Zestoretic

Description

Zestoretic-20 combines Lisinopril, an ACE inhibitor, with Hydrochlorothiazide, a thiazide diuretic, to provide dual blood pressure control. Lisinopril lowers blood pressure by suppressing the renin-angiotensin-aldosterone system, helping relax and widen blood vessels. Hydrochlorothiazide increases urinary sodium and water excretion, reducing blood volume and pressure. Together, they offer better control in patients not responding adequately to monotherapy.

Indications

Used in:

• Mild to moderate hypertension.

• Patients not adequately controlled on single-agent blood pressure therapy.

How to Use

• Take once daily, preferably at the same time each morning.

• Swallow whole with water. Can be taken with or without food.

• Do not skip or double doses.

Side Effects

Common:

• Dizziness, headache, dry cough, fatigue.

• Low blood pressure (including upon standing).

Less Common:

• Nausea, vomiting, diarrhea, dry mouth.

• Muscle cramps, weakness, palpitations.

• Skin rash or itching.

• Electrolyte changes (high or low potassium, high uric acid).

Rare:

• Pancreatitis.

• Agranulocytosis (low white blood cells).

• Liver enzyme elevation.

When Not to Use

Avoid if:

• History of angioedema due to ACE inhibitors.

• Allergy to Lisinopril, Hydrochlorothiazide or sulfonamide-derived drugs.

• Anuria (no urine output).

• Pregnant or planning pregnancy.

Precautions & Warnings

• Monitor blood pressure, kidney function, and electrolytes regularly.

• May lower blood pressure excessively in volume-depleted patients (e.g. diarrhea, dehydration).

• Use cautiously in patients with liver disease, as thiazides can disturb electrolyte balance.

• Discontinue before parathyroid function tests due to calcium elevation risk.

Drug Interactions

Use with caution when combined with:

• Potassium supplements or potassium-sparing diuretics.

• NSAIDs (may reduce antihypertensive effect).

• Lithium (risk of toxicity).

• Insulin / Antidiabetic drugs (may alter glucose balance).

• Alcohol or sedatives (enhances low BP effect).

Doctor’s Overview

Dr. Adeel Khurshid (Cardiologist):
“This combination is useful when single-drug therapy isn’t enough. It controls blood pressure from two angles — vascular relaxation and fluid reduction. Regular monitoring of potassium and kidney function is essential, especially in elderly or diabetic patients.”

Storage

Store at room temperature, away from direct heat and light. Keep out of children’s reach.

Disclaimer

This is a general medical information profile, not a substitute for professional advice. Always follow the dose and monitoring plan provided by your physician.