Zestoretic

Generic name: Lisinopril and hydrochlorothiazide

What is Zestoretic?

Zestoretic is a combination product that contains two medicines: Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, and hydrochlorothiazide, a diuretic. These two medications work together to lower blood pressure in patients who may not have experienced adequate blood pressure lowering from other medications. This should not be the first medication used to treat high blood pressure.

What is the most important information I should know about Zestoretic?

If taken during the second or third trimester of pregnancy, Zestoretic may cause serious harm or even death to an unborn baby. If you become pregnant while taking Zestoretic, you should immediately stop taking it and tell your doctor.

Zestoretic can cause a rare but serious allergic reaction leading to extreme swelling of the face, lips, tongue, throat, or gut (causing severe abdominal pain). You may have an increased risk of experiencing these symptoms if you have ever had an allergy to ACE inhibitor-type medicines or if you are African American. If you experience any of these symptoms, seek emergency medical attention.

Tell your doctor if you experience light-headedness, especially during the first few days of Zestoretic therapy. If you faint, stop taking Zestoretic until you have talked to your doctor.

Do not stand or sit up quickly when taking Zestoretic, especially in the morning. Sit or lie down at the first sign of dizziness, light-headedness, or fainting.

Vomiting, diarrhea, fever, exercise, hot weather, alcohol, excessive perspiration, and dehydration may lead to an excessive fall in blood pressure. Consult with your doctor if you experience these. Make sure to drink plenty of fluids when taking Zestoretic.

Zestoretic may decrease your blood levels of infection-fighting white blood cells, especially if you have a condition known as a collagen vascular disease (such as lupus) or kidney disease. Promptly report any indication of infection, such as sore throat or fever, to your doctor.

Zestoretic can also activate lupus or gout if you are susceptible.

Do not drive or perform other possibly unsafe tasks until you know how you react to Zestoretic; this drug may cause dizziness, light-headedness, or fainting. These effects may be worse if you take it with alcohol or certain medicines.

Zestoretic may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.

Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.

Zestoretic may not work as well in black patients. They may also be at greater risk of side effects. Contact your doctor if your symptoms do not improve or if they become worse.

Zestoretic may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Zestoretic. Use sunscreen or wear protective clothing if you must be outside for more than a short time.

Who should not take Zestoretic?

You should not take Zestoretic if you do not produce urine, you have a history of sensitivity or allergic reaction to ACE inhibitors, or you are allergic to sulfonamide-derived medications. You may be more at risk of experiencing sensitivity or an allergic reaction to Zestoretic if you have allergies or bronchial asthma. You should not take Zestoretic if you are allergic to lisinopril, hydrochlorothiazide, or any of the medication's other ingredients.

What should I tell my doctor before I take the first dose of Zestoretic?

Mention all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Zestoretic. Also, talk to your doctor about your complete medical history, especially if you are pregnant or plan on becoming pregnant. Also discuss this medication with your doctor if you have any of the following: diabetes; a history of liver or kidney problems, bone marrow suppression, heart disease, or scleroderma; severe immune system problems; lupus; asthma; are on a sodium-restricted diet, or if you have ever had an allergy or sensitivity to an ACE inhibitor or sulfonamide-derived medications.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults: The usual dose is 10/12.5 (10 milligrams [mg] of lisinopril and 12.5 mg of hydrochlorothiazide) or 20/12.5 (20 mg of lisinopril and 12.5 mg of hydrochlorothiazide). Your doctor may increase your dose to 20/25 mg depending on your condition and how you respond to the medication.

How should I take Zestoretic?

You should take Zestoretic with or without food at the same time every day. Continue to use Zestoretic even if you feel well. Do not miss any doses.

What should I avoid while taking Zestoretic?

You should avoid operating automobiles or heavy machinery until you know how Zestoretic will affect you. Also avoid becoming dehydrated; drink adequate fluids while taking Zestoretic. Do not take salt substitutes or supplements containing potassium unless otherwise directed by your doctor.

Do not stand or sit up quickly when taking Zebeta, especially in the morning. Sit or lie down at the first sign of dizziness, light-headedness, or fainting.

Avoid the sun, sunlamps, or tanning booths until you know how you react to Zestoretic. Use sunscreen or wear protective clothing if you must be outside for more than a short time.

What are possible food and drug interactions associated with Zestoretic?

If Zestoretic is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Zestoretic with the following: certain diuretics, such as thiazide-type diuretics and potassium-sparing diuretics such as spironolactone, amiloride, and triamterene; cholestyramine; colestipol; corticosteroids; insulin and oral antidiabetic medicines; lithium; methenamine; norepinephrine; nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen; potassium supplements; salt substitutes containing potassium; and skeletal muscle relaxants.

What are the possible side effects of Zestoretic?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: dizziness, headache, low blood pressure (especially when rising from a seated position), fatigue, cough, nausea, tiredness, diarrhea

Zestoretic can cause a rare but serious allergic reaction leading to extreme swelling of the face, lips, tongue, throat, or gut (causing severe abdominal pain). You may have an increased risk of experiencing these symptoms if you have ever had an allergy to ACE inhibitor-type medicines or if you are African American. If you experience any of these symptoms, seek emergency medical attention.

Zestoretic may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.

Can I receive Zestoretic if I am pregnant or breastfeeding?

Zestoretic should not be taken during pregnancy. Taking Zestoretic during your second or third trimesters of pregnancy could cause serious harm or even death to your unborn baby. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding. Zestoretic is excreted in breast milk, and should not be taken if you are nursing unless you are directed to do so by your doctor.

What should I do if I miss a dose of Zestoretic?

If you miss a dose of Zestoretic, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

How should I store Zestoretic?

Store at 77 degrees F (25 degrees C) in a tightly closed container. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Zestoretic out of the reach of children.