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Zestoretic Side Effects

Generic Name: hydrochlorothiazide / lisinopril

Note: This document contains side effect information about hydrochlorothiazide / lisinopril. Some of the dosage forms listed on this page may not apply to the brand name Zestoretic.

For the Consumer

Applies to hydrochlorothiazide / lisinopril: oral tablet

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:

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

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:

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

General

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]

References

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

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

Some side effects of Zestoretic may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

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. Drugs.com 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.

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