Lisinopril/hydrochlorothiazide | Side Effects & More
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Generic Name:

hydrochlorothiazide-lisinopril, Oral tablet

All Brands

  • Prinzide
  • Zestoretic
SECTION 1 of 4

Highlights for hydrochlorothiazide-lisinopril

Oral tablet
1

Lisinopril/hydrochlorothiazide is a combination of two drugs in a single form that work in different ways to treat hypertension (high blood pressure). This drug is usually given when one medicine isn’t enough to control your blood pressure.

2

Your doctor will decide a dose that’s right for you. Effective doses of this drug are between 10–80 mg lisinopril/12.5–50 mg hydrochlorothiazide.

3

This drug can cause rare but serious allergic side effects. These include swelling of your head, neck, and lips, which may cause trouble breathing.

4

Common side effects include dizziness, headache, persistent cough, fatigue, and low blood pressure when you stand up from a sitting or lying position.

5

Lisinopril/hydrochlorothiazide may affect your kidney function and electrolyte levels. Your doctor may do blood tests to check for these changes.

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 effects that may be dangerous.

Use during pregnancy warning. You shouldn’t take this drug during pregnancy. This drug can harm or be fatal to your unborn baby. If you become pregnant, call your doctor and stop taking this drug right away.

Allergic reaction

This drug can cause allergic reactions. Some of these reactions can be severe. These include head and neck swelling, trouble breathing, and severe stomach pain.

Low blood pressure

This drug can cause very low blood pressure. Tell your doctor if you have signs of low blood pressure, such as dizziness or feeling like you might faint.

Liver failure

This drug can rarely cause a syndrome that starts as jaundice (yellowing of your skin or the whites of your eyes) and progress to severe liver damage. If you develop jaundice or have tests that show that your liver enzymes have increased, your doctor will tell you to stop taking this drug.

Drug features

This drug is a prescription drug. It’s available as an oral tablet.

This drug is available as a generic drug. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This drug is a combination of two drugs in a single form. It’s important to know about all the drugs in the combination because they each may have unique traits.

This drug may be taken in combination with beta-blockers, angiotensin receptor blockers, calcium channel blockers, and diuretics to treat high blood pressure.

Why it's used

This drug is used to treat high blood pressure.

How it works

Lisinopril belongs to a class of drugs called angiotensin-converting enzyme inhibitors. Hydrochlorothiazide belongs to a class of drugs called diuretics.

More Details

How it works

Lisinopril belongs to a class of drugs called angiotensin-converting enzyme inhibitors. Hydrochlorothiazide belongs to a class of drugs called diuretics. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

It’s thought that hydrochlorothiazide works to remove excess salt and water from your body. This keeps your heart from working as hard to pump blood. This lowers your blood pressure levels.

Lisinopril relaxes the blood vessels in your body. This reduces stress on your heart and lowers your blood pressure.

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hydrochlorothiazide-lisinopril Side Effects

Oral tablet

More Common Side Effects

The most common side effects that occur with lisinopril/hydrochlorothiazide include:

  • dizziness

  • headache

  • persistent cough

  • fatigue

  • low blood pressure, especially when you stand up from a sitting or lying position

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 any of these serious side effects. Call 9-1-1 if your symptoms feel life threatening or if you think you’re having a medical emergency.

  • serious allergic reactions. Symptoms include:

    • swelling of your head, neck, or lips
    • stomach pain
  • low blood pressure. Symptoms include:

    • dizziness
    • fainting
  • liver failure. Symptoms include:

    • yellowing of your skin and the whites of your eyes
    • increased liver enzymes
    • fatigue
    • stomach pain
    • nausea and vomiting
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug doesn’t cause drowsiness.

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.
SECTION 3 of 4

hydrochlorothiazide-lisinopril May Interact with Other Medications

Oral tablet

Lisinopril/hydrochlorothiazide can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol interaction

The use of drinks that contain alcohol can increase your risk of low blood pressure when you stand up from a sitting or lying position from lisinopril/hydrochlorothiazide. This can cause dizziness. If you drink alcohol, talk to your doctor.

Medications that might interact with this drug

Barbiturates and narcotics

Taking certain barbiturates and narcotics with lisinopril/hydrochlorothiazide may increase your chance for low blood pressure when standing up from a sitting or lying position.

These drugs include:

  • phenobarbital
  • morphine
  • fentanyl
  • hydrocodone

Blood pressure drugs

Taking other drugs that reduce blood pressure with lisinopril/hydrochlorothiazide may cause your blood pressure to drop too low. This can cause dizziness, headache, or fatigue.

These drugs include:

  • angiotensin receptor blockers (ARBs), 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.

Lisinopril/hydrochlorothiazide interacts with other blood pressure drugs that increase your potassium levels. Your doctor may check your potassium level with blood tests.

These drugs include:

  •  potassium-sparing diuretics, such as:
    • spironolactone
    • amiloride
    • triamterene

Cholesterol drugs

Certain cholesterol drugs can reduce the amount of lisinopril/hydrochlorothiazide that your body absorbs. This means that it may not work as well to treat your blood pressure.

These drugs include:

  • cholestyramine  
  • colestipol

Corticosteroids and adrenocorticotropic hormones

Taking these drugs with lisinopril/hydrochlorothiazide may cause low levels of electrolytes.

