Lisinopril Hydrochlorothiazide, often abbreviated to Lisinopril/HCTZ is a generic combination medicine used for the treatment of high blood pressure (hypertension). Produced and marketed by Teva pharmaceutical company, Lisinopril Hydrochlorothiazide is based on a branded Zestoretic, a combination treatment consisting of two active ingredients – an ACE inhibitor lisinopril and a diuretic hydrochlorothiazide. It is commonly prescribed in those cases where single-agent medicines failed to produce the desired results.

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High blood pressure (hypertension): A short introduction

High blood pressure, also known as hypertension, is a medical condition estimate to affect roughly a quarter of all inhabitants of the United Kingdom. As such, it is a rather common condition that is, on the other hand, not that easy to notice as it can remain asymptomatic or produce non-specific and seemingly unrelated array of symptoms such as headaches, nosebleeds or tiredness. However, when left untreated, high blood pressure can lead to a number of far more serious complications and conditions such as atherosclerosis, angina, heart attack and stroke.

What causes hypertension?

As of now, there is no consensus when it comes to causes of high blood pressure. Despite this, several risk factors have been identified. Most importantly, the correlation between age and risk of developing hypertension has been highlighted by numerous studies. On the other hand, most experts agree that it is highly likely that genetic and hence hereditary factors play a prominent if not central role in the development of this condition.

Aside from this, there are different harmful lifestyle choices and habits that have been shown to act as risk factors. These include:

  • Excessive alcohol consumption
  • Excessive caffeine consumption
  • Being overweight
  • Lack of physical activity
  • Smoking
  • A diet rich in salts

When commencing treatment, the doctor will usually recommend taking certain steps in order to eliminate or at least improve these harmful practices. In milder cases, just lifestyle changes might be enough to bring blood pressure back to normal levels.

Lisinopril Hydrochlorothiazide as high blood pressure treatment

If lifestyle changes aren’t enough to make a significant change, your doctor will recommend using prescription treatment. Lisinopril Hydrochlorothiazide is a combined treatment, meaning it relies on two distinct active ingredients in order to produce the desired effects. Lisinopril is classified as an ACE inhibitor that works by inhibiting the activity of ACE enzyme and subsequent transformation of angiotensin into angiotensin II which is facilitated by ACE. This compound plays a crucial role in narrowing and tightening of the blood vessels. Without it, the smooth muscle tissue lining the blood vessels will be relaxed, thus contributing to the normalisation of the blood pressure.

Hydrochlorothiazide, the other active ingredient of this medicine, works by increasing the amount of salts the kidneys extract from the blood and later excrete through urine. With this mechanism of action hydrochlorothiazide will also reduce the amount of water in the blood, thus helping lower the pressure even further.

How is Lisinopril Hydrochlorothiazide used?

Before commencing the treatment, it is very important to ensure you completely understand the directions provided by your prescriber, as well as guidelines that you can find in the official patient information leaflet that is issued within every pack of the medicine. By strictly adhering to these instructions, you will increase your chances of success while at the same time minimising the risk of side effects.

Here we will provide you with just some of the most general guidelines and considerations so you can get the idea of how Lisinopril Hydrochlorothiazide treatment will look like.

  • Always use exactly as prescribed
  • Most of users will take a single dose every day with the exact amount being determined by your doctor and possibly changed over the course of the treatment
  • Maximum daily dose is 40mg of lisinopril and 25mg of hydrochlorothiazide
  • During the treatment, you will have to monitor your blood pressure regularly
  • Take tablets whole with water
  • Never exceed the prescribed amount
  • If you miss a dose, take it when you remember, provided that the next one is not due – if it is, just skip the missed dose and continue with the treatment as usual
  • Never take a double dose to make up for the missed one

Are there any Lisinopril Hydrochlorothiazide side effects?

While not everyone using this medicine will experience side effects, it is still important to get familiar with them so you can react quickly and call your doctor or emergency services if they do manifest. One of the situations where immediate medical attention might be necessary is an allergic reaction to the medicine. This adverse effect is easily recognised due to its characteristic signs including hives and swelling of the face, lips and neck. Other situations that might necessitate medical attention include:

  • Pancreatitis
  • Heart attack
  • Stroke
  • Stevens-Johnson syndrome
  • Toxic epidermal necrolysis
  • Hepatitis
  • Persistent dry cough
  • Muscle pain or cramps
  • Increased heart rate
  • Low white cell count

When we take into account the frequency of occurrence of different side effects, we can list them in the following manner:

Frequency of occurrence Side effects
Common (1 in 10 users) Headache, tiredness, lethargy, feeling or being sick, kidney problems, diarrhoea
Uncommon (1 in 100 users) Weakness, vertigo, altered sensation of taste, dryness of the mouth, indigestion, rash, chest pain, palpitations, poor circulation, muscle spasms, impotence, mood swings, insomnia
Rare (1 in 1000 users) Muscle and joint pain, fever, pain and inflammation of the blood vessels, sensitivity to light, anaemia, psoriasis, male breast enlargement, confusion, hair loss, kidney failure
Very rare (1 in 10.000 users) Decrease in blood platelets, swollen lymph nodes, increased immune response, breathing difficulties, sinusitis, inflammation of the lungs, skin problems, decrease in blood sugar

 

Keep in mind that this is not a full list of all documented side effects. For a more comprehensive overview, please refer to the official patient information leaflet.

Lisinopril Hydrochlorothiazide contraindications

There are also several scenarios when the use of Lisinopril Hydrochlorothiazide might be contraindicated. This may be the case if you are currently taking any of the following medicines:

  • Diuretics
  • Non-steroidal anti-inflammatory drugs (including aspirin and ibuprofen)
  • Sympathomimetics
  • Diabetes treatments
  • Immunosuppressants
  • Tricyclic antidepressants
  • Corticosteroids
  • Laxatives
  • Calcium supplements
  • Cardiac glycosides
  • Cholesterol reducing drugs
  • Potassium supplements
  • Lithium
  • Trimethoprim

Alternatively, the doctor might advise against using Lisinopril Hydrochlorothiazide if you are affected or have recently been affected by:

  • Severe liver dysfunction
  • Kidney diseases
  • Angioedema
  • Diabetes
  • Imbalance of blood salts
  • Heart valve disease
  • Enlarged heart
  • Asthma
  • Systemic lupus erythematosus

Finally, this medicine should never be used by women who are pregnant, are trying to conceive or are currently breastfeeding.