Lisinopril and Hydrochlorothiazide

ACE Inhibitor · ACE inhibitor/Thiazide diuretic

Indications

Mild to moderate hypertension in patients stabilized when the individual components given in the same proportions.

Dosage

Adults: Initial (if not controlled with lisinopril/ hydrochlorothiazide monotherapy): 10/12.5 mg tab or 20/12.5 mg tab daily. Titrate: May increase after 2-3 wk. Max, 80/50 mg daily. Children: Not recommended.

Adverse Effects

Dizziness, headache, cough, fatigue, hypotension, angioneurotic oedema, nausea, impotence, diarrhoea, syncope, GI upset, renal impairment, gout, pancreatitis, palpitations, chest discomfort, muscle cramps/weakness, paraesthesia, asthaenia, blood dyscrasias, increased cholesterol and triglycerides.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Caution advised or effect undetermined. Contraindications: Anuria, angioneurotic oedema related to previous ACE inhibitor therapy, hereditary or idiopathic angioedema, hyperkalaemia, severe hepatic or renal impairment, renal transplant, sulfonamide hypersensitivity. Precautions: Fluid or electrolyte imbalance, ischaemic heart or cerebrovascular disease, haemodialysis, renal or hepatic impairment, gout/hyperuricaemia, diabetes, surgery anaesthesia, aortic or mitral valve stenosis, hypertrophic cardiomyopathy, renal artery stenosis, collagen vascular disease, apheresis. Monitor serum electrolytes.

Interactions

K+ sparing diuretics or K+ supplements, lithium, other antihypertensives, trimethoprim, heparin, anaesthetics, TCADs, antipsychotics, allopurinol, NSAIDs, rifampicin, immunosuppressants, antidiabetic agents, sympathomimetics, procainamide, hyposensitising agents, alcohol, mTOR inhibitors (e.g., everolimus, temsirolimus, sirolimus), tissue plasminogen activator, racecadotril, muscle relaxants, drugs that cause torsade de pointes, barbiturates, digoxin, amphotericin, cytostatics, laxative, Ca++ salts, colestyramine, colestipol, corticosteroids, sotalol, sodium aurothiomalate, amantadine, tissue plasminogen activator, ACTH.

Advice to Patient

Swallow whole tablet with a glass of water. Complete full course of therapy even if you feel better before completion of course. Contact prescriber if there is allergic reaction (swelling on face/lips/tongue/throat, difficulty in breathing, severe or sudden swelling on ankles/hands/feet, severe itching on skin), yellowing of skin or eyes, loss of appetite or dark coloured urine. If you feel dizzy or light-headed, lie down until relieved.

Pharmacokinetics

LISINOPRIL: Onset of action: 1 hr. Peak effect: Hypotensive: Oral: Approx. 6 hrs. Duration: 24 hrs. Metabolism: Not metabolized. Bioavailability: Children 2-15 yrs: 20%-36%. 6-16 yrs: Approx. 28%. Adults: Approx. 25%; reduced to 16% with NYHA Class II-IV heart failure. Half-life elimination: 12 hrs. Time to peak: Paediatric patients 6 mth-15 yrs: 5-6 hrs. Adults: Approx. 7 hrs. Excretion: Primarily urine. HYDROCHLOROTHIAZIDE: Onset of action: Diuresis: Infants: 2-6 hrs. Adults: Approx. 2 hrs. Peak effect: 4-6 hrs. Duration: Infants: 8 hrs. Adults: 6-12 hrs. Absorption: Well absorbed, absorption is decreased in patients with CHF. Metabolism: Not metabolized. Bioavailability: 65%-75%. Half-life elimination: Approx. 6-15 hrs. Time to peak: Approx. 1-5 hrs. Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.