Diabetes drugs

Taking certain diabetes drugs with lisinopril/hydrochlorothiazide may affect your blood sugar levels. Your doctor may change the dose of your diabetes drug.

These drugs include:

  • metformin
  • glyburide
  • glipizide
  • insulin

Injectable gold

Taking these drugs together may cause reddening and warmth to your face (flushing), stomach problems, low blood pressure, dizziness, and a fast heart rate.

Lithium

Taking these drugs together can cause lithium toxicity. This may cause confusion, increased urination, thirst, or an irregular heart rate.

Pain drugs

Taking certain pain drugs with lisinopril/hydrochlorothiazide may decrease your kidney function. This can cause problems with urination or swelling in your legs.

These drugs include:

  • aspirin
  • diclofenac
  • indomethacin
  • ketoprofen
  • ketorolac
  • sulindac
  • flurbiprofen

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.

People with diabetes

This drug can affect your blood sugar levels. Your doctor may need to change your dose of your diabetes medicines.

People with certain heart problems

This drug may lower your blood pressure too much if you have aortic stenosis or hypertrophic cardiomyopathy.

People with poor kidney function

This drug can further reduce your kidney function. Talk to your doctor about whether this drug is safe for you.

People with high potassium levels

This drug may increase your potassium levels more. This is often temporary, but may lead to serious heart rate problems.

People with a cough

This drug may cause a persistent cough or make your cough worse. This cough usually goes away when you stop taking this medicine.

Pregnant women

During the first trimester, this drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

During the second and third trimesters, this drug 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.

Women who are breast-feeding

This drug may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors

Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

For children

This medicine hasn’t been studied in children and shouldn’t be used in children under the age of 18.

Allergies

This drug can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives
  • severe stomach pain

Call 9-1-1 or go to the nearest emergency room if you develop these symptoms.

Don’t take this drug again if you’ve ever had an allergic reaction to it or any angiotensin-converting enzyme inhibitors, diuretics, or sulfonamide drugs. Taking it again could be fatal (cause death).

SECTION 4 of 4

How to Take hydrochlorothiazide-lisinopril (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it 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

Brand: Zestoretic

Form: Oral tablet
Strengths:
  • 10 mg lisinopril/12.5 mg hydrochlorothiazide
  • 20 mg lisinopril/12.5 mg hydrochlorothiazide
  • 20 mg lisinopril/25 mg hydrochlorothiazide

Brand: Prinzide

Form: Oral tablet
Strengths:
  • 10 mg lisinopril/12.5 mg hydrochlorothiazide
  • 20 mg lisinopril/12.5 mg hydrochlorothiazide

Generic: lisinopril/hydrochlorothiazide

Form: Oral tablet
Strengths:
  • 10 mg lisinopril/12.5 mg hydrochlorothiazide
  • 20 mg lisinopril/12.5 mg hydrochlorothiazide
  • 20 mg lisinopril/25 mg hydrochlorothiazide
Adult dosage (ages 18–64 years)

The typical starting dose is 10–20 mg lisinopril/12.5 mg hydrochlorothiazide taken once per day. Your doctor will increase your dose as needed.

Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children and shouldn’t be used in children under the age of 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Warnings

Your doctor may increase your dose after 2–3 weeks of treatment.

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

This drug comes with serious risks if you don't take it as prescribed.

If you don't take it at all

Your blood pressure may increase. This can lead to a heart attack or a stroke.

If you stop taking it suddenly

Your blood pressure may increase.

If you don't take it on schedule

You may still have high blood pressure. Or you may have more side effects because a consistent level of the drug isn’t in your body. This drug may stop working for you and you may need to use another blood pressure medicine.

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time.

Never try to catch up by taking two doses at once. This could result in toxic side effects.

If you take too much

You may have some of the side effects of this drug. These include:

  • low blood pressure
  • dizziness
  • fainting

If you think you’ve taken too much of the drug, act right away. Call your doctor or local Poison Control Center, or go to the nearest emergency room. 

How to tell if the drug is working

Your doctor will check your blood pressure to tell if this drug is working for you. Your doctor may also ask you to check your blood pressure at home.

This drug is used for long-term treatment.

However, if you’re able to control your high blood pressure with other drugs or lifestyle changes, you may no longer need to take it.

Important considerations for taking this drug
take with or without food This drug can be taken with or without food
timing Take this drug at the same time each day
can crush or cut Don’t crush or cut the tablet
storage Store this drug at room temperature See Details
refillable Prescription is refillable
travel Travel See Details
self-management Self-management See Details
clinical monitoring Clinical monitoring See Details
diet considerations Your diet See Details

Store this drug at room temperature

Keep it from 68–77°F (20–25°C).

Keep this drug away from light and humidity.

Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

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

You may need to check your blood pressure at home. You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

You may need to buy a blood pressure monitor. These are available at most pharmacies.

Clinical monitoring

While you’re being treated with this drug, your doctor may check the following:

  • blood pressure
  • kidney function
  • electrolyte levels

Your diet

Your diet may affect how well your high blood pressure is controlled. Ask your doctor if you should make changes to your diet.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about other 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 24, 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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