The combination of Lisinopril and hydrochlorothiazide is used in the treatment of high blood pressure (hypertension). Hydrochlorothiazide is a diuretic, and Lisinopril belongs to a class of drugs called ACE inhibitors, which work by inhibiting the production of angiotensin II (causes vasoconstriction). As a result, Lisinopril increases the diameter of the vessels and improves blood flow.
| Generic name | Lisinopril and hydrochlorothiazide |
| Brand name | Prinzide, Zestoretic |
| Drug class | ACE inhibitors and diuretic |
| Drug group | Antihypertensive |
| Indications | Treatment of hypertension |
| Boxed warnings | Pregnancy |
Lisinopril/ Hydrochlorothiazide combination is available as tablets, and it is sold under the brand names: Prinzide and Zestoretic.
Lisinopril/hydrochlorothiazide is available as tablets only.
Oral tablets (Lisinopril-Hydrochlorothiazide)
-Lisinopril hctz 10-12.5 mg
-Lisinopril hctz 20-12.5 mg
-Lisinopril hctz 20-25 mg
Lisinopril Hydrochlorothiazide combination is used in the treatment of patients with mild to moderate hypertension.
Adults
Initial dose:
- Lisinopril 10 mg/hydrochlorothiazide 12.5 mg
- Lisinopril 20 mg/hydrochlorothiazide 12.5 mg
- With further increase of the dose depending on the clinical response.
- Vomiting
- Nausea
- Diarrhea
- Hallucination
- Changes in mood
A dose of more than 80 mg/day of Lisinopril or more than 50 mg/day of hydrochlorothiazide is not recommended.
Before using Lisinopril/ Hydrochlorothiazide, it’s necessary to be cautious of these:
Allergy
You should tell your doctor if you:
1. Have a thiazide-related diuretic allergy
2. Are allergic to Lisinopril, or any other ACE inhibitors
3. Have had angioedema from previous treatment with ACE inhibitors
Pregnancy
ACE inhibitors may cause injury and death to the developing fetus when they are used during second and third trimesters, they should be discontinued as soon as possible once pregnancy is detected.
Breastfeeding
The safety of this drug during breastfeeding has not been established, you should discuss the matter of breastfeeding with your doctor.
Infants and children
The safety and efficacy of Lisinopril/ Hydrochlorothiazide have not been established in pediatrics.
Surgery and general anesthetics
This drug should be stopped before you have a general anesthetic. The use of ACE inhibitors will inhibit angiotensin II formation and may result in hypotension. You have to discuss it with your doctor before any operation including dental surgery.
Before using this medication, tell your doctor or pharmacist if you are taking any other drug, to reduce the risk of drug interactions.
Hydrochlorothiazide/Lisinopril side effects include:
- Angioedema
- Cholestatic jaundice
- Cough
- Hyperkalemia
- Hypersensitivity reactions (e.g., Anaphylactic/anaphylactoid reactions)
- Hypotension (low blood pressure)
- Syncope (fainting)
These side effects can be serious, if you experience any of them you should seek medical attention immediately.
The combination of Lisinopril and hydrochlorothiazide is used in the treatment of high blood pressure (hypertension). Hydrochlorothiazide is a diuretic, and Lisinopril belongs to a class of drugs called ACE inhibitors, which work by inhibiting the production of angiotensin II (causes vasoconstriction). As a result, Lisinopril increases the diameter of the vessels and improves blood flow.
| Drug entity | Nature of interaction |
| ACE Inhibitors |
Thiazide diuretics enhance the hypotensive effect of ACE Inhibitors. Thiazide diuretics enhance the nephrotoxic effect of ACE Inhibitors. |
| Allopurinol | ACE inhibitors and thiazide diuretics increase the possibility of allergic reactions to Allopurinol. |
| Amifostine | Antihypertensives can enhance the hypotensive effect of Amifostine. |
| Angiotensin II Receptor Blockers | These drugs can enhance the adverse effects of ACE inhibitors. |
| Antacids | Antacids decrease the serum concentration of ACE inhibitors. |
| Azathioprine | ACE inhibitors enhance the neutropenic effect of Azathioprine. |
| Bile acid sequestrants | Decrease the absorption of thiazide diuretics. |
| Calcitriol | Thiazide diuretics enhance the hypercalcemic effect of Calcitriol. |
| Calcium salts | Thiazide diuretics decrease the excretion of Calcium Salts. Concomitant use can also lead to metabolic alkalosis. |
| Corticosteroids | Can increase the hypokalemic effect of thiazide diuretics. |
| Cyclosporin | ACE inhibitors can enhance the nephrotoxic effect of Cyclosporin. |
| Eplerenone | Enhance the hyperkalemic effect of ACE inhibitors. |
| Ferric Gluconate | ACE inhibitors may enhance the adverse or toxic effects of ferric gluconate. |
| Lithium |
ACE inhibitors may increase the serum concentration of Lithium. Thiazide diuretics may decrease the excretion of Lithium. |
| Loop Diuretics |
Loop Diuretics enhance the hypotensive effect of ACE inhibitors. Loop Diuretics may enhance the nephrotoxic effect of ACE Inhibitors. |
| Methylphenidate |
May diminish the antihypertensive effect of antihypertensives. |
| Nonsteroidal anti-inflammatory drugs |
Diminish the antihypertensive effect of ACE Inhibitors. Diminish the therapeutic effect of Thiazide Diuretics. |
| Potassium Salts |
Can enhance the hyperkalemic effect of ACE inhibitors. |
| Potassium-Sparing Diuretics |
May enhance the hyperkalemic effect of ACE inhibitors. |
| Rituximab |
Antihypertensives may enhance the hypotensive effect of rituximab. |
| Salicylates |
May diminish the antihypertensive effect of ACE Inhibitors. |
| Sirolimus |
This drug enhances the adverse or toxic effects of ACE inhibitors. |
| Trimethoprim |
May enhance the hyperkalemic effect of ACE Inhibitors. |
| Yohimbine |
Diminish the antihypertensive effect of Antihypertensives. |
1. Joint formulary committee, BNF 80 (The British National Formulary), 80th Revised edition, Pharmaceutical Press, London, United Kingdom, [2020]
2. Lacy, C. (2006). Lexi-Comp’s Drug information handbook international. Hudson, Ohio: Lexi-Comp.
Lisinopril is an ACE inhibitor that is used in the treatment of high blood pressure, kidney disease and heart failure. It is available as tablets and oral solutions.
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