Captopril / Hydrochlorothiazide Side Effects

Medically reviewed by Drugs.com. Last updated on Mar 2, 2024.

Applies to captopril / hydrochlorothiazide: oral tablet.

Important warnings This medicine can cause some serious health issues

Oral route (tablet)

Use in Pregnancy. When used in pregnancy during the second and third trimesters, ACE inhibitors can cause injury and even death to the developing fetus.

When pregnancy is detected, captopril and hydrochlorothiazide should be discontinued as soon as possible.

Serious side effects

Along with its needed effects, captopril / hydrochlorothiazide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking captopril / hydrochlorothiazide:

More common

• black, tarry stools
• chest pain
• chills
• cough
• fever
• painful or difficult urination
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• swollen glands
• trouble breathing
• unusual bleeding or bruising
• unusual tiredness or weakness

Less common

• blurred vision
• cloudy urine
• confusion
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fast, pounding, or irregular heartbeat or pulse
• sweating

Rare

• arm, back, or jaw pain or discomfort
• bloody urine
• chest discomfort, tightness, or heaviness
• decreased blood pressure
• decreased frequency or amount of urine
• dilated neck veins
• increased need to urinate
• increased thirst
• irregular breathing
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• loss of appetite
• lower back or side pain
• nausea
• paleness or cold feeling in fingertips and toes
• passing urine more often
• problems in urination or increase in amount of urine
• swelling of the face, fingers, feet, or lower legs
• tingling or pain in the fingers or toes when exposed to cold
• vomiting
• weight gain

incidence not known

• persistent non-healing sore
• pink growth
• reddish patch or irritated area
• shiny bump
• white, yellow or waxy scar-like area

Other side effects

Some side effects of captopril / hydrochlorothiazide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• difficulty in moving
• itching skin, rash
• muscle pain or stiffness
• pain in joints

Less common

• change or loss of taste

For healthcare professionals

Applies to captopril / hydrochlorothiazide: oral tablet.

Gastrointestinal

Captopril:

• Common (1% to 10%): Nausea, vomiting, gastric irritations, abdominal pain, diarrhea, constipation, dry mouth, peptic ulcer, aphthous ulcers
• Rare (0.01% to 0.1%): Intestinal angioedema
• Very rare (less than 0.01%): Glossitis, pancreatitis
• Frequency not reported: Dyspepsia

Hydrochlorothiazide:

• Frequency not reported: Sialadenitis, gastric irritation, diarrhea, constipation, pancreatitis, cramping, nausea, vomiting^[Ref]

Nervous system

Captopril:

• Common (1% to 10%): Taste impairment, dizziness, headache, paresthesias
• Rare (0.01% to 0.1%): Drowsiness
• Very rare (less than 0.01%): Cerebrovascular incidents
• Frequency not reported: Syncope, ataxia, somnolence

Hydrochlorothiazide:

• Frequency not reported: Paresthesia, lightheadedness, vertigo, dizziness, headache^[Ref]

Dermatologic

Captopril:

• Common (1% to 10%): Pruritus, rash, alopecia
• Uncommon (0.1% to 1%): Angioedema
• Very rare (less than 0.01%): Urticaria, Stevens-Johnson syndrome, erythema multiforme, photosensitivity, pemphigoid reactions, erythroderma, exfoliative dermatitis

Hydrochlorothiazide:

• Frequency not reported: Cutaneous vasculitis, photosensitivity reactions, rash, cutaneous lupus erythematosus-like reactions, reactivation of cutaneous lupus erythematosus, urticaria, toxic epidermal necrolysis, purpura^[Ref]

Other

Captopril:

• Common (1% to 10%): Chest pain, malaise, fatigue
• Very rare (less than 0.01%): Gynecomastia, fever
• Frequency not reported: Asthenia

Hydrochlorothiazide:

• Frequency not reported: Fever, weakness^[Ref]

Cardiovascular

Captopril:

