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

Treats high blood pressure. This medicine contains an ACE inhibitor and a diuretic (water pill).

Brand Name(s):

Zestoretic

When This Medicine Should Not Be Used:

How to Use This Medicine:

Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Swallow the tablet whole. Do not break, crush, or chew it.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

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

• Do not use this medicine together with aliskiren if you have diabetes.
• Do not use this medicine together with sacubitril. Do not use this medicine and sacubitril/valsartan within 36 hours of each other.
• Some foods and medicines can affect how lisinopril/hydrochlorothiazide works. Tell your doctor if you are using any of the following:
  • Aliskiren, cholestyramine, colestipol, everolimus, gold injection, lithium, sirolimus, temsirolimus
  • Another blood pressure medicine, including an angiotensin receptor blocker (ARB)
  • Insulin or oral diabetes medicine
  • NSAID pain or arthritis medicine (including aspirin, celecoxib, diclofenac, ibuprofen, or naproxen)
  • Steroid medicine (including hydrocortisone, methylprednisolone, prednisolone, prednisone)
• Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium.
• Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used together with this medicine.

Warnings While Using This Medicine:

• This medicine is not safe to take during pregnancy, especially in your second or third trimester. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Tell your doctor if you are breastfeeding, or if you have kidney disease, liver disease, heart or blood vessel disease, heart failure, diabetes, high cholesterol, gout, lupus, trouble urinating, or a history of allergies or asthma, or if you have had surgery of the nerves.
• This medicine may cause the following problems:
  • Angioedema (severe swelling), including head, neck, and intestinal swelling
  • Low blood pressure
  • Liver problems
  • Eye or vision problems, including glaucoma, myopia
  • Kidney problems
  • High uric acid
  • High cholesterol or fats in the blood
  • Increased risk for skin cancer
• This medicine could lower your blood pressure too much, especially when you first use it or if you are dehydrated. Stand or sit up slowly if you feel lightheaded or dizzy.
• Do not stop using the medicine without asking your doctor, even if you feel well. This medicine will not cure your high blood pressure, but it will help keep it in the normal range. You may have to take blood pressure medicine for the rest of your life.
• Drink plenty of fluids if you exercise, sweat more than usual, or have diarrhea or vomiting while you are using this medicine.
• This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

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
• Blistering, peeling, red skin rash
• Change in how much or how often you urinate
• Confusion, weakness, uneven heartbeat, trouble breathing, numbness in your hands, feet, or lips
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Dry mouth, increased thirst, muscle cramps
• Eye pain, vision changes, seeing halos around lights
• Fever, chills, sore throat, body aches
• Lightheadedness, dizziness, fainting
• Severe stomach pain
• Sores, reddish patch or irritated area, shiny bump, pink growth, or white, yellow or waxy scar-like area on the skin

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

• Dry cough

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