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Zestoretic (lisinopril, hydrochlorothiazide) is an ACE inhibitor and thiazide diuretic used to treat hypertension (high blood pressure) in patients who don't respond to a single treatment or who are very likely to need multiple treatments.

This medication contains two active ingredients, which are easier to take together:

• lisinopril is an angiotensin converting enzyme (ACE) inhibitor which works by relaxing blood vessels, improving blood flow and increasing oxygen supply to the heart.
• hydrochlorothiazide is a thiazide diuretic that removes water from the body through urination, which reduces blood pressure.

Together the two ingredients effectively reduce blood pressure, reducing risk of kidney damage, stroke, heart attack, and death.

Taking Zestoretic

Zestoretic comes in tablets, of which there are several strengths:

• 10/12.5 mg lisinopril/hydrochlorothiazide
• 20/12.5 mg lisinopril/hydrochlorothiazide
• 20/25 mg lisinopril/hydrochlorothiazide

Tablets are taken once per day, with or without food as desired. The start of treatment can be relatively complicated; patients are usually started on lower dose of 10/12.5 mg tablets, but this can be increased every two or three weeks according to patient response. Especially if other medications are being taken, it might take a few months of regular doctor visits to get everything adjusted properly.

Treatment can continue indefinitely. If the underlying issue isn't addressed, a patient may remain on Zestoretic for the remainder of life. As is usually the case with high blood pressure treatments, patients are also encouraged to make lifestyle changes to address the underlying issues causing the high blood pressure. These changes include:

• Eating better
• Getting regular exercise
• Getting plenty of sleep
• Avoiding stress
• Quitting smoking
• Cutting back on salt

Given time, patients who do make lifestyle changes can eventually stop hypertension treatments. A small percentage of patients do everything right, yet still get high blood pressure for unclear reasons; these patients will likely need to continue treatment.

Warnings & Side Effects

Zestoretic should not be used while pregnant; the medication can cause severe harm or even death to unborn babies. Effects of Zestoretic on nursing babies is less clear, though the medication is present in milk.

Zestoretic is an ACE inhibitor; do not use this product if there have been problems with other ACE inhibitors.

Do not use Zestoretic if unable to pass urine.

Side effects are usually mild and transient. Most commonly reported are:

• Dry cough
• More frequent urination
• Dry mouth
• Increased thirst
• Lightheadedness
• Dizziness
• Weakness

More rare, but more serious, side effects that call for immediate medical attention include:

• Confusion
• Fainting
• Difficulty breathing
• Dark urine
• Pale stools
• Eye pain
• Fever, chills
• Severe stomach pain

Regular doctor checkups are recommended. Not only will it ensure the medication is working properly, it will allow doctors to screen for developing complications. Zestoretic can cause a number of issues that would otherwise be very difficult to detect, such as:

• Swelling in the intestines
• Glaucoma
• Kidney or liver issues
• High cholesterol in the blood
• High uric acid

Zestoretic can interact with a range of other medications. In particular it should not be used with aliskiren, sacubitril, or valsartan. Other medications may cause issues, like NSAID painkillers (ibuprofen, aspirin, etc). Always check with a doctor or pharmacist before mixing treatments.