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Zestoretic Side Effects

Generic Name: hydrochlorothiazide / lisinopril

Note: This page contains side effects data for the generic drug hydrochlorothiazide / lisinopril. It is possible that some of the dosage forms included below may not apply to the brand name Zestoretic.

In Summary

More frequent side effects include: dizziness and headache. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to hydrochlorothiazide / lisinopril: oral tablet

As well as its needed effects, hydrochlorothiazide / lisinopril may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking hydrochlorothiazide / lisinopril, check with your doctor immediately:

Less common:
  • Blurred vision
  • body aches or pain
  • chills
  • confusion
  • cough
  • diarrhea
  • difficulty breathing
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • ear congestion
  • fever
  • headache
  • loss of voice
  • nasal congestion
  • nausea
  • runny nose
  • sneezing
  • sore throat
  • sweating
  • unusual tiredness or weakness
  • vomiting

Minor Side Effects

Some hydrochlorothiazide / lisinopril side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Less common:
  • Acid or sour stomach
  • belching
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • decreased interest in sexual intercourse
  • heartburn
  • inability to have or keep an erection
  • indigestion
  • lack or loss of strength
  • loss in sexual ability, desire, drive, or performance
  • muscle cramps
  • rash
  • stomach discomfort, upset, or pain

For Healthcare Professionals

Applies to hydrochlorothiazide / lisinopril: oral tablet


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

Frequency not reported: Paresthesia, lightheadedness, vertigo

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]


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

Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema

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]


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

Frequency not reported: Fever, weakness, cramping

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


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

Frequency not reported: Postural hypotension, necrotizing angiitis, vasculitis

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]


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

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

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]


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

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

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


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

Frequency not reported: Glycosuria

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


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

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

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]


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

Frequency not reported: Xanthopsia

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


Frequency not reported: Hemoglobin decreased, hematocrit decreased, anemia

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

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]


Frequency not reported: BUN increased, serum creatinine increased

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

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]


Frequency not reported: Libido decreased, depression

Frequency not reported: Restlessness, depression, sleep disturbance

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]


Frequency not reported: Liver enzymes elevated, bilirubin elevated

Frequency not reported: Intrahepatic cholestatic jaundice

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


Frequency not reported: Viral infection, influenza

Frequency not reported: Anaphylactic reactions

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


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

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]


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


1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. "Product Information. Prinzide (lisinopril-hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.

It is possible that some side effects of Zestoretic may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.