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Ensuring Safe Treatment With Lisinopril-Hydrochlorothiazide

Some Lisinopril-Hydrochlorothiazide Warnings and Precautions

Some lisinopril-hydrochlorothiazide precautions and warnings to be aware of include the following:
  • There are a number of medicines with which lisinopril-hydrochlorothiazide may interact (see Drug Interactions With Lisinopril-Hydrochlorothiazide).
  • Lisinopril-hydrochlorothiazide is more likely than other drugs to cause allergic reactions. For example, there have been reports of severe allergic reactions occurring in people taking lisinopril-hydrochlorothiazide during dialysis. There have also been reports of severe reactions in people getting bee or wasp venom to protect against stings. Finally, people with a history of asthma or allergies are more likely to have an allergic reaction to lisinopril-hydrochlorothiazide. Make sure to discuss these risks with your healthcare provider. Also, seek emergency medical attention immediately if you notice things such as hives, an unexplained rash, difficulty breathing, or swelling of the face or throat.
  • Medicines like lisinopril-hydrochlorothiazide that contain an ACE inhibitor may cause swelling (angioedema) of the head and neck, including the tongue, lips, eyes, or throat. This occurs more frequently in African Americans than in Caucasians. Seek emergency medical care immediately if you notice swelling in the head or neck area, experience wheezing, or have difficulty breathing or swallowing.
  • In addition to head and neck angioedema, medicines like lisinopril-hydrochlorothiazide have also been known to cause swelling in the intestines. This is known as intestinal angioedema. Symptoms may include, but are not limited to, stomach pain with or without vomiting. Seek medical attention immediately if you develop any of these symptoms.
  • Lisinopril-hydrochlorothiazide may cause extreme low blood pressure in some people. Extreme low blood pressure is more likely to occur when you first start taking the medicine or if your healthcare provider changes your dosage. It is also more likely to happen in people who are taking a diuretic, who are on dialysis, who have congestive heart failure, who have diarrhea or vomiting, or who sweat a lot. This is why it is important to drink fluids regularly while taking lisinopril-hydrochlorothiazide. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, contact your healthcare provider. If you have fainted, stop taking lisinopril-hydrochlorothiazide until you have talked to your healthcare provider. Also, make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how lisinopril-hydrochlorothiazide affects you.


  • Drugs that contain hydrochlorothiazide, including this medication, can sometimes cause a potentially dangerous eye reaction (a particularly dangerous type of glaucoma). This reaction usually occurs within days to weeks of starting the drug. Because this reaction can permanently damage vision, let your healthcare provider know right away if you develop vision changes and/or eye pain. The main treatment for this reaction is to stop taking this medication, although other treatment, including surgery, may sometimes be necessary. 
  • People on lisinopril-hydrochlorothiazide can be at increased risk of infections. Talk to your healthcare provider if you develop any infections, such as a sore throat or fever.
  • Lisinopril-hydrochlorothiazide is a pregnancy Category D medication, meaning that it poses health risks to your unborn child. Let your healthcare provider know if you are pregnant or thinking of becoming pregnant. If you become pregnant while taking lisinopril-hydrochlorothiazide, contact your healthcare provider immediately (see Prinzide and Pregnancy for more information).
  • Medicines like lisinopril-hydrochlorothiazide that contain an ACE inhibitor are known to cause a cough. If a cough becomes bothersome, talk to your healthcare provider about alternate medication options for your condition (see Lisinopril Cough).
  • While taking lisinopril-hydrochlorothiazide, do not use potassium supplements or salt substitutes with potassium unless you have discussed this with your doctor. Taking lisinopril-hydrochlorothiazide can cause potassium in the blood can increase or decrease to dangerous levels in some people.
  • This medication may cause a decrease in kidney function, especially in people who are elderly, have kidney disease, have severe congestive heart failure (CHF), or are taking nonsteroidal anti-inflammatory drugs (NSAIDs) or diuretics (water pills). Your healthcare provider may choose to monitor your kidney function with a blood test while you are taking it. Contact your healthcare provider if you notice a decrease in urination or swelling in your hands, legs, ankles, or feet, which can be signs of kidney problems.


  • In clinical studies, medicines that contain an ACE inhibitor, including lisinopril-hydrochlorothiazide, have rarely been known to cause liver failure. Contact your healthcare provider immediately if you notice things such as nausea, tiredness, lethargy, itchy or yellowing skin, abdominal pain (or stomach pain), or flu-like symptoms.
  • If you have moderate to severe liver disease (such as cirrhosis), your body may metabolize the lisinopril-hydrochlorothiazide differently than intended. Therefore, your healthcare provider may start you on a lower dose of lisinopril-hydrochlorothiazide and monitor your situation more closely or recommend another blood pressure medicine.
  • Lisinopril-hydrochlorothiazide may affect electrolytes in the blood (including sodium, potassium, magnesium, and chloride). Therefore, your healthcare provider will most likely check these levels regularly. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider. These symptoms may include a dry mouth, increased thirst, weakness, tiredness, restlessness, seizures, confusion, muscle pain or cramps, decrease in urine output, weak or irregular heartbeat, nausea, or vomiting.
  • Because of the hydrochlorothiazide, lisinopril-hydrochlorothiazide is more likely to worsen systemic lupus erythematosus or, in some cases, even cause the condition.
  • Because of the hydrochlorothiazide, lisinopril-hydrochlorothiazide is also known to worsen gout.
  • Lisinopril-hydrochlorothiazide may cause high blood sugar (hyperglycemia) in people with diabetes or, in some cases, even cause diabetes in people without a history of the condition.
  • Lisinopril-hydrochlorothiazide may increase levels of cholesterol and triglycerides in the blood.
  • Certain parts of lisinopril-hydrochlorothiazide pass through breast milk. Therefore, if you are nursing, talk with your healthcare provider about whether you should stop taking lisinopril-hydrochlorothiazide or discontinue breastfeeding.
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