Lisinopril and Hydrochlorothiazide (Oral)

 

Lisinopril and hydrochlorothiazide are drugs often used in combination as a two-pronged treatment for high blood pressure (hypertension).

Overview

A combination of two drugs, Lisinopril and hydrochlorothiazide is a common treatment for patients with high blood pressure. The two drugs work together to deliver a treatment which is often more effective than either of the drugs in isolation.

Lisinopril belongs to a group of drugs known as angiotensin-converting enzyme (ACE) inhibitors. It decreases the levels of types of chemicals in the body which are known to tighten the blood vessels. Reducing the levels of these chemicals prevents the blood vessels from being as restricted and therefore allows the blood to flow more smoothly around the body, increasing the supply of oxygen to the vital organs.

Hydrochlorothiazide is a diuretic. It increases the amount of urine that the body produces and helps the kidneys to get rid of more salt. Excess salt is known to increase blood pressure, so allowing the kidneys to process more of it to remove it from the body leads to lower blood pressure.

High blood pressure is a condition which affects many people and increases the strain placed on the circulatory system. It can often be treated easily and effectively, but if patients are left without treatment, the kidneys, blood vessels, heart and brain may be severely affected. If these organs experience sufficient damage, it could lead to patients having strokes, experiencing heart failure, having heart attacks, losing their vision, kidney failure and heart disease.

It is also possible to reduce blood pressure by making lifestyle changes. Eating less fat and salt, getting plenty of exercise, not drinking to excess and not smoking can all help to reduce blood pressure naturally. If these lifestyle changes do not help, or your blood pressure needs to be reduced quickly, doctors may prescribe Lisinopril and hydrochlorothiazide to treat the condition.

Lisinopril and hydrochlorothiazide can only be obtained through a prescription from a doctor. The drugs come in the form of tablets which are to be taken according to the doctor's recommendations. In many cases, patients are prescribed a course of Lisinopril and hydrochlorothiazide to be continued indefinitely and it is not uncommon for patients to take these drugs for the rest of their lives.

As with all drugs, there is a risk of side effects associated with taking Lisinopril and hydrochlorothiazide. The most common side effects are dizziness and lightheadedness, which often go away after a few weeks of taking the drug as the body gets used to having the substances in its system.

Conditions Treated

  • High blood pressure

Type Of Medicine

  • ACE inhibitor

Side Effects

As with all drugs, taking Lisinopril and hydrochlorothiazide can come with the risk of side effects.

Before prescribing this medication, doctors will weigh up the benefits of the drugs against the risk of any possible side effects that they may cause. There is always the chance that side effects may occur, but remember that doctors will only prescribe Lisinopril and hydrochlorothiazide if they believe that the potential positive effects of the drug outweigh the potential for negative side effects.

Lisinopril and hydrochlorothiazide can cause some minor side effects which are relatively common but do not usually pose a risk to patients as they can often be treated or managed effectively. These minor side effects include:

  • Lightheadedness
  • Excessive tiredness
  • Headaches
  • Dry cough
  • Dizziness

Any or all of the side effects listed above can come as a result of taking Lisinopril and hydrochlorothiazide, especially in the early stages of taking the drug. In many cases, the body will adjust to having the medication in the system, and the side effects will go away on their own, without medical intervention. Patients can reduce their risk of dizziness and lightheadedness by ensuring that they stand or sit slowly when they have been lying down.

Patients experiencing any of the side effects listed above need not worry as these are perfectly normal. They only need to speak to their doctor or healthcare professional if the side effects are particularly severe or long-lasting.

Serious side effects as a result of taking Lisinopril and hydrochlorothiazide are rare but they do occur in some patients. Anyone experiencing any of the following after taking Lisinopril and hydrochlorothiazide should let their doctor or healthcare professional know as soon as possible as further treatment may be required. These side effects include:

    • Muscle weakness
    • Muscle cramps
    • High levels of potassium in the blood
    • Kidney problems
    • Difficulty urinating
    • Loss of vision
    • Pain in the eyes
    • Fainting or loss of consciousness
    • Dehydration
    • Mineral loss
    • Extreme thirst
    • Confusion
    • Changes to the patient's heartbeat beating too fast, slow or at an irregular rhythm

The combination of these two drugs very rarely causes very serious and severe side effects in patients. In very rare cases, taking Lisinopril and hydrochlorothiazide can cause serious liver problems which, if left untreated, can be fatal. If patients experience any of the symptoms of liver damage they should seek urgent medical attention and make sure that the medical staff are aware that they have been taking Lisinopril and hydrochlorothiazide. The symptoms of liver damage include:

  • Severe nausea
  • Vomiting, which does not stop or settle down
  • Stomach cramps
  • Yellowing of the skin
  • Yellowing of the eyes
  • Loss of appetite
  • Very dark urine

It is very rare for patients to experience a severe allergic reaction after taking lisinopril and hydrochlorothiazide, but it is possible in some cases. Symptoms of an allergic reaction to this drug include:

  • Rash
  • Hives
  • Itching
  • Severe dizziness
  • Difficult breathing
  • Swollen or sore throat
  • Swelling of the tongue and/or face

Patients experiencing any of the above symptoms should seek immediate medical attention as intervention may be required. Doctors may have to reconsider alternative treatment plans to avoid further allergic reactions.

Dosage

Lisinopril and hydrochlorothiazide are often combined and prescribed in the form of a single tablet. These tablets should be swallowed with water, usually once a day, with or without food. Patients should read the instructions for taking the tablets very carefully, and follow them exactly. If they have any questions or concerns they should speak to their doctor or pharmacist as soon as possible. Patients should not make any changes to their dosage without speaking to the doctor or pharmacist.

It can be helpful for patients to take the drug at the same time each day in order to remember to take the tablet. If patients do forget to take a dose, they should take it as soon as they remember. However, if it is close to being time to take the next dose, patients should forget about the missed dose and continue the treatment as normal. Patients should never double up on doses to make up for a skipped dose.

Patients should continue to take their tablets even if they feel well. Lisinopril and hydrochlorothiazide are not a cure for high blood pressure, they are used to control the condition, but in order to do so, they must be taken every day.

Adult dose to treat high blood pressure

The dose of Lisinopril and hydrochlorothiazide can and will be adjusted from patient to patient. In most cases, patients will be prescribed an initial dose of 12.5 mg of hydrochlorothiazide and 10 to 20 mg of Lisinopril to be taken once a day. Doctors may increase this dose at intervals of 2 weeks apart if blood pressure does not begin to fall with the initial dose. The doses can be increased up to a maximum of 50 mg of hydrochlorothiazide and 80 mg of Lisinopril per day.

Interactions

When any two or more pharmaceuticals are combined within the body, there is always a risk of interaction. Interactions between drugs can occur when drugs begin to influence the way in which other drugs perform within the body. Interactions could stop one or more drugs from being effective in their treatment of a particular condition or they could bring about or worsen side effects for the patient. In order to keep an eye on interactions and try to avoid them wherever possible, it is important that patients keep an up-to-date and accurate list of all of the drugs which they are currently taking, or have stopped taking recently. This list should include all prescription and non-prescription medication, as well as dietary supplements, illegal substances and vitamins or minerals.

Drugs which are known to interact with Lisinopril and hydrochlorothiazide include:

  • Dofetilide
  • Aliskiren
  • Drugs which impair the immune system
  • Birth control (specifically types of birth control which include drospirenone)
  • ARBs (valsartan, losartan)
  • Sacubitril
  • Everolimus
  • Sirolimus
  • Certain cough and cold treatments
  • Certain diet pills
  • Ibuprofen

Lisinopril and hydrochlorothiazide can also interfere with lab tests. Patients taking these medications have been known to experience false results from tests for parathyroid function. If patients know they are due to have a parathyroid function test, they should ensure that doctors are aware that they are currently taking Lisinopril and hydrochlorothiazide and the results may therefore be affected.

Warnings

Lisinopril and hydrochlorothiazide are drugs which have been deemed safe to prescribe to patients with high blood pressure. They are commonly used to treat patients and are often taken once a day for the rest of a patient's life. However, this does not mean that these drugs are completely without risk. Whenever drugs are prescribed, there is always some possibility that they could cause harm. Patients should always ensure that their doctor has a full and up-to-date medical history for them as well as a list of all of the medication that they are currently or have recently been taking. In the case of Lisinopril and hydrochlorothiazide, it is particularly important to inform your doctor if any of the following statements are true:

  • You are allergic to lisinopril, hydrochlorothiazide or any of the other listed ingredients of the tablets
  • You are currently taking valsartan or sacubitril, or you have been taking these drugs within the last 2 days
  • You are currently taking any of the following drugs; aspirin, ibuprofen naproxen, indomethacin, cholestyramine, colestipol, digoxin, insulin, lithium, steroids, methylprednisolone, potassium supplements, pain medication, other treatments for high blood pressure.
  • You are currently on dialysis, or you have kidney problems
  • You have any allergies
  • You have ever suffered from liver disease
  • You have ever been diagnosed with angioedema
  • You have been diagnosed with lupus
  • You are currently pregnant or plan on becoming pregnant
  • You are currently breastfeeding or plan to breastfeed
  • You have due to have any surgery, including dental surgery
  • You have ever suffered from alcohol or substance abuse issues
  • You suffer from type one or type two diabetes

Be aware that Lisinopril and hydrochlorothiazide can cause dizziness, lightheadedness and fainting, especially in the early stages of taking the drug. Patients should not drive or operate heavy machinery, or undertake any activity which requires them to be fully aware and alert until they are confident that they are safe to do so.

