This drug can cause serious (possibly fatal) harm to an unborn baby if used during pregnancy. Therefore, it is important to prevent pregnancy while taking this medication. Consult your doctor for more details and to discuss the use of reliable forms of birth control while taking this medication. If you are planning pregnancy, become pregnant, or think you may be pregnant, contact your doctor immediately.

This medication is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This product contains 2 medications, lisinopril and hydrochlorothiazide. Lisinopril is called an ACE inhibitor and works by relaxing blood vessels so that blood can flow through the body more easily. Hydrochlorothiazide is called a "water pill" (diuretic) and causes your body to get rid of extra salt and water. This effect may increase the amount of urine you make when you first start the medication. It also helps to relax the blood vessels so that blood can flow through the body more easily.

These medications are used together when 1 drug is not controlling your blood pressure. Your doctor may direct you to start taking the individual medications first, and then switch you over to this combination product if this is the best dose combination for you. Do not continue taking the individual medications (lisinopril and/or hydrochlorothiazide) after you start this medication.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication may also be used to treat congestive heart failure and to help protect the kidneys from damage due to diabetes.

Take this medication by mouth with or without food, usually once daily or as directed by your doctor. If this medication causes you to urinate more frequently, then it is best to take this medication in the morning or during the day (at least 4 hours before your bedtime) to avoid having to get up during the night to urinate. Consult your doctor or pharmacist if you have questions about your dosing schedule.

The dosage is based on your medical condition and response to treatment.

Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day. Also, keep your doses in a special pill box with 1 space marked for each day of the week. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

For the treatment of high blood pressure, it may take 2 to 4 weeks before the full benefit of this drug occurs. It may take several weeks or months to see the full benefit when this drug is used for heart failure.

Tell your doctor if your condition worsens (e.g., your routine blood pressure readings increase).

Dizziness, lightheadedness, tiredness, or headache may occur as your body adjusts to the medication. Dry cough may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: extreme thirst, very dry mouth, muscle cramps/weakness, swelling of the hands/feet, fast/slow/irregular heartbeat, fainting, muscle/joint aches, tingling/numbness of the hands/feet.

Tell your doctor immediately if any of these rare but very serious side effects occur: signs of infection (e.g., fever, chills, persistent sore throat), yellowing eyes/skin, dark urine, severe stomach/abdominal pain, persistent tiredness, persistent nausea/vomiting, easy bruising/bleeding, unusual change in the amount of urine (not including the normal increase in urine when you first start this drug), seizures.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking this product, tell your doctor or pharmacist if you are allergic to either lisinopril or hydrochlorothiazide; or to other ACE inhibitors (e.g., captopril, benazepril); or to other thiazides (e.g., chlorothiazide); or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: history of an allergic reaction that included swelling of the face/lips/tongue/throat (angioedema), an inability to make urine (anuria).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease (e.g., renal artery stenosis), liver disease, blood exchange procedures (e.g., apheresis, dialysis), high cholesterol/triglycerides, loss of too much body water (dehydration), untreated mineral imbalance (e.g., high calcium, high/low potassium, low magnesium), gout, collagen vascular disease (e.g., lupus, scleroderma).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Before having surgery, tell your doctor or dentist that you are taking this medication.

Drink plenty of fluids while taking this medication to help prevent dizziness unless directed otherwise by your doctor. Too much sweating, diarrhea, or vomiting may cause you to feel lightheaded. Report prolonged diarrhea or vomiting to your doctor.

This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors.

This product may increase or decrease your potassium levels. Before using potassium supplements or salt substitutes containing potassium, consult your doctor or pharmacist.

If you have diabetes, this product may change your blood sugar levels. Check your blood glucose levels regularly as directed by your doctor. Tell your doctor immediately if you have symptoms of high blood sugar such as increased thirst and urination, or signs of low blood sugar such as nervousness, hunger, and shaking. Your anti-diabetic medication or diet may need to be adjusted.

Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, elderly people may be at greater risk for dizziness while using this drug.

This medication is not recommended for use during pregnancy due to the risk for harm to an unborn baby. Consult your doctor for more details. (See also Warning section.)

Hydrochlorothiazide passes into breast milk and may have undesirable effects on a nursing infant. Breast-feeding while using this medication is not recommended. Consult your doctor before breast-feeding.

See also Precautions section.

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medication because very serious interactions may occur: dofetilide.

If you are currently using the medication listed above, tell your doctor or pharmacist before starting this product.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially: alpha blockers (e.g., prazosin, terazosin), aspirin, cisapride, diazoxide, drugs that may affect the bone marrow (e.g., azathioprine, trimethoprim-containing products), drugs that can increase dizziness (e.g., narcotic pain relievers such as morphine, barbiturates such as phenobarbital), drugs that may decrease your potassium level (e.g., amphotericin B, corticotropin, corticosteroids including prednisone), drugs that may increase your potassium level (e.g., potassium-sparing diuretics such as spironolactone, potassium supplements, salt substitutes), drugs whose removal from the body is affected by the acid level of urine (e.g., amphetamine, methenamine, quinidine), lithium, nonsteroidal anti-inflammatory drugs-NSAIDs (e.g., celecoxib, ibuprofen, indomethacin), probenecid, gold injections.

A very serious reaction may occur if you are getting injections for bee/wasp sting allergy (desensitization) and are also taking lisinopril/hydrochlorothiazide. Make sure all your doctors know which medicines you are using.

If taken together with this drug, cholestyramine and colestipol can decrease the amount of this medication that is absorbed by your body. If you are taking either of these drugs, separate them from this medication by at least 4 hours.

Check the labels on all your medicines (e.g., cough-and-cold products, diet aids, nonsteroidal anti-inflammatory drugs-NSAIDs for pain/fever reduction) because they may contain ingredients that could increase your blood pressure (e.g., decongestants such as pseudoephedrine, phenylephrine) or reduce the effect of this medication (e.g., ibuprofen, naproxen). Ask your pharmacist about using these products safely.

Some nonprescription medicines may also contain aspirin, which may decrease the effect of the lisinopril in this product. Low-dose aspirin should be continued if prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually at dosages of 81-325 milligrams per day). Consult your doctor or pharmacist for more details.

This product can affect the results of certain lab tests (e.g., parathyroid, protein-bound iodide, tyramine and phentolamine tests). Make sure laboratory personnel and all your doctors know you use this drug.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, fainting.

Do not share this medication with others.

Lifestyle changes such as stress reduction programs, exercise, and dietary changes may help this medicine work better. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

Laboratory and/or medical tests (e.g., kidney/liver function, blood potassium level) should be performed from time to time to monitor your progress or check for side effects. Consult your doctor for more details.

Check your blood pressure regularly while taking this medication, especially when you first start this drug or when your dose is changed. Learn how to monitor your own blood pressure at home, and share the results with your doctor.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).

Information last revised July 2009 Copyright(c) 2009 First DataBank, Inc.