Zestoretic

Pronunciation: lye-SIN-oh-pril/HYE-droe-KLOR-oh-THYE-a-zide
Generic Name: Lisinopril/Hydrochlorothiazide
Brand Name: Examples include Prinzide and Zestoretic

Zestoretic may cause injury or death to the fetus if taken during pregnancy. If you think you may be pregnant, contact your doctor right away.

Zestoretic is used for:

Treating high blood pressure.

Zestoretic is an angiotensin-converting enzyme (ACE) inhibitor and thiazide diuretic combination. It works by removing excess fluid from the body and causing blood vessels to relax or widen.

Do NOT use Zestoretic if:

• you are allergic to any ingredient in Zestoretic, any other sulfonamide medicine (eg, sulfamethoxazole, glyburide, probenecid), or another ACE inhibitor (eg, captopril)


• you have a history of angioedema (swelling of the face, lips, throat, or tongue; difficulty swallowing or breathing; or unusual hoarseness), including angioedema caused by treatment with an ACE inhibitor


• you are unable to urinate


• you are pregnant


• you are taking dofetilide or ketanserin

Contact your doctor or health care provider right away if any of these apply to you.

Before using Zestoretic:

Some medical conditions may interact with Zestoretic. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are able to become pregnant


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have liver problems, blood vessel problems (eg, stroke), heart problems (eg, congestive heart failure, aortic stenosis), or high cholesterol


• if you have a history of kidney problems (eg, renal artery stenosis), you are on dialysis or apheresis, or you have had a kidney transplant


• if you have gout, or electrolyte imbalances (eg, high or low potassium levels, low blood sodium levels), or you are on a low-salt (sodium) diet


• if you are dehydrated, drink alcohol, or have low blood volume or low blood pressure


• if you have a collagen vascular disorder (eg, lupus, scleroderma), bone marrow problems, or severe immune system problems


• if you have a history of allergies or asthma, or if you are receiving treatments to reduce sensitivity to bee or wasp stings


• if you have diabetes, especially if you are also taking aliskiren


• if you are scheduled to have major surgery or receive anesthesia


• if you have recently had a certain type of nerve surgery (sympathectomy)


• if you have never taken another medicine for high blood pressure

Some MEDICINES MAY INTERACT with Zestoretic. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Digoxin, dofetilide, or ketanserin because the risk of irregular heartbeat may be increased


• Aldosterone blockers (eg, eplerenone), aliskiren, potassium preparations, potassium-sparing diuretics (eg, triamterene), salt substitutes containing potassium, or trimethoprim because the risk of high blood potassium levels may be increased


• Adrenocorticotropic hormone (ACTH), barbiturates (eg, phenobarbital), corticosteroids (eg, prednisone), dextran sulfate, diazoxide, diuretics (eg, furosemide), narcotic pain medicine (eg, codeine), or other medicines for high blood pressure because the risk of low blood pressure may be increased


• Angiotensin receptor blockers (ARBs) (eg, losartan) because the risk of serious kidney problems and high blood potassium levels may be increased


• Certain gold-containing medicines (eg, sodium aurothiomalate) because flushing, nausea, vomiting, and low blood pressure may occur


• Cholestyramine, colestipol, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, indomethacin, celecoxib), or salicylates (eg, aspirin) because they may decrease Zestoretic's effectiveness


• Lithium, or thiopurines (eg, azathioprine) because the risk of their side effects may be increased by Zestoretic


• Insulin or other diabetes medicines (eg, glyburide) because their effectiveness may be decreased by Zestoretic

This may not be a complete list of all interactions that may occur. Ask your health care provider if Zestoretic may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Zestoretic:

Use Zestoretic as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Zestoretic by mouth with or without food.


• If you take cholestyramine or colestipol, ask your doctor or pharmacist how to take it with Zestoretic.


• Take Zestoretic on a regular schedule to get the most benefit from it.


• Taking Zestoretic at the same time each day will help you remember to take it.


• Continue to use Zestoretic even if you feel well. Do not miss any doses.


• 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.

Ask your health care provider any questions you may have about how to use Zestoretic.

Important safety information:

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


• Zestoretic may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.


• Zestoretic may cause a serious side effect called angioedema. Black patients may be at greater risk of developing this side effect. Contact your doctor at once if you develop swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness.


• Zestoretic contains a sulfonamide called hydrochlorothiazide, which can cause certain eye problems (myopia, angle-closure glaucoma). Your risk may be increased if you are allergic to sulfonamide medicines (eg, sulfamethoxazole) or to penicillin antibiotics (eg, amoxicillin). Untreated angle-closure glaucoma can lead to permanent vision loss. If these eye problems occur, symptoms usually occur within hours to weeks of starting Zestoretic. Contact your doctor immediately if you experience symptoms such as vision changes (eg, decreased vision clearness) or eye pain.


• Check with your doctor before you use a salt substitute or a product that has potassium in it.


• Drink plenty of fluids while taking Zestoretic and avoid engaging in activities that cause excessive sweating. Dehydration, excessive sweating, vomiting, or diarrhea may lead to a fall in blood pressure. Contact your health care provider at once if any of these occur.


• 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.


• Diabetes patients - Zestoretic may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.


• A persistent, unproductive cough may occur. Tell your doctor if this occurs. If caused by Zestoretic, recovery is usually rapid when the medicine is stopped.


• 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.


• Tell your doctor or dentist that you take Zestoretic before you receive any medical or dental care, emergency care, or surgery.


• 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 a sunscreen or wear protective clothing if you must be outside for more than a short time.


• Zestoretic may interfere with certain lab tests, including parathyroid function. Be sure your doctor and lab personnel know you are taking Zestoretic.


• Lab tests, including blood electrolytes, blood pressure, complete blood cell counts, and kidney and liver function, may be performed while you use Zestoretic. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Zestoretic with caution in the ELDERLY; they may be more sensitive to its effects.


• Zestoretic should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: Zestoretic may cause birth defects and fetal or newborn death if you take it while you are pregnant. Do not become pregnant while you take Zestoretic. If you think you may be pregnant, contact your doctor right away. Zestoretic is found in breast milk. Do not breast-feed while taking Zestoretic.

Possible side effects of Zestoretic:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Dizziness; headache; light-headedness; nonproductive cough; tiredness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); blurred vision or other vision changes (eg, decreased vision clearness); change in the amount of urine produced; chest pain or discomfort; dark urine; difficult or painful urination; drowsiness; dry mouth; eye pain; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; joint pain, stiffness, or swelling; loss of appetite; mood or mental changes (eg, depression); muscle cramps, pain, or weakness; numbness, burning, or tingling; numbness of an arm or leg; one-sided weakness; pale stools; persistent or unusual nausea or vomiting; red, swollen, blistered, or peeling skin; restlessness; severe or persistent cough; severe or persistent headache, dizziness, or light-headedness; shortness of breath; slurred speech; stomach pain (with or without nausea or vomiting); sudden, unusual weight loss or gain; symptoms of high blood sugar (eg, fast breathing; flushing; fruit-like breath odor; increase in thirst, hunger, or urination); symptoms of low blood sodium (eg, confusion, mental or mood changes, seizures, sluggishness); trouble swallowing; unusual bruising or bleeding; unusual thirst, weakness, or tiredness; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Zestoretic side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; severe dizziness or light-headedness; symptoms of blood electrolyte problems (eg, confusion; irregular heartbeat; mental or mood changes; muscle cramps, pain, or weakness; seizures; sluggishness); symptoms of dehydration (eg, drowsiness; dry eyes; fast heartbeat; nausea; restlessness; unusual thirst, tiredness, or weakness; vomiting).

Proper storage of Zestoretic:

Store Zestoretic at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in bathroom. Keep Zestoretic out of the reach of children and away from pets.

General information:

• If you have any questions about Zestoretic, please talk with your doctor, pharmacist, or other health care provider.


• Zestoretic is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Zestoretic. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Zestoretic resources

• Zestoretic Side Effects (in more detail)
• Zestoretic Use in Pregnancy & Breastfeeding
• Drug Images
• Zestoretic Drug Interactions
• Zestoretic Support Group
• 4 Reviews for Zestoretic - Add your own review/rating

• Zestoretic Prescribing Information (FDA)


• Zestoretic Advanced Consumer (Micromedex) - Includes Dosage Information


• Zestoretic Consumer Overview


• Prinzide Prescribing Information (FDA)

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