Drinking alcohol whilst taking Lisinopril and hydrochlorothiazide can increase the severity of any side effects of taking the drug. Patients are advised to speak to their doctor about drinking alcohol safely whilst receiving this treatment

If you suffer from diabetes, taking Lisinopril and hydrochlorothiazide can interfere with blood sugar levels. It may be necessary to take extra tests to monitor blood sugar levels more closely than usual. Speak to your doctor if you notice a change in your blood sugar levels as a result of the Lisinopril and hydrochlorothiazide, as they may need to adjust your medication, or might be able to make recommendations about how to manage your blood sugar through changes to your exercise and diet.

Some of the possible side effects of these drugs can include diarrhea, vomiting and sweating. All of these symptoms can lead to severe dehydration which can have an additional impact on your kidneys. Whilst taking Lisinopril and hydrochlorothiazide is it important to stay hydrated and drink plenty of fluids in order to retain water levels.

Lisinopril and hydrochlorothiazide can make your skin more sensitive to sunlight. Patients should limit their exposure to the sun where possible. Patients taking Lisinopril and hydrochlorothiazide should not use sun lamps or tanning booths. They should ensure that they wear sunscreen whilst outdoors and wear clothes which cover the majority of the surface of the skin. If patients do experience severe sunburn whilst taking Lisinopril and hydrochlorothiazide, especially if the sunburn starts to blister, they should seek medical attention and inform their doctor.

Lisinopril and hydrochlorothiazide can interfere with the way in which your body absorbs and stores potassium. Be aware that taking potassium supplements or eating a diet rich in potassium can be dangerous whilst taking Lisinopril and hydrochlorothiazide.

Patients should make sure that their dentist knows that they are taking Lisinopril and hydrochlorothiazide before they undergo any dental procedures.

Older patients may be more at risk of experiencing side effects when taking these drugs. They are particularly susceptible to dizziness and to problems with the kidneys. Older patients should get in touch with their doctors if they feel that the side effects have become too much.

It is not recommended for patients to take Lisinopril and hydrochlorothiazide if they are pregnant. It is believed that the drugs may have a harmful effect on unborn babies. Speak to your doctor if you are pregnant or planning on becoming pregnant whilst taking this drug.

Storage

As with all medication, Lisinopril and hydrochlorothiazide should be stored in the airtight containers in which the medication was provided by the doctor or pharmacist. This container should be clearly labeled so that patients and other people sharing the space are easily able to identify the medication and that it does not get confused with any other forms of prescription drugs.

Lisinopril and hydrochlorothiazide need to be kept away from direct sunlight and in a place which is not exposed to excess moisture or changes in temperature. Bathrooms are not a good place to keep medication as the moisture in the air can harm the tablets.

Medication should be kept well out of the reach of pets and children. Patients should be aware that many pill organizers are not child-proof and that these containers can easily be opened by even very young children. Patients who are often in the company of children should try to avoid using pill organizers wherever possible in order to avoid the risk of children coming into harm by swallowing the medication.

Any medication which is no longer needed should be returned to a medical institution as part of a medicine take-back program. Patients should not try to dispose of the medication themselves. Flushing the pills down the toilet or placing them in with normal household waste can risk exposing large quantities of a powerful medication to other people and could potentially put them at risk of harm.

Summary

Lisinopril and hydrochlorothiazide are two different drugs used in a combined effort to reduce blood pressure in patients suffering from hypertension. They are often combined into a single pill in a common and effective treatment for high blood pressure. This treatment is usually given to patients who have first been treated with either one of these drugs, but where the individual drugs on their own have not been enough.

Lisinopril is a type of drug which works to decrease the chemicals in the body which constrict the blood vessels. Reducing the amounts of these chemicals in the body allows the blood vessels to open up and lets the blood flow easily around the body, ensuring that there is a steady supply of oxygen to the heart, brain and other organs. Increasing the size of the blood vessels directly reduces blood pressure.

Hydrochlorothiazide is a type of drug known as a diuretic. It allows the body to excrete more salt and increases the levels of urine production. Salt has been directly linked to high blood pressure levels, so letting salt leave the body is another way of helping to reduce blood pressure.

As with all drugs, there are some risks associated with taking Lisinopril and hydrochlorothiazide. Dizziness and lightheadedness are often experienced as side effects of taking these drugs. These side effects are more likely to be experienced by older patients, but they are still a risk for all patients who are treated with Lisinopril and hydrochlorothiazide.

There are a quite a few different pharmaceuticals which are known to cause interactions with Lisinopril and hydrochlorothiazide. All patients who are currently taking any other medications on a regular basis should check with their doctor and/or pharmacist to ensure that there are no risks of serious interactions occurring.