Zestoretic (20/12.5mg) 28 Tablets

Hydrochlorothiazide and Lisinopril are combined in this tablet to treat hypertension. Hydrochlorothiazide is a diuretic that inhibits the reabsorption of sodium and chloride ions in the distal convoluted tubule of the kidney, leading to increased water loss and reduced blood volume, which helps lower blood pressure. Lisinopril, on the other hand, is an angiotensin-converting enzyme (ACE) inhibitor. It blocks the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, thereby reducing blood pressure by promoting vasodilation and decreasing peripheral resistance. This dual mechanism of action effectively lowers blood pressure by targeting both fluid retention and the renin-angiotensin-aldosterone system.

Hydrochlorothiazide, Lisinopril

Thiazide diuretic, ACE inhibitor.

Tablet

The following are the uses of Hydrochlorothiazide, Lisinopril Tablet:

• Used for treating high blood pressure (hypertension) to lower blood pressure and reduce associated risks.
• Used for managing heart failure, helping to improve symptoms and slow disease progression.
• Used to enhance heart function after a heart attack, reducing the workload on the heart.
• Used to prevent kidney damage and improve kidney function in diabetic patients.
• Used for reducing fluid retention (edema) caused by various conditions.
• Used to treat diabetic kidney disease, slowing its advancement and preserving kidney function.
• Used for long-term management of hypertension and associated cardiovascular risks.

In the case of an overdose of Hydrochlorothiazide and Lisinopril Tablet, symptoms may include excessive urination, dehydration, dizziness, and hypotension. In more severe cases, it can lead to electrolyte imbalances, kidney dysfunction, and cardiovascular complications. Prompt medical intervention is necessary, including monitoring vital signs, intravenous fluid administration, and symptomatic treatment. It is crucial to seek emergency medical care immediately if an overdose is suspected.

In the case of a missed dose of Hydrochlorothiazide, it is generally recommended to take the missed dose as soon as you remember, unless it is almost time for your next scheduled dose. You can then resume your regular dosing schedule. For Lisinopril, if you miss a dose, take it as soon as you remember, but if it is close to the time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double the dose to make up for a missed one.

To take Hydrochlorothiazide, Lisinopril Tablet, swallow the tablet whole with a glass of water, preferably at the same time each day, as directed by your healthcare provider. It is recommended to take this medication in the morning to avoid potential sleep disturbances.

Following are the conditions or situations when Hydrochlorothiazide, Lisinopril Tablet should not be used:

• Must not be taken if you are allergic to any of the ingredients, including hydrochlorothiazide or lisinopril.
• Not suitable for individuals with a history of angioedema, a severe swelling reaction, caused by previous use of ACE inhibitors.
• Contraindicated in patients with hereditary angioedema.
• Should not be used during pregnancy, especially during the second and third trimesters, as it can cause harm to the fetus.
• Not recommended for individuals with severe renal impairment or kidney failure.
• Should be avoided if you have anuria, a condition where the kidneys cannot produce urine.
• Not suitable for patients with severe liver disease or impaired liver function.
• Discontinue use if you experience a severe decrease in blood pressure resulting in symptoms like dizziness or fainting.
• Contraindicated in patients undergoing dialysis due to possible severe reactions.

The side effects of Hydrochlorothiazide, Lisinopril Tablet may include:

• Dizziness
• Fatigue or weakness
• Headache
• Nausea and vomiting
• Diarrhea
• Skin rash or itching
• Muscle cramps
• Increased sensitivity to sunlight

Following are the precautions and warnings:

