ZESTORETIC (lisinopril +hctz) 20/12.5mg x28s Tablets

Patient Education - English

• Generic Name: hydrochlorothiazide and lisinopril

• Pronounced: HYE droe KLOR oh THYE a zide and lye SIN oh pril

• Brand Names: Prinzide, Zestoretic

What is the most important information I should know about hydrochlorothiazide and lisinopril?

Do not use this medication if you are unable to urinate.

You should not use this medication if you are allergic to any other ACE inhibitor, such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

Before taking hydrochlorothiazide and lisinopril, tell your doctor if you have kidney disease (or are on dialysis), liver disease, congestive heart failure, gout, lupus, diabetes, or an allergy to sulfa drugs.

Lisinopril can cause birth defects in the baby if you take the medication during pregnancy. Do not use hydrochlorothiazide and lisinopril without telling your doctor if you are pregnant or planning a pregnancy.

Avoid the regular use of salt substitutes in your diet, and do not take potassium supplements while taking hydrochlorothiazide and lisinopril, unless your doctor has told you to.

Some things can cause your blood pressure to get too low. This includes vomiting, diarrhea, heavy sweating, heart disease, dialysis, a low-salt diet, or taking other diuretics (water pills). Follow your doctor's instructions about the type and amount of liquids you should drink while taking hydrochlorothiazide and lisinopril. Tell your doctor if you have a prolonged illness that causes diarrhea or vomiting.

What is hydrochlorothiazide and lisinopril?

Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Lisinopril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme. Lisinopril lowers blood pressure and also relieves symptoms of fluid retention.

The combination of hydrochlorothiazide and lisinopril is used to treat hypertension (high blood pressure).

Hydrochlorothiazide and lisinopril may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking hydrochlorothiazide and lisinopril?

Do not use this medication if you are unable to urinate.

You should not use this medication if you are allergic to any other ACE inhibitor, such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take hydrochlorothiazide and lisinopril:

• kidney disease (or if you are on dialysis);
• liver disease;
• heart disease or congestive heart failure;
• asthma or allergies;
• gout;
• lupus;
• diabetes; or
• an allergy to sulfa drugs.

FDA pregnancy category D. Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Lisinopril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment.

Hydrochlorothiazide can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take hydrochlorothiazide and lisinopril?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take each dose with a full glass of water.

Some things can cause your blood pressure to get too low. This includes vomiting, diarrhea, heavy sweating, heart disease, dialysis, a low-salt diet, or taking other diuretics (water pills). Follow your doctor's instructions about the type and amount of liquids you should drink while taking hydrochlorothiazide and lisinopril. Tell your doctor if you have a prolonged illness that causes diarrhea or vomiting.

While you are taking this medication, your blood pressure will need to be checked on a regular basis. Do not miss any scheduled appointments.

Your blood and urine may also be tested if you have been vomiting or are dehydrated.

Hydrochlorothiazide can interfere with the results of a thyroid test. Tell any doctor who treats you that you are using a thiazide diuretic.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Store hydrochlorothiazide and lisinopril at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include nausea, weakness, dizziness, dry mouth, thirst, muscle pain or weakness, or feeling like you might pass out.

What should I avoid while taking hydrochlorothiazide and lisinopril?

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid drinking alcohol, which can increase some of the side effects of hydrochlorothiazide and lisinopril.

Avoid the regular use of salt substitutes in your diet, and do not take potassium supplements while taking hydrochlorothiazide and lisinopril, unless your doctor has told you to.

What are the possible side effects of hydrochlorothiazide and lisinopril?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

• high potassium (slow heart rate, weak pulse, muscle weakness, tingly feeling);
• low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling);
• dry mouth, thirst, nausea, vomiting;
• feeling weak, drowsy, restless, or light-headed;
• a red, blistering, peeling skin rash;
• jaundice (yellowing of the skin or eyes);
• urinating less than usual or not at all;
• swelling, weight gain, feeling short of breath; or
• fever, chills, body aches, flu symptoms.

Less serious side effects may include:

• cough;
• dizziness, tired feeling, depressed mood;
• headache, blurred vision;
• diarrhea, constipation, upset stomach; or
• mild skin rash, increased sweating.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

What other drugs will affect hydrochlorothiazide and lisinopril?

Cold or allergy medicine, sedatives, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety can add to the side effects of hydrochlorothiazide and lisinopril. Tell your doctor if you regularly use any of these medicines, or any other blood pressure medications.

Before taking this medication, tell your doctor if you are using any of the following drugs:

• other diuretics (water pills) or blood pressure medications;
• gold injections to treat arthritis;
• lithium (Lithobid, Eskalith);
• cholestyramine (Prevalite, Questran) or colestipol (Colestid);
• steroids (prednisone and others);
• NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Motrin, Advil), diclofenac (Voltaren), indomethacin, naproxen (Aleve, Naprosyn), piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others; or
• insulin or diabetes medicine taken by mouth.

This list is not complete and there may be other drugs that can interact with hydrochlorothiazide and lisinopril. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about hydrochlorothiazide and lisinopril.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.