What is hydrochlorothiazide and lisinopril?

Hydrochlorothiazide is a thiazide diuretic (water pill). Lisinopril is in an ACE inhibitor (ACE stands for angiotensin converting enzyme).

Hydrochlorothiazide and lisinopril is a combination medicine used to treat hypertension (high blood pressure). Lowering blood pressure may lower your risk of a stroke or heart attack.

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

Hydrochlorothiazide and lisinopril side effects

Get emergency medical help if you have signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat. You may be more likely to have an allergic reaction if you are African-American.

Hydrochlorothiazide and lisinopril may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• eye pain, vision problems;
• little or no urination;
• weakness, drowsiness, or feeling restless;
• fever, chills, sore throat, mouth sores, trouble swallowing;
• jaundice (yellowing of the skin or eyes);
• high potassium–nausea, tingly feeling, chest pain, irregular heartbeats, loss of movement;
• low potassium–leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling; or
• low sodium–headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.

Common side effects of hydrochlorothiazide and lisinopril may include:

• cough;
• headache;
• dizziness; or
• tired feeling.

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

Warnings

Do not use if you are pregnant. If you become pregnant, stop taking hydrochlorothiazide and lisinopril and tell your doctor right away.

You should not use this medicine if you have ever had angioedema, if you are unable to urinate, or if you are allergic to sulfa drugs or to any ACE inhibitor. Do not take hydrochlorothiazide and lisinopril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use hydrochlorothiazide and lisinopril together with any medication that contains aliskiren (a blood pressure medicine).

Before taking this medicine

You should not use this medicine if you are allergic to hydrochlorothiazide or lisinopril, or if:

• you have hereditary angioedema;
• you are unable to urinate;
• you recently took a heart medicine called sacubitril;
• you have an allergy to sulfa drugs; or
• you have ever had a severe allergic reaction to any ACE inhibitor (benazepril, captopril, enalapril, fosinopril, moexipril, perindopril, quinapril, ramipril, trandolapril).

Do not take hydrochlorothiazide and lisinopril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use hydrochlorothiazide and lisinopril together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking hydrochlorothiazide and lisinopril with aliskiren if you have kidney disease.

Tell your doctor if you have ever had:

• kidney disease (or if you are on dialysis);
• cirrhosis or other liver disease;
• glaucoma;
• heart disease or congestive heart failure;
• asthma or allergies;
• gout;
• lupus;
• an allergy to sulfa drugs or penicillin; or
• if you are on a low-salt diet.

Do not use if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant. Lisinopril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

You should not breastfeed while using hydrochlorothiazide and lisinopril.

Hydrochlorothiazide and lisinopril is not approved for use by anyone younger than 18 years old.

How should I take hydrochlorothiazide and lisinopril?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking hydrochlorothiazide and lisinopril. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

Your blood pressure will need to be checked often, and you may need occasional blood tests.

If you need surgery, tell your surgeon you currently use this medicine.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

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

Hydrochlorothiazide and lisinopril dosing information

Usual Adult Dose for Hypertension:

Initial dose: Hydrochlorothiazide 12.5 mg-Lisinopril 10 to 20 mg orally once a day, depending on the current monotherapy dose

Maximum dose: Hydrochlorothiazide 50 mg-Lisinopril 80 mg per day

Comments:
-May increase dose every 2 to 3 weeks.
-If blood pressure is controlled with monotherapy hydrochlorothiazide 25 mg per day, but significant potassium loss occurs, then similar or greater blood pressure control without electrolyte disturbance may be achieved with hydrochlorothiazide 12.5 mg-lisinopril 10 mg orally once a day.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking hydrochlorothiazide and lisinopril?

Hydrochlorothiazide may increase your risk of skin cancer. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Your doctor may want you to have skin examinations on a regular basis.

Drinking alcohol can further lower your blood pressure and may increase certain side effects of hydrochlorothiazide and lisinopril.

Do not use potassium supplements or salt substitutes while you are taking this medicine, unless your doctor has told you to.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. 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.

What other drugs will affect hydrochlorothiazide and lisinopril?

Tell your doctor about all your other medicines, especially:

• any other blood pressure medication;
• lithium;
• everolimus, sirolimus, temsirolimus; or
• NSAIDs (nonsteroidal anti-inflammatory drugs)–aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

What is hydrochlorothiazide and losartan?

Hydrochlorothiazide is a diuretic (water pill). Losartan is an angiotensin II receptor antagonist (sometimes called an ARB blocker).

Hydrochlorothiazide and losartan is a combination medicine used to treat high blood pressure (hypertension). It is also used to lower the risk of stroke in certain people with heart disease.

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

Hydrochlorothiazide and losartan side effects

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

Hydrochlorothiazide and losartan may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• irregular heartbeats;
• eye pain, vision problems;
• kidney problems–little or no urination, rapid weight gain, swelling in your hands, feet, or ankles;
• new or worsening symptoms of lupus–joint pain, and a skin rash on your cheeks or arms that worsens in sunlight; or
• signs of an electrolyte imbalance–increased thirst or urination, confusion, vomiting, constipation, muscle pain, leg cramps, irregular heartbeats, numbness or tingling, severe weakness, loss of movement, feeling jittery or unsteady.

Common side effects of hydrochlorothiazide and losartan may include:

• dizziness;
• back pain; or
• cold symptoms such as stuffy nose, sneezing, sore throat.

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

Warnings

You should not use hydrochlorothiazide and losartan if you are unable to urinate.

Do not use if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant.

If you have diabetes, do not use hydrochlorothiazide and losartan together with any medication that contains aliskiren (a blood pressure medicine).

Before taking this medicine

You should not use this medicine if you are allergic to hydrochlorothiazide or losartan, if you are unable to urinate.

If you have diabetes, do not use hydrochlorothiazide and losartan together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking hydrochlorothiazide and losartan with aliskiren if you have kidney disease.

Tell your doctor if you have ever had:

• lupus;
• liver or kidney disease;
• asthma or allergies;
• diabetes;
• gout;
• congestive heart failure;
• glaucoma;
• low or high levels of potassium in your blood;
• high cholesterol or triglyceride levels; or
• an allergy to penicillin or sulfa drugs.

Do not use if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant. Hydrochlorothiazide and losartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

You should not breastfeed while using this medicine.

Hydrochlorothiazide and losartan is not approved for use by anyone younger than 18 years old.

How should I take hydrochlorothiazide and losartan?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Your blood pressure will need to be checked often.

Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking hydrochlorothiazide and losartan. This can lead to very low blood pressure, a serious electrolyte imbalance, or kidney failure.

If you need surgery or medical tests, tell the surgeon ahead of time that you are using hydrochlorothiazide and losartan.

If you have high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

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

Hydrochlorothiazide and losartan dosing information

Usual Adult Dose for Hypertension:

HYPERTENSION:
Hydrochlorothiazide 12.5 to 25 mg-Losartan 50 to 100 mg orally once a day

Maximum dose: Hydrochlorothiazide 25 mg-Losartan 100 mg orally once a day

Comments:
-A patient whose blood pressure is not adequately controlled with hydrochlorothiazide or losartan monotherapy may be switched to hydrochlorothiazide 12.5 mg-losartan 50 mg orally once a day.
-May increase dose if blood pressure remains uncontrolled after about 3 weeks.

Use: Treatment of hypertension. This drug is not indicated for initial therapy except when hypertension is severe enough that the benefit of achieving prompt blood pressure control exceeds the risk of initiating combination therapy.

SEVERE HYPERTENSION:
Initial treatment: Hydrochlorothiazide 12.5 mg-Losartan 50 mg orally once a day; if blood pressure remains uncontrolled after 2 to 4 weeks, may initiate maximum dose.

Maximum dose: Hydrochlorothiazide 25 mg-Losartan 100 mg orally once a day

HYPERTENSION WITH LEFT VENTRICULAR HYPERTROPHY:
Initial therapy: Losartan monotherapy; if blood pressure remains uncontrolled, may initiate this drug.

Add-on therapy: Hydrochlorothiazide 12.5 mg-Losartan 50 mg orally once a day; if blood pressure remains uncontrolled, initiate hydrochlorothiazide 12.5 mg-losartan 100 mg orally once a day, followed by hydrochlorothiazide 25 mg-losartan 100 mg orally once a day, if needed.

Use: To reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy, but there is evidence that this benefit does not apply to Black patients.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking hydrochlorothiazide and losartan?

Hydrochlorothiazide may increase your risk of skin cancer. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Your doctor may want you to have skin examinations on a regular basis.

Do not use potassium supplements or salt substitutes, unless your doctor has told you to.

Drinking alcohol can further lower your blood pressure and may cause side effects.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids.

What other drugs will affect hydrochlorothiazide and losartan?

If you also take cholestyramine or colestipol, take your hydrochlorothiazide and losartan dose 4 hours before or 4 to 6 hours after you take the other medicine.

Tell your doctor about all your other medicines, especially:

• a diuretic or “water pill”;
• other blood pressure medications;
• lithium; or
• NSAIDs (nonsteroidal anti-inflammatory drugs)–aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

What is hydrochlorothiazide and telmisartan?

Hydrochlorothiazide is a diuretic (water pill). Telmisartan is an angiotensin II receptor blocker (sometimes called an ARB blocker).

Hydrochlorothiazide and telmisartan is a combination medicine is used to treat high blood pressure (hypertension). Lowering blood pressure may lower your risk of a stroke or heart attack.

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

Hydrochlorothiazide and telmisartan side effects

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

In rare cases, hydrochlorothiazide and telmisartan can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, or dark colored urine.

Also call your doctor at once if you have:

• eye pain, vision problems;
• a light-headed feeling, like you might pass out;
• jaundice (yellowing of the skin or eyes);
• swelling in your hands or feet, unusual weight gain;
• easy bruising, unusual bleeding; or
• signs of an electrolyte imbalance–dry mouth, increased thirst, drowsiness, confusion, feeling restless, vomiting, muscle pain or weakness, lack of energy, fast heartbeats, little or no urine, or a seizure.

Common side effects of hydrochlorothiazide and telmisartan may include:

• dizziness, feeling tired;
• nausea, diarrhea;
• back pain; or
• cold or flu symptoms.

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

Warnings

Do not use if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant.

You should not use this medicine if you are unable to urinate.

If you have diabetes, do not use hydrochlorothiazide and telmisartan together with any medication that contains aliskiren (a blood pressure medicine).

Before taking this medicine

You should not use hydrochlorothiazide and telmisartan if you are allergic to hydrochlorothiazide or telmisartan, if you are unable to urinate.

If you have diabetes, do not use hydrochlorothiazide and telmisartan together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking hydrochlorothiazide and telmisartan with aliskiren if you have kidney disease.

Tell your doctor if you have ever had:

• kidney disease;
• liver disease;
• glaucoma;
• low or high levels of magnesium or potassium in your blood;
• asthma or allergies;
• lupus;
• diabetes; or
• an allergy to penicillin or sulfa drugs.

Do not use if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant. Hydrochlorothiazide and telmisartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

You should not breastfeed while using this medicine.

How should I take hydrochlorothiazide and telmisartan?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take this medicine with or without food.

Your blood pressure will need to be checked often.

Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking hydrochlorothiazide and telmisartan. This can lead to very low blood pressure, a serious electrolyte imbalance, or kidney failure.

If you need surgery or medical tests, tell the surgeon ahead of time that you are using this medicine.

It may take up to 4 weeks for this medication to control your blood pressure. Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Store at room temperature away from moisture and heat. Keep each tablet in its blister pack until you are ready to take it. Gently push the tablet through the foil to remove it.

Hydrochlorothiazide and telmisartan dosing information

Usual Adult Dose for Hypertension:

Hydrochlorothiazide 12.5 to 25 mg-Telmisartan 80 mg orally once a day

Maximum dose: Hydrochlorothiazide 25 mg-Telmisartan 160 mg orally once a day

Comments:
-This drug may be substituted for the individual titrated components.
-If blood pressure remains uncontrolled by hydrochlorothiazide 25 mg orally once a day monotherapy, may switch to hydrochlorothiazide 12.5 to 25 mg-telmisartan 80 mg orally once a day. Reassess after 2 to 4 weeks; may increase up to hydrochlorothiazide 25 mg-telmisartan 160 mg orally once a day.
-If blood pressure is controlled by hydrochlorothiazide 25 mg orally once a day monotherapy, but hypokalemia occurs, may switch to hydrochlorothiazide 12.5 mg-telmisartan 80 mg orally once a day.
-If blood pressure remains uncontrolled by telmisartan 80 mg orally once a day monotherapy, may switch to hydrochlorothiazide 12.5 mg-telmisartan 80 mg orally once a day; may titrate up to hydrochlorothiazide 25 mg-telmisartan 160 mg orally once a day, if necessary.

Use: Treatment of hypertension; not indicated for initial therapy.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

Overdose symptoms may include fast or slow heart rate, feeling light-headed, or fainting.

What should I avoid while taking hydrochlorothiazide and telmisartan?

Hydrochlorothiazide may increase your risk of skin cancer. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Your doctor may want you to have skin examinations on a regular basis.

Do not use potassium supplements or salt substitutes, unless your doctor has told you to.

Drinking alcohol can further lower your blood pressure and may cause side effects.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids.

What other drugs will affect hydrochlorothiazide and telmisartan?

If you also take cholestyramine or colestipol, avoid taking these medications within 4 hours before or 4 hours after you take hydrochlorothiazide and telmisartan.

Tell your doctor about all your other medicines, especially:

• any other heart or blood pressure medications;
• digoxin;
• lithium;
• a diuretic or “water pill”;
• insulin or oral diabetes medicine;
• opioid pain medicine;
• a sleeping pill;
• steroid medicine or adrenocorticotrophic hormone (ACTH);
• a barbiturate such as butabarbital, phenobarbital, or secobarbital; or
• NSAIDs (nonsteroidal anti-inflammatory drugs)–aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.