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Lisinopril/hydrochlorothiazide Generic Name & Formulations
Legal Class
Rx
General Description
Lisinopril, hydrochlorothiazide; 10mg/12.5mg, 20mg/12.5mg, 20mg/25mg; tabs.
Pharmacological Class
ACE inhibitor + diuretic.
How Supplied
Contact supplier
Manufacturer
Mechanism of Action
Lisinopril inhibits angiotensin-converting enzyme. It suppresses the renin-angiotensin-aldosterone system. The mechanism of the antihypertensive effect of thiazides is unknown.
Lisinopril/hydrochlorothiazide Indications
Indications
Hypertension.
Lisinopril/hydrochlorothiazide Dosage and Administration
Adult
Switching from monotherapy with either component: initially 10/12.5 or 20/12.5 once daily, then adjust. Allow 2–3 weeks for titration of HCTZ component. If on diuretic: if possible, suspend diuretic for 2–3 days, then adjust. Or, substitute for individually titrated components. CrCl <30mL/min: not recommended.
Children
Not established.
Nursing Considerations
To minimize dose-independent side effects, it is usually appropriate to begin combination therapy only after a patient has failed to achieve the desired effect with monotherapy.
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
Elimination
Renal.
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