• Hydrochlorothiazide and Lisinopril Tablets should be used with caution in patients with impaired kidney function as both drugs are primarily eliminated by the kidneys. Regular monitoring of kidney function is necessary during treatment.
• This medication may cause dizziness and lightheadedness, especially when standing up from a sitting or lying position. Patients should rise slowly to prevent falls.
• Lisinopril can cause angioedema, a serious allergic reaction with swelling beneath the skin. Discontinue use and seek immediate medical attention if swelling of the face, lips, tongue, or throat occurs.
• Patients with a history of angioedema related to previous ACE inhibitor therapy are at increased risk and should not take this medication.
• Hydrochlorothiazide may lead to an increased level of cholesterol and triglycerides in the body, so lipid levels should be monitored periodically during therapy.
• Diabetic patients should be aware that Hydrochlorothiazide may increase blood sugar levels, and lisinopril may cause false low blood sugar readings. Close monitoring of blood glucose is necessary.
• This medication may cause electrolyte imbalances, including low potassium and sodium levels. Regular monitoring of electrolyte levels is recommended.
• Caution should be exercised when using this medication in pregnant or breastfeeding women as it may cause harm to the fetus or infant. Consult a healthcare professional for alternative treatments.

Following are the drug interactions for Hydrochlorothiazide, Lisinopril Tablet:

• May decrease the elimination of lithium (Eskalith) from the body, which could lead to more lithium in the body and potentially cause dangerous side effects.
• When taken with nonsteroidal anti-inflammatory drugs (NSAIDs), there's an increased risk of kidney function deterioration and a decrease in the blood pressure-lowering effects of Lisinopril.
• Can increase blood levels of lithium, potentially leading to lithium toxicity.
• Use with potassium-sparing diuretics may increase the risk of hyperkalemia (high potassium levels).
• May reduce the effectiveness of diabetes medications, including insulin, requiring close monitoring of blood sugar levels.
• The diuretic effect of Hydrochlorothiazide may be reduced by NSAIDs, potentially limiting its blood pressure-lowering effects.
• Hydrochlorothiazide can raise blood calcium levels, and this effect may be increased when used with calcium supplements or other drugs that increase calcium levels.
• Antacids containing aluminum or magnesium can decrease the absorption of Hydrochlorothiazide, reducing its effectiveness.

Following are the food interactions for Hydrochlorothiazide, Lisinopril Tablet:

• Avoid excessive salt intake, as the medication may reduce sodium levels, and high salt consumption can counteract its effects.
• Potassium-rich foods like bananas, oranges, and spinach are recommended, as Hydrochlorothiazide can cause potassium loss.
• Avoid alcohol consumption, as it may increase the risk of dizziness and affect blood pressure control.
• Grapefruit and grapefruit juice should be limited as they can increase Lisinopril levels in the blood, potentially causing an excessive drop in blood pressure.
• Maintain a balanced diet, as the medication may affect blood sugar levels, and regular meals can help stabilize them.
• Avoid potassium supplements without medical advice, as excessive potassium intake can be harmful when combined with the medication.
• Avoid high-fat meals, as they may decrease the absorption of Lisinopril, reducing its effectiveness.

Hydrochlorothiazide, Lisinopril Tablets should be stored in a secure and dry location, preferably in a medicine cabinet or a designated storage area, away from direct sunlight, moisture, and heat. It is crucial to keep the tablets in their original container, tightly sealed, to maintain their integrity and prevent exposure to environmental factors. Always check the expiration date on the packaging to ensure the medication's effectiveness and safety. When disposing of unused or expired tablets, avoid flushing them down the toilet or sink. Instead, follow local guidelines or consult your pharmacist for safe disposal methods to minimize environmental impact. Keep the medication out of children's reach to prevent accidental consumption, and ensure that it is stored in a secure location.

Following are the quick tips for Hydrochlorothiazide, Lisinopril Tablet:

• Always take the medication as directed by your doctor.
• Swallow the tablet whole with a glass of water, don't crush or chew.
• Maintain a consistent schedule for taking your doses.
• If you experience dizziness, lightheadedness, or weakness, change positions slowly and be cautious when standing up.
• Regular blood tests and kidney function monitoring may be required while on this medication.
• Inform your doctor about all medications and supplements you are taking.
• Store the medication in a cool, dry place, away from direct sunlight.