• Common (1% to 10%): Tachycardia, palpitations
• Uncommon (0.1% to 1%): Tachyarrhythmia, angina pectoris, hypotension, Raynaud's syndrome, flush, pallor, myocardial infarction, congestive heart failure
• Very rare (less than 0.01%): Cardiac arrest, cardiogenic shock
• Frequency not reported: Rhythm disturbances, orthostatic hypotension

Hydrochlorothiazide:

• Frequency not reported: Postural hypotension, cardiac arrhythmias, vasculitis^[Ref]

Respiratory

Captopril:

• Common (1% to 10%): Cough, dyspnea
• Very rare (less than 0.01%): Bronchospasm, rhinitis, allergic alveolitis/eosinophilic pneumonia

Hydrochlorothiazide:

• Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema^[Ref]

Psychiatric

Captopril:

• Common (1% to 10%): Sleep disorders, insomnia
• Very rare (less than 0.01%): Confusion, depression
• Frequency not reported: Nervousness

Hydrochlorothiazide:

• Frequency not reported: Restlessness, depression, sleep disturbances^[Ref]

Genitourinary

Captopril:

• Common (1% to 10%): Proteinuria
• Uncommon (0.1% to 1%): Polyuria, oliguria, urinary frequency
• Very rare (less than 0.01%): Impotence

Hydrochlorothiazide:

• Frequency not reported: Glycosuria^[Ref]

Metabolic

Captopril:

• Common (1% to 10%): Anorexia
• Very rare (less than 0.01%): Hyperkalemia, hypoglycemia, serum potassium increased, serum sodium decreased
• Frequency not reported: Symptomatic hyponatremia

Hydrochlorothiazide:

• Frequency not reported: Anorexia, hyperglycemia, hyperuricemia, electrolyte imbalance, hyponatremia, hypokalemia, cholesterol increased, triglycerides increased, loss of appetite^[Ref]

Renal

Captopril:

• Uncommon (0.1% to 1%): Renal insufficiency, renal failure, nephrotic syndrome
• Very rare (less than 0.01%): BUN increased, serum creatinine increased

Hydrochlorothiazide:

• Frequency not reported: Renal dysfunction, interstitial nephritis^[Ref]

Hematologic

Captopril:

• Uncommon (0.1% to 1%): Eosinophilia
• Very rare (less than 0.01%): Neutropenia/agranulocytosis, pancytopenia, anemia, thrombocytopenia, lymphadenopathy, hemoglobin decreased, hematocrit decreased, leukocytes decreased, thrombocytes decreased, erythrocyte sedimentation rate increased

Hydrochlorothiazide:

• Frequency not reported: Leukopenia, neutropenia/agranulocytosis, thrombocytopenia, aplastic anemia, hemolytic anemia, bone marrow depression^[Ref]

Immunologic

Captopril:

• Uncommon (0.1% to 1%): Antinuclear antibody positive
• Very rare (less than 0.01%): Autoimmune diseases
• Frequency not reported: Anaphylactoid reactions

Hydrochlorothiazide:

• Frequency not reported: Anaphylactic reactions^[Ref]

Hepatic

Captopril:

• Very rare (less than 0.01%): Impaired hepatic function and cholestasis including jaundice, hepatitis including necrosis, elevated liver enzymes and bilirubin

Hydrochlorothiazide:

• Frequency not reported: Intrahepatic cholestatic jaundice^[Ref]

Musculoskeletal

Captopril:

• Very rare (less than 0.01%): Myalgia, arthralgia
• Frequency not reported: Myasthenia

Hydrochlorothiazide:

• Frequency not reported: Muscle spasm^[Ref]

Ocular

Captopril:

• Very rare (less than 0.01%): Blurred vision

Hydrochlorothiazide:

• Frequency not reported: Xanthopsia, transient blurred vision, acute myopia, secondary acute angle-closure glaucoma^[Ref]

Further information

Captopril/hydrochlorothiazide side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer