Zestoretic (Lisinopril/HCTZ)

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Zestoretic 10mg/12.5mg

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Zestoretic 20mg/25mg

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Zestoretic 20mg/12.5mg

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Lisinopril/HCTZ 10mg/12.5mg

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Lisinopril/HCTZ 10mg/12.5mg
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Lisinopril/HCTZ 20mg/12.5mg

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Zestoretic (Lisinopril/HCTZ) Dosage and Side Effects

ZESTORETIC lowers high blood pressure.  ZESTORETIC contains a combination of 2 drugs, lisinopril and hydrochlorothiazide:

  • Lisinopril is an angiotensin converting enzyme (ACE) inhibitor. You can recognize ACE inhibitors because their medicinal ingredient ends in ‘-PRIL'. It lowers blood pressure.

  • Hydrochlorothiazide is a diuretic or “water pill” that increases urination. This lowers blood pressure.

This medicine does not cure high blood pressure. It helps to control it. Therefore, it is important to continue taking ZESTORETIC regularly even if you feel fine.

Warnings and Precautions

Serious Warnings and Precautions

Pregnancy: ZESTORETIC should not be used during pregnancy. If you discover that you are pregnant while taking ZESTORETIC, stop the medication and contact your doctor, nurse, or pharmacist as soon as possible.

BEFORE you use ZESTORETIC talk to your doctor, nurse, or pharmacist if you:

  • Have experienced an allergic reaction to any drug used to lower blood pressure or penicillin.

  • Have recently received or are planning to get allergy shots for bee or wasp stings or have an allergy.

  • Have narrowing of an artery or a heart valve.

  • Have had a heart attack or stroke.

  • Have heart failure.

  • Have diabetes, liver or kidney disease.

  • Have lupus, gout, or asthma.

  • Are dehydrated or suffer from excessive vomiting, diarrhea, or sweating.

  • Are taking a salt substitute that contains potassium, potassium supplements, or a potassium-sparing diuretic (a specific kind of “water pill”).

  • Are taking a medicine that contains aliskiren, such as Rasilez, used to lower high blood pressure. The combination withZESTORETIC is not recommended.

  • Are taking an angiotensin receptor blocker (ARB). You can recognize an ARB because its medicinal ingredient ends in “-SARTAN”.

  • Are on a low-salt diet.

  • Are on dialysis.

  • Are receiving gold (sodium aurothiomalate) injections.

  • Are less than 18 years old.

  • Are on LDL Apheresis (a treatment to lower the LDL cholesterol in the blood).

  • Are taking drugs such as:

    • Temsirolimus and everolimus (used to treat cancer),

    • Sirolimus (used to prevent organ rejection after a transplant).

Taking ACE inhibitors, such as ZESTORETIC with these types of drugs may increase your chances of having an allergic reaction (angioedema).

Hydrochlorothiazide in ZESTORETIC can cause Sudden Eye Disorders:

  • Myopia: sudden nearsightedness or blurred vision.

  • Glaucoma: an increased pressure in your eyes, eye pain. Untreated, it may lead to permanent vision loss.

These eye disorders are related and can develop within hours to weeks of starting ZESTORETIC.

Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.

You may become sensitive to the sun while taking ZESTORETIC. Exposure to sunlight should be minimized until you know how you respond.

If you are going to have surgery and will be given an anesthetic, be sure to tell your doctor or dentist that you are taking ZESTORETIC.

Driving and using machines:

Before you perform tasks which may require special attention, wait until you know how you respond to ZESTORETIC. Dizziness, lightheadedness, or fainting can especially occur after the first dose and when the dose is increased.

Side Effects

Side effects may include:

  • dizziness

  • headache

  • cough

  • drowsiness, fatigue, weakness

  • rash

  • abdominal pain, upset stomach, decreased appetite, constipation

  • muscle pain or cramps

If any of these affects you severely, tell your doctor, nurse or pharmacist.

ZESTORETIC can cause abnormal blood test results. Your doctor will decide when to perform blood tests and will interpret the results.

This is not a complete list of side effects. For any unexpected effects while taking ZESTORETIC, contact your doctor, nurse or pharmacist.

Interactions with this medication

As with most medicines, interactions with other drugs are possible. Tell your doctor, nurse, or pharmacist about all the medicines you take, including drugs prescribed by other doctors, vitamins, minerals, natural supplements, or alternative medicines.

The following may interact with ZESTORETIC:

  • Adrenocorticotropic hormone (ACTH) may be used to treat nephrotic syndrome and in diagnostic tests.

  • Alcohol, barbiturates (sleeping pills), or narcotics (strong pain medications). They may cause low blood pressure and dizziness when you go from lying or sitting to standing up.

  • Amantadine used to treat the flu and reduce symptoms of Parkinson's disease.

  • Amphotericin B, an antifungal drug.

  • Antacids.

  • Drugs used to treat cancer (such as cyclophosphamide, methotrexate, temsirolimus and everolimus).

  • Antidepressants, in particular selective serotonin reuptake inhibitors (SSRIs), including citalopram, escitalopram, and sertraline.

  • Drugs to treat diabetes such as:

    • Insulin,

    • Oral medications (such as sulphonylureas).

    Your dose of these types of drugs may need to be changed when taking them in combination with ZESTORETIC.

  • Bile acid resins used to lower cholesterol.

  • Blood pressure-lowering drugs, including diuretics (“water pills”), aliskiren-containing products (e.g. Rasilez), diazoxide, methyldopa and beta blockers such as atenolol, metoprolol, propranolol, calcium channel blockers such as felodipine, amlodipine, nifedipine, and angiotensin II receptor blockers such as candesartan, valsartan, losartan. When taken in combination with ZESTORETIC may cause excessively low blood pressure.

  • Calcium or vitamin D supplements.

  • Capsaicin, an ingredient in some creams used to relieve arthritis pain.

  • Corticosteroids used to treat joint pain and swelling.

  • Cyclosporine used to treat autoimmune diseases.

  • Digoxin, a drug used to treat heart conditions, or other medicines to control the rhythm of your heart.

  • Drugs that slow down or speed up bowel function, including atropine, biperiden, domperidone and metoclopramide.

  • Drugs used to treat epilepsy, including carbamazepine and topiramate.

  • Gold (sodium aurothiomalate), used to treat auto-immune conditions such as rheumatoid arthritis and psoriatic arthritis.

  • Gout medications, including allopurinol and probenecid.

  • Lithium, a medicine to treat bipolar disease.

  • Drugs that can cause low blood potassium levels (hypokalemia) such as:

    • Laxatives,

    • Corticosteroids (such as prednisone),

    • Salicylic acid derivatives.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), used to reduce pain and swelling. Examples include ibuprofen, naproxen, and celecoxib.

  • Drugs that can increase blood potassium levels (hyperkalemia) such as:

    • Potassium supplements,

    • Salt substitutes.

  • Rituximab used to treat cancer, transplant rejection, and some autoimmune diseases.

  • Sirolimus, a drug used to prevent organ rejection after a transplant.

  • Skeletal muscle relaxants used to relieve muscle spasms, including tubocurare.

  • Tetracycline antibiotics.

Proper Use of this medication

Take ZESTORETIC exactly as prescribed.

It is recommended to take your dose at about the same time everyday.

ZESTORETIC can be taken with or without food. If ZESTORETIC causes upset stomach, take it with food or milk.

Usual adult dose:

The dosage of ZESTORETIC is individualized and taken once a day.

It may be prescribed as follows:

One tablet of 10/12.5 mg

Or,

One or two tablets of 20/12.5 mg,

One or two tablets of 20/25 mg

Overdose:

If you think you have taken too much ZESTORETIC contact your doctor, nurse, pharmacist, hospital emergency department or regional Poison control Centre immediately, even if there are no symptoms.

Missed dose:

If you have forgotten to take your dose during the day, carry on with the next one at the usual time. Do not double dose.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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