Lisinopril/hydrochlorothiazide

— THERAPEUTIC CATEGORIES —
  • Hypertension

Lisinopril/hydrochlorothiazide Generic Name & Formulations

General Description

Lisinopril, hydrochlorothiazide; 10mg/12.5mg, 20mg/12.5mg+; tabs; +scored.

Pharmacological Class

ACE inhibitor + diuretic.

How Supplied

Contact supplier

Lisinopril/hydrochlorothiazide Indications

Indications

Hypertension.

Lisinopril/hydrochlorothiazide Dosage and Administration

Adult

Not for initial therapy. Initially 10mg/12.5mg or 20mg/12.5mg. Wait 2–3 weeks before increasing HCTZ dose. Max 80mg/50mg daily. CrCl <30mL/min: not recommended.

Children

Not recommended.

Lisinopril/hydrochlorothiazide Contraindications

Contraindications

History of ACEI-associated or other angioedema. Anuria. Sulfonamide hypersensitivity. Concomitant aliskiren in patients with diabetes. Concomitant neprilysin inhibitor (eg, sacubitril); do not give within 36hrs of switching to or from sacubitril/valsartan.

Lisinopril/hydrochlorothiazide Boxed Warnings

Boxed Warning

Fetal toxicity.

Lisinopril/hydrochlorothiazide Warnings/Precautions

Warnings/Precautions

Fetal toxicity may develop; discontinue if pregnancy is detected. Severe CHF. Ischemic heart disease. Cerebrovascular disease. Arrhythmias. Salt/volume depletion. Postsympathectomy. Renal or hepatic impairment. Dialysis (esp. high-flux membrane). Gout. Asthma. SLE. Acute myopia. Secondary angle-closure glaucoma. Renal or aortic stenosis. Hypertrophic cardiomyopathy. Surgery. Monitor renal function and serum potassium in diabetics, serum electrolytes. Monitor WBCs in renal and collagen vascular disease. Discontinue if angioedema, laryngeal edema, marked elevations of liver enzymes, or jaundice occurs. Black patients may have higher risk of angioedema than non-black patients. Elderly. Neonates. Pregnancy. Nursing mothers: not recommended.

Lisinopril/hydrochlorothiazide Pharmacokinetics

See Literature

Lisinopril/hydrochlorothiazide Interactions

Interactions

See Contraindications. Increased risk of angioedema with concomitant neprilysin inhibitor or mTOR inhibitor (eg, temsirolimus, sirolimus, everolimus). Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Concomitant aliskiren in renal impairment (CrCl <60mL/min): not recommended. May cause hypotension or increased BUN with diuretics. Antagonized by, and increased risk of renal failure with, NSAIDs including selective COX-2 inhibitors; monitor. May increase lithium levels (not recommended); monitor frequently. Nitritoid reactions with concomitant injectable gold (sodium autothiomalate); rare. Dosage adjustment of antidiabetics (oral agents, insulin) may be required. Impaired absorption with cholestyramine, colestipol resins. May antagonize pressor amines (eg, norepinepherine). Potentiates tubocurarine. Hyperkalemia with K+-sparing diuretics, K+ supplements and K+-containing salt substitutes. Hypokalemia with ACTH, corticosteroids. Orthostatic hypotension may be increased by alcohol, CNS depressants. May interfere with parathyroid tests.

Lisinopril/hydrochlorothiazide Adverse Reactions

Adverse Reactions

Dizziness, headache, cough, fatigue, orthostatic hypotension, diarrhea, vomiting, dyspepsia, upper respiratory infection, muscle cramps, asthenia, paresthesia, rash, impotence, electrolyte disturbances (hypokalemia, hyperkalemia, hyponatremia), hyperuricemia.

Lisinopril/hydrochlorothiazide Clinical Trials

See Literature

Lisinopril/hydrochlorothiazide Note

Notes

Formerly known under the brand name Prinzide.

Lisinopril/hydrochlorothiazide Patient Counseling

See Literature