Lisinopril and Hydrochlorothiazide (patient information)

IMPORTANT WARNING

Do not take lisinopril and hydrochlorothiazide if you are pregnant. If you become pregnant while taking lisinopril and hydrochlorothiazide, call your doctor immediately. Lisinopril and hydrochlorothiazide may harm the fetus.

Why this medication is prescribed

The combination of lisinopril and hydrochlorothiazide is used to treat high blood pressure. Lisinopril is in a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly. Hydrochlorothiazide is in a class of medications called diuretics ('water pills'). It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.

How this medication should be used

The combination of lisinopril and hydrochlorothiazide comes as a tablet to take by mouth. It is usually taken once a day with or without food. To help you remember to take lisinopril and hydrochlorothiazide, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take lisinopril and hydrochlorothiazide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Lisinopril and hydrochlorothiazide controls high blood pressure but does not cure it. Continue to take lisinopril and hydrochlorothiazide even if you feel well. Do not stop taking lisinopril and hydrochlorothiazide without talking to your doctor.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Special precautions

Before taking lisinopril and hydrochlorothiazide:

• tell your doctor and pharmacist if you are allergic to lisinopril, hydrochlorothiazide, benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), trandolapril (Mavik), sulfa drugs, or any other medications.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin), indomethacin (Indocin), and naproxen (Aleve, Naprosyn); barbiturates such as phenobarbital (Luminal, Solfoton); cholestyramine (Questran); colestipol (Colestid); digoxin (Lanoxin); insulin or oral medications for diabetes; lithium (Eskalith, Lithobid); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); other diuretics; other medications for high blood pressure; pain medications; and potassium supplements. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you are on dialysis or are being treated with desensitization (a process to reduce your reaction to an allergen) and if you have or have ever had allergies; asthma; diabetes; gout; high cholesterol; collagen vascular disease such as lupus or scleroderma (a condition in which extra tissue grows on the skin and some organs); heart failure; any condition that causes you to urinate less than you normally do; a stroke or 'mini-stroke'; heart, kidney, or liver disease; or angioedema, a condition that causes difficulty swallowing or breathing and painful swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs.
• tell your doctor if you plan to become pregnant or are breast-feeding.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking lisinopril and hydrochlorothiazide.
• ask your doctor about the safe use of alcoholic beverages while you are taking lisinopril and hydrochlorothiazide. Alcohol can make the side effects from lisinopril and hydrochlorothiazide worse.
• you should know that diarrhea, vomiting, not drinking enough fluids, and sweating a lot can cause a drop in blood pressure, which may cause lightheadedness and fainting.
• you should know that lisinopril and hydrochlorothiazide may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking lisinopril and hydrochlorothiazide. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

Special dietary instructions

Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, or an exercise program, follow these directions carefully.

What to do if you forget a dose

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Side effects

Minor side effects

Lisinopril and hydrochlorothiazide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness
• headache
• cough
• excessive tiredness
• pain, burning, or tingling in the hands or feet
• decrease in sexual ability
• heartburn

Severe side effects

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• difficulty breathing or swallowing
• stomach pain
• upset stomach
• vomiting
• fever, sore throat, chills, and other signs of infection
• muscle pain, cramps, or weakness
• yellowing of the skin or eyes
• dry mouth
• thirst
• weakness
• restlessness
• confusion
• seizures
• decrease in urination
• lightheadedness
• fainting
• chest pain
• rapid, pounding, slow, or irregular heartbeat
• pain in big toe
• tingling in arms and legs
• loss of muscle tone
• weakness or heaviness in legs
• lack of energy
• cold, gray skin

Lisinopril and hydrochlorothiazide may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storage conditions needed for this medication

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• lightheadedness
• fainting
• blurred vision
• dry mouth
• thirst
• weakness
• drowsiness
• restlessness
• confusion
• seizures
• muscle pains or cramps
• infrequent urination
• upset stomach
• vomiting
• rapid or pounding heartbeat

Other information

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to lisinopril and hydrochlorothiazide. Your doctor may order certain lab tests to check your body's response to lisinopril and hydrochlorothiazide.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking lisinopril and hydrochlorothiazide.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

• Prinzide®
• Zestoretic®