Lisinopril/hydrochlorothiazide (By mouth)

Introduction

Hydrochlorothiazide (hye-droe-klor-oh-THYE-a-zide), Lisinopril (lye-SIN-oh-pril)

Treats high blood pressure. A lower blood pressure will reduce the risk of stroke and heart attack. This medicine is a combination of an angiotensin-converting enzyme (ACE) inhibitor and a diuretic (water pill).

Brand Name(s)

Prinzide, Zestoretic

When This Medicine Should Not Be Used

How to Use This Medicine

Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• This medicine should not be the first medicine you use to treat your condition. It is meant to be used only after you have tried other medicines that have not worked or have caused unwanted side effects.
• Carefully follow your doctor's instructions about any special diet. Be sure to drink plenty of fluids if you exercise, sweat more than usual, or have diarrhea or vomiting.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are using lithium (Eskalith®, Lithobid®), gold injections (such as sodium aurothiomalate), other blood pressure medicine (such as losartan, olmesartan, valsartan, Atacand®, Avapro®, Cozaar®, or Hyzaar®), or a diuretic or water pill (such as amiloride, chlorthalidone, eplerenone, furosemide, spironolactone, triamterene, Aldactazide®, Aldactone®, Dyazide®, Dyrenium®, Inspra®, Lasix®, Maxzide®, Midamor®, Moduretic®, or Thalitone®). Your doctor will need to know if you are using insulin or a diabetes medicine that you take by mouth (such as glipizide, glyburide, metformin, Actos®, Amaryl®, Avandia®, Glucotrol®, or Glucophage®) or a steroid medicine (such as dexamethasone, prednisolone, prednisone, or Medrol®).
• Tell your doctor if you are using pain or arthritis medicine (such as aspirin, celecoxib, diclofenac, ibuprofen, naproxen, piroxicam, rofecoxib, valdecoxib, Advil®, Aleve®, Bextra®, Celebrex®, Feldene®, Motrin®, Vioxx®, or Voltaren®). Make sure your doctor knows if you use norepinephrine, tubocurarine, or a medicine to lower your cholesterol (such as cholestyramine, colestipol, Colestid®, or Questran®).
• Ask your doctor before you use medicines, supplements, or salt substitutes that contain potassium.
• Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine.

Warnings While Using This Medicine

• Using this medicine while you are pregnant can harm your unborn baby, especially after the first 3 months of pregnancy. Use an effective form of birth control to prevent pregnancy. Tell your doctor right away if you become pregnant.
• Make sure your doctor knows if you are breastfeeding, or if you have kidney problems, liver disease, congestive heart failure, dehydration, edema or swelling, heart or blood vessel disease, heart valve problems, low blood pressure, high cholesterol, or mineral imbalance (such as high or low calcium, magnesium, potassium, or sodium in the blood). Tell your doctor if you have glaucoma, gout, lupus, an autoimmune disorder (such as a collagen vascular disease), or a history of asthma.
• Stop using this medicine and call your doctor right away if you have severe stomach pain (with or without vomiting). This could be a symptom of a serious allergic reaction.
• This medicine could lower your blood pressure too much and cause you to feel dizzy or lightheaded. If you faint, stop using this medicine until you have talked to your doctor. Stand or sit up slowly if you are dizzy. Low blood pressure is more likely to happen when you begin to use the medicine.
• Check with your doctor right away if you experience dizziness, fainting, confusion, muscle pain, weakness, or a fast heartbeat. Drink more fluids when you exercise or if the weather is hot. Heavy sweating or diarrhea and vomiting can cause dehydration or electrolyte imbalances (loss of sodium, potassium, or magnesium). Check with your doctor if you become sick with severe nausea, vomiting, or diarrhea.
• Liver problems may occur. Stop using this medicine and check with your doctor right away if you have pain or tenderness in your upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin.
• Check with your doctor if you notice any signs of fever, chills, or sore throat. These could be symptoms of an infection caused by low white blood cell counts.
• Check with your doctor immediately if blurred vision, difficulty reading, eye pain, or any other change in vision occurs. Your doctor may want an eye doctor to check your eyes.
• Allergic reactions, including angioedema, are rare, but are more common among black patients.
• This medicine may be less effective in black patients.
• Tell your doctor if you have diabetes. This medicine may raise your blood sugar levels.
• Even if you feel well, do not stop using this medicine without asking your doctor. This medicine will not cure your high blood pressure, but it will help lower it and keep it down. You may have to take blood pressure medicine for the rest of your life.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood and urine tests may be needed to check for unwanted effects.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blurred vision, or changes in vision
• Change in how much or how often you urinate, or problems urinating
• Confusion, body weakness, uneven heartbeat, shortness of breath, or numbness or tingling in your hands, feet, or lips
• Dark-colored urine or pale stools
• Dry mouth, increased thirst, or muscle cramps
• Fast, slow, or pounding heartbeat
• Fever, chills, runny or stuffy nose, sore throat, and body aches
• Increased shakiness or hunger
• Lightheadedness, dizziness, or fainting
• Nausea, vomiting, loss of appetite, or stomach pain
• Rapid weight gain
• Severe stomach pain
• Swelling in your hands, ankles, or feet
• Unusual tiredness or weakness
• Yellowing of your skin or the whites of your eyes

If you notice these less serious side effects, talk with your doctor:

• Dry cough
• Headache

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088