Indications 

Zestoretic is a prescription medicine indicated for the treatment of hypertension (high blood pressure). 

Zestoretic contains two medications: hydrochlorothiazide, a thiazide diuretic (water pill) and lisinopril, an angiotensin converting enzyme (ACE) inhibitor. 

Hydrochlorothiazide works by increasing urine production to eliminate excess salt and water in