Hydrochlorothiazide / Lisinopril Side Effects

Medically reviewed by Drugs.com. Last updated on Feb 10, 2025.

Applies to hydrochlorothiazide / lisinopril: oral tablet.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby, especially in your second or third trimester. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away. You may need to stop using this medicine.

You should not use this medicine together with sacubitril. Do not use this medicine and sacubitril/valsartan (Entresto®) within 36 hours of each other.

This medicine may cause a serious type of allergic reaction, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

Call your doctor right away if you have severe stomach pain (with or without nausea or vomiting). This could be a symptom of a condition called intestinal angioedema.

Dizziness, lightheadedness, or fainting may also occur, especially when you get up suddenly from a lying or sitting position or if you have been taking a diuretic (water pill). . If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water or salt and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests, or if you have any questions, check with your doctor.

Check with your doctor if you have a fever, chills, or sore throat. These could be symptoms of an infection resulting from low white blood cells.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Check with your doctor immediately if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment. This could be a sign of a serious eye problem. Your doctor may want an eye doctor (ophthalmologist) to check your eyes.

Check with your doctor right away if you have bloody urine, a decrease in frequency or amount of urine, an increase in blood pressure, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, trouble breathing, unusual tiredness or weakness, vomiting, or weight gain. These could be symptoms of a serious kidney problem.

Hyperkalemia (high potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have stomach pain, confusion, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, trouble breathing, or weakness or heaviness of the legs. Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium.

This medicine may increase your risk of getting skin cancer (eg, non-melanoma skin cancer). Avoid sun exposure. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds. Talk to your doctor if you have concerns about this risk.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery.

This medicine may be less effective in black patients. Black patients also have an increased risk of swelling of the hands, arms, face, mouth, or throat. Talk with your doctor if you have concerns about this.

Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine. Tell your doctor if you are drinking alcohol or using pain relievers or sleeping pills.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, and herbal or vitamin supplements.

Serious side effects

Along with its needed effects, hydrochlorothiazide / lisinopril 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 hydrochlorothiazide / lisinopril:

Other side effects

Some side effects of hydrochlorothiazide / lisinopril 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:

For healthcare professionals

Applies to hydrochlorothiazide / lisinopril: oral tablet.

General adverse events

The most common adverse reactions were dizziness, headache, cough, fatigue, and orthostatic effects.^[Ref]

Nervous system

• Common (1% to 10%): Dizziness, headache, paresthesia
• Uncommon (0.1% to 1%): Syncope
• Frequency not reported: Vertigo, somnolence, tinnitus

Hydrochlorothiazide:

• Frequency not reported: Paresthesia, lightheadedness, vertigo

Lisinopril:

• Common (1% to 10%): Dizziness, headache, syncope
• Uncommon (0.1% to 1%): Paresthesia, vertigo, taste disturbance
• Rare (less than 0.1%): Olfactory disturbance
• Frequency not reported: Transient ischemic attacks, ataxia, memory impairment, tremor, stroke, peripheral neuropathy, hypersomnia^[Ref]

Respiratory

• Common (1% to 10%): Cough, upper respiratory tract infection
• Frequency not reported: Common cold, nasal congestion, bronchitis, pharyngeal pain, dyspnea, pulmonary congestion, chronic sinusitis, allergic rhinitis, pharyngeal discomfort

Hydrochlorothiazide:

• Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema

Lisinopril:

• Common (1% to 10%): Cough
• Uncommon (0.1% to 1%): Rhinitis
• Very rare (less than 0.01%): Bronchospasm, sinusitis, allergic alveolitis/eosinophilic pneumonitis
• Frequency not reported: Pulmonary embolism, pulmonary infarction, paroxysmal nocturnal dyspnea, malignant lung neoplasms, hemoptysis, pulmonary edema, pulmonary infiltrates, asthma, pleural effusion, pneumonia, wheezing, orthopnea, painful respiration, epistaxis, laryngitis, pharyngitis, rhinorrhea^[Ref]

Other

• Common (1% to 10%): Fatigue, asthenia
• Frequency not reported: Chest pain, chest discomfort, fever, trauma, otalgia

Hydrochlorothiazide:

• Frequency not reported: Fever, weakness, cramping

Lisinopril:

• Uncommon (0.1% to 1%): Asthenia, fatigue
• Frequency not reported: Malaise, edema, facial edema, pain, chills, peripheral edema, chest sound abnormal, breast pain^[Ref]

Cardiovascular

• Common (1% to 10%): Orthostatic effects, hypotension
• Frequency not reported: Palpitation, flushing

Hydrochlorothiazide:

• Frequency not reported: Postural hypotension, necrotizing angiitis, vasculitis

Lisinopril:

• Common (1% to 10%): Orthostatic effects
• Uncommon (0.1% to 1%): Myocardial infarction or cerebrovascular accident, palpitation, tachycardia, Raynaud's syndrome
• Frequency not reported: Flushing, cardiac arrest, worsening heart failure, arrhythmias, angina pectoris, decreased blood pressure, vasculitis^[Ref]

Gastrointestinal

• Common (1% to 10%): Diarrhea, nausea, vomiting, dyspepsia
• Frequency not reported: Abdominal pain, gastrointestinal cramps, dry mouth, constipation, heartburn, intestinal angioedema

Hydrochlorothiazide:

• Frequency not reported: Sialadenitis, gastric irritation, diarrhea, constipation, pancreatitis

Lisinopril:

• Common (1% to 10%): Diarrhea, vomiting
• Uncommon (0.1% to 1%): Nausea, abdominal pain, indigestion
• Rare (0.01% to 0.1%): Dry mouth
• Very rare (less than 0.01%): Pancreatitis, intestinal angioedema
• Frequency not reported: Gastritis, flatulence, salivation increased^[Ref]

Musculoskeletal

• Common (1% to 10%): Muscle cramps
• Frequency not reported: Back pain, shoulder pain, knee pain, back strain, myalgia, foot pain

Hydrochlorothiazide:

• Frequency not reported: Systemic lupus erythematosus, muscle spasm, muscle weakness

Lisinopril:

• Frequency not reported: Pelvic pain, flank pain, arthritis, arthralgia, neck pain, hip pain, joint pain, leg pain, arm pain, lumbago^[Ref]

Genitourinary

• Common (1% to 10%): Impotence
• Frequency not reported: Urinary tract infection

Hydrochlorothiazide:

• Frequency not reported: Glycosuria

Lisinopril:

• Uncommon (0.1% to 1%): Impotence
• Frequency not reported: Dysuria^[Ref]

Dermatologic

• Frequency not reported: Pruritus, skin inflammation, diaphoresis, cutaneous pseudolymphoma, angioedema

Hydrochlorothiazide:

• Frequency not reported: Cutaneous vasculitis, photosensitivity reactions, rash, cutaneous lupus erythematosus-like reactions, reactivation of cutaneous lupus erythematosus, urticaria, toxic epidermal necrolysis, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, alopecia, purpura

Lisinopril:

• Uncommon (0.1% to 1%): Rash, pruritus
• Rare (0.01% to 0.1%): Angioedema, urticaria, alopecia, psoriasis
• Very rare (less than 0.01%): Diaphoresis, pemphigus, toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, cutaneous pseudolymphoma
• Frequency not reported: Photosensitivity, skin lesions, skin infections^[Ref]

Ocular

• Frequency not reported: Xanthopsia, transient blurred vision, acute myopia, acute angle-closure glaucoma

Hydrochlorothiazide:

• Frequency not reported: Xanthopsia

Lisinopril:

• Frequency not reported: Visual loss, diplopia, photophobia^[Ref]

Hematologic

• Frequency not reported: Hemoglobin decreased, hematocrit decreased, anemia

Hydrochlorothiazide:

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

Lisinopril:

• Rare (0.01% to 0.1%): Hemoglobin decreased, hematocrit decreased
• Very rare (less than 0.01%): Bone marrow depression, anemia, thrombocytopenia, leukopenia, neutropenia, agranulocytosis, hemolytic anemia, lymphadenopathy^[Ref]

Renal

• Frequency not reported: BUN increased, serum creatinine increased

Hydrochlorothiazide:

• Frequency not reported: Renal dysfunction, interstitial nephritis, renal failure

Lisinopril:

• Common (1% to 10%): Renal dysfunction
• Uncommon (0.1% to 1%): Blood urea increased, serum creatinine increased
• Rare (0.01% to 0.1%): Uremia, acute renal failure
• Very rare (less than 0.01%): Oliguria/anuria
• Frequency not reported: Progressive azotemia, pyelonephritis^[Ref]

Psychiatric

• Frequency not reported: Libido decreased, depression

Hydrochlorothiazide:

• Frequency not reported: Restlessness, depression, sleep disturbance

Lisinopril:

• Uncommon (0.1% to 1%): Sleep disturbance, mood alteration, depressive symptoms
• Rare (less than 0.1%): Mental confusion
• Frequency not reported: Hallucination, insomnia, nervousness, irritability^[Ref]

Hepatic

• Frequency not reported: Liver enzymes elevated, bilirubin elevated

Hydrochlorothiazide:

• Frequency not reported: Intrahepatic cholestatic jaundice

Lisinopril:

• Uncommon (0.1% to 1%): Liver enzymes elevated, bilirubin elevated
• Very rare (less than 0.01%): Hepatitis, jaundice, hepatic failure^[Ref]

Immunologic

• Frequency not reported: Viral infection, influenza

Hydrochlorothiazide:

• Frequency not reported: Anaphylactic reactions

Lisinopril:

• Very rare (less than 0.01%): Autoimmune disease
• Frequency not reported: Anaphylactoid reactions, herpes zoster^[Ref]

Metabolic

Hydrochlorothiazide:

• Frequency not reported: Anorexia, hyperglycemia, hyperuricemia, hyponatremia, hypokalemia, hypochloremic alkalosis, hypomagnesemia, cholesterol increased, triglycerides increased, gout, appetite lost

Lisinopril:

• Uncommon (0.1% to 1%): Hyperkalemia
• Rare (0.01% to 0.1%): Hyponatremia
• Very rare (less than 0.01%): Hypoglycemia
• Frequency not reported: Anorexia, gout, weight loss, dehydration, fluid overload, weight gain^[Ref]

Endocrine

Lisinopril:

• Rare (less than 0.1%): Syndrome of inappropriate antidiuretic hormone secretion, gynecomastia
• Frequency not reported: Diabetes mellitus^[Ref]

See also:

Further information

Hydrochlorothiazide/lisinopril 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.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer