may be increased by Zestoretic
Insulin, sulfonylureas (eg, glyburide), or other medicines for diabetes because their effectiveness may be decreased by Zestoretic

This may not be a complete list of all interactions that may occur. Ask your health care provider if Zestoretic 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 Zestoretic :

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

Take Zestoretic by mouth with or without food.
If you take cholestyramine or colestipol, ask your doctor or pharmacist how to take it with Zestoretic .
Take Zestoretic on a regular schedule to get the most benefit from it.
Taking Zestoretic at the same time each day will help you remember to take it.
Continue to use Zestoretic even if you feel well. Do not miss any doses.
If you miss a dose of Zestoretic , 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 Zestoretic .

Important safety information:

Zestoretic may cause dizziness, lightheadedness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use Zestoretic with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
Zestoretic may cause dizziness, lightheadedness, 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.
Check with your doctor before you use a salt substitute or a product that has potassium in it.
Drink plenty of fluids while taking Zestoretic 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.
Diabetes patients - Zestoretic 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.
A persistent, unproductive cough may occur. Tell your doctor if this occurs. Recovery is 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.
Zestoretic may not work as well in black patients. They may also be at greater risk of side effects. Contact your doctor if your symptoms do not improve or if they become worse.
Tell your doctor or dentist that you take Zestoretic before you receive any medical or dental care, emergency care, or surgery.
Zestoretic may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Zestoretic . Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
Lab tests, including blood electrolytes, blood pressure, and kidney function, may be performed while you use Zestoretic . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
Use Zestoretic with caution in the ELDERLY; they may be more sensitive to its effects.
Zestoretic should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
PREGNANCY and BREAST-FEEDING: Zestoretic may cause birth defects or fetal death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. Zestoretic is found in breast milk. Do not breast-feed while taking Zestoretic .

Possible side effects of Zestoretic :

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:

Coughing; diarrhea; dizziness; headache; lightheadedness; nausea; persistent nonproductive cough; tiredness; vomiting.

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); confusion; difficulty swallowing; fainting; fast, slow, or irregular heartbeat; fever; hoarseness; increased hunger or thirst; muscle cramps; muscle weakness; severe dizziness or lightheadedness; shortness of breath; sore throat; unusual or severe drowsiness; unusual stomach pain; 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. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately. Symptoms may include dizziness; fainting; weakness.

Proper storage of Zestoretic :

Store Zestoretic at 77 degrees F (25 degrees C) in a tightly closed container. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in bathroom. Keep Zestoretic out of the reach of children and away from pets.

General information:

If you have any questions about Zestoretic , please talk with your doctor, pharmacist, or other health care provider.
Zestoretic 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.

This information is a summary only. It does not contain all information about Zestoretic . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: October 1, 2008

Database Edition 08.4.1.001