Fosinopril hydrochlorothiazide | Side Effects, & More
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Generic Name:

fosinopril-hydrochlorothiazide, Oral tablet

All Brands

  • Monopril-HCT (Discontinued)
A discontinued drug is a drug that has been taken off the market due to safety issues, shortage of raw materials, or low market demand.
SECTION 1 of 4

Highlights for fosinopril-hydrochlorothiazide

Oral tablet
1

Fosinopril/hydrochlorothiazide is a combination medication used to treat hypertension (high blood pressure).

2

Fosinopril/hydrochlorothiazide is a generic drug. It’s not available in a brand-name version.

3

The more common side effects that can occur include headache, cough, tiredness, or dizziness.

4

Don’t take this drug if you’re pregnant. It may cause birth defects or miscarriage (loss of the pregnancy). Talk to your doctor if you’re pregnant or planning to become pregnant.

5

This drug can cause sudden swelling of the face, arms, legs, lips, tongue, throat, and intestines. Tell your doctor right away if you have swelling in these areas, or have pain in your stomach area.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to drug effects that may be dangerous.

Pregnancy warning. Don’t take this drug if you’re pregnant. Fosinopril/hydrochlorothiazide may cause birth defects or miscarriage (loss of the pregnancy). Tell your doctor if you’re pregnant or planning to become pregnant.

Allergic reaction

Fosinopril/hydrochlorothiazide may cause an allergic reaction called angioedema. This can cause swelling of the face, lips, tongue, throat, hands, feet, or intestines. If you have this reaction, call 9-1-1 or go to the nearest emergency room right away.

Low blood pressure

Fosinopril/hydrochlorothiazide may cause an allergic reaction called angioedema. This can cause swelling of the face, lips, tongue, throat, hands, feet, or intestines. If you have this reaction, call 9-1-1 or go to the nearest emergency room right away.

Low white blood cell count

This drug can cause a low white blood cell count. This can increase your risk of infections, especially if you have a history of systemic lupus erythematosus, kidney problems, or scleroderma. Tell your doctor right away if you have any signs of infection, such as fever or sore throat.

What is fosinopril/hydrochlorothiazide?

Fosinopril/hydrochlorothiazide is a combination drug available by prescription. It comes in the form of a tablet you take by mouth. This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

Fosinopril/hydrochlorothiazide is a combination of two drugs in a single pill. It’s important to know about all the drugs in the combination because each drug may affect you in a different way.

Fosinopril/hydrochlorothiazide is a generic drug. It’s not available as a brand-name drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. Talk to your doctor to see if the generic version will work for you.

Why it's used

Fosinopril/hydrochlorothiazide is used to treat high blood pressure.

How it works

Fosinopril belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors. Hydrochlorothiazide belongs to a class of drugs called diuretics.

See Details

How it works

Fosinopril belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors. Hydrochlorothiazide belongs to a class of drugs called diuretics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Fosinopril and hydrochlorothiazide both lower blood pressure, but in different ways. Fosinopril relaxes the blood vessels in your body. Hydrochlorothiazide works in your kidneys to remove sodium (salt) and water from your body. Both of these actions help reduce blood pressure.

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fosinopril-hydrochlorothiazide Side Effects

Oral tablet

More Common Side Effects

Some of the more common side effects that can occur with use of fosinopril/hydrochlorothiazide include:

  • headache

  • persistent (long-lasting cough)

  • tiredness

  • dizziness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Allergic reaction (angioedema). Symptoms can include:

    • swelling of face, lips, tongue, or throat
    • trouble breathing
    • trouble swallowing
    • stomach pain, with or without nausea and vomiting
    • hives
  • Low white blood cell count. Symptoms can include:

    • fever
    • chills
  • Eye problems. Symptoms can include:

    • blurry vision
    • eye pain
  • Gout (a painful form of arthritis). Symptoms can include:

    • yellowing of your skin and the whites of your eyes
    • joint pain and stiffness
    • redness and swelling
  • Muscle pain or cramps

  • Chest pain

Pharmacist's Advice
Healthline Pharmacist Editorial Team

Fosinopril/hydrochlorothiazide may cause tiredness. Avoid driving or operating heavy machinery until you know how this drug affects you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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fosinopril-hydrochlorothiazide May Interact with Other Medications

Oral tablet

Fosinopril/hydrochlorothiazide can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Blood pressure drugs

Some blood pressure drugs can increase your risk of low blood pressure, high blood potassium, and kidney problems when taken with fosinopril/hydrochlorothiazide. These drugs include:

  • Angiotensin receptor blockers, such as:
    • losartan
    • valsartan
    • olmesartan
    • candesartan
  • Angiotensin-converting enzyme (ACE) inhibitors, such as:
    • benazepril
    • captopril
    • enalapril
    • lisinopril
  • Direct renin inhibitors, such as:
    • aliskiren (Don’t take aliskiren with this drug if you have diabetes or kidney problems.)

Cholesterol drugs

When used with fosinopril/hydrochlorothiazide, certain cholesterol drugs can make fosinopril/hydrochlorothiazide less effective. These drugs include:

  • cholestyramine
  • colestipol resins

Diabetes drugs

Taking insulin along with fosinopril/hydrochlorothiazide may change the way insulin acts in your body. Your doctor may change your dosage based on this change.

Gastrointestinal (GI) upset drugs

When taken with fosinopril/hydrochlorothiazide, certain drugs used to treat GI issues such as stomach acid problems can make fosinopril/hydrochlorothiazide less effective. These drugs include:

  • aluminum hydroxide
  • magnesium hydroxide
  • simethicone

Joint pain drugs

Sodium aurothiomalate (injectable gold) is used to treat joint pain. When used with fosinopril/hydrochlorothiazide, it may cause a reaction. Symptoms can include facial flushing (reddening), nausea, vomiting, and low blood pressure.

Mood stabilizing drugs (lithium)

Lithium is used to treat certain mood disorders. Taking this drug with fosinopril/hydrochlorothiazide can increase the level of lithium in your body. This raises your risk of side effects from lithium.

Pain and inflammation drugs

When used together, certain drugs used to treat pain and inflammation can make this medication less effective. They can also cause kidney problems. These drugs include NSAIDs (nonsteroidal anti-inflammatory drugs) such as:

  • naproxen
  • ibuprofen
  • diclofenac
  • aspirin

Potassium supplements

These supplements can increase the amount of potassium in your blood. (Potassium is a mineral that helps your nerves, muscles, and organs work normally.) When these supplements are taken with fosinopril/hydrochlorothiazide, potassium levels can get very high. High levels of potassium can cause heart rhythm problems that can be life threatening.

These drugs include:

  • potassium chloride
  • potassium gluconate
  • potassium bicarbonate

Water pills (potassium-sparing diuretics)

Certain types of diuretics, called potassium-sparing diuretics, can increase the amount of potassium in your blood. This level can be increased further when these drugs are taken with fosinopril/hydrochlorothiazide. Very high levels of potassium can cause heart rhythm problems that can be life threatening. (Potassium is a mineral that helps your nerves, muscles, and organs work normally.)

These drugs include:

  • spironolactone
  • amiloride
  • triamterene

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Fosinopril/hydrochlorothiazide warnings
kidney problems
People with kidney problems

You’re at higher risk for certain serious side effects when using this drug. These include a low white blood cell count, which can increase your risk of infection, and high potassium levels. Before taking this drug, be sure your doctor knows that you have kidney problems.

congestive heart failure
People with congestive heart failure

You’re at higher risk for very low blood pressure when using this drug. Before taking this drug, be sure your doctor knows that you have heart failure.

liver problems
People with liver problems

Using this drug can make your liver function worse. It can cause problems with the balance of electrolytes in your body. (Electrolytes are minerals that help control the fluid balance in your body and help with other important functions.) And it could lead to hepatic coma (loss of brain function when the liver can’t remove toxins from the blood). Before taking this drug, be sure your doctor knows that you have liver problems.

scleroderma
People with scleroderma

You’re at higher risk for a low white blood cell count when using this drug. This raises your risk of infection. Before taking this drug, be sure your doctor knows that you have scleroderma.

systemic lupus erythematosus
People with systemic lupus erythematosus

Use of this drug can cause your lupus to flare up. It also raises your risk of a low white blood cell count, which makes you more likely to have infections. Before taking this drug, be sure your doctor knows that you have lupus.

sulfonamide allergy
People with sulfonamide allergy

Hydrochlorothiazide is a sulfonamide drug. If you’re allergic to sulfonamides, don’t take fosinopril/hydrochlorothiazide. Be sure to tell your doctor about all of your allergies.

pregnant women
Pregnant women

Fosinopril/hydrochlorothiazide is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

breastfeeding
Women who are breast-feeding

Fosinopril/hydrochlorothiazide may pass into breast milk and can cause serious side effects in a breast-fed child. Talk to your doctor if you breast-feed your baby. You’ll need to decide either to stop breast-feeding or stop taking this drug.

call doctor
When to call the doctor

Call your doctor right away if you become pregnant while taking this drug.

allergies
Allergies

Fosinopril/hydrochlorothiazide can cause a severe allergic reaction (angioedema). This can cause symptoms such as:

  • trouble breathing
  • trouble swallowing
  • swelling of your face, lips, tongue, or throat
  • hives

If you have these symptoms, call 9-1-1 or go to the nearest emergency room right away.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

SECTION 4 of 4

How to Take fosinopril-hydrochlorothiazide (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Hypertension

Generic: fosinopril/hydrochlorothiazide

Form: Oral tablet
Strengths: 
  • 10 mg fosinopril/12.5 mg hydrochlorothiazide
  • 20 mg fosinopril/12.5 mg hydrochlorothiazide
Adult dosage (ages 18–64 years)
  • The typical starting dose is 10 mg fosinopril/12.5 mg hydrochlorothiazide or 20 mg fosinopril/12.5 mg hydrochlorothiazide, once a day in the morning.
  • Your doctor may increase the dose based on how your body reacts to it.
Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children.   

Senior dosage (ages 65 years and older)
  • The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects.
  • Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.
Special considerations

Kidney problems: If you have mild to moderate kidney problems, your doctor will likely prescribe the adult dose. If you have severe kidney problems, don’t take this drug.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Fosinopril/hydrochlorothiazide comes with serious risks if you don't take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your high blood pressure or heart failure may get worse. You may be at higher risk of heart attack or stroke. Don’t stop taking fosinopril/hydrochlorothiazide without talking to your doctor.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • low blood pressure
  • dizziness
  • fainting

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

Your blood pressure should go down, but you’ll likely not feel any different. Your doctor will monitor your blood pressure. You can also check it at home using a home blood pressure monitor.

Fosinopril/hydrochlorothiazide is used for long-term treatment.

Important considerations for taking fosinopril/hydrochlorothiazide
timing
Take this drug once each day in the morning. Try to take it at the same time each day.
can crush or cut
You can cut or crush the tablet
storage
Store this drug carefully
See Details
not refillable
Prescription is not refillable
travel
Travel
See Details
self-management
Self-management
See Details
clinical monitoring
Clinical monitoring
See Details
diet considerations
Your diet
See Details
not usually stocked
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.
hidden costs
Hidden costs
See Details
prior authorization
Insurance
See Details

Store this drug carefully

  • Store this medication at room temperature from 68–77°F (20–25°C).
  • Don’t freeze this drug. Keep it away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Travel

When traveling with your medication:

  • Always carry your medication with you, such as in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor may suggest that you monitor your blood pressure. You can do this using a home blood pressure monitor. Your doctor can tell you where to buy this device and how to use it.

Clinical monitoring

Your doctor will monitor the following:

  • Blood pressure: Your doctor will check your blood pressure to make sure this drug is keeping your blood pressure under control.
  • Electrolyte levels: This drug can cause changes in your electrolyte levels. This includes potassium levels. Your doctor will check your levels to make sure your electrolytes are in a healthy range. (Electrolytes are minerals that manage the fluid levels and other functions in your body.)
  • Kidneys: This drug can make kidney problems worse, or even cause new ones. If this drug causes problems for your kidneys, your doctor may need to reduce your dose, or you may need to stop using it.  You may be more sensitive to this drug if you have a history of kidney problems. This means you may need a lower dose.
  • Liver: This drug can increase the level of liver enzymes in your body. These enzymes are signs of liver problems. Your doctor will monitor your enzyme level.
  • Other: This drug can increase glucose (blood sugar) levels, cholesterol levels, triglyceride levels, and uric acid levels. Your doctor will monitor these levels.

Your diet

Fosinopril can cause low blood pressure. A low-salt diet puts you at even higher risk of low blood pressure. If you’re on a low-salt diet, talk to your doctor about whether this drug is right for you.

Hidden costs

You may need to buy a home blood pressure monitor to check your blood pressure at home. Your doctor can tell you more.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

What does the pill look like?

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on September 23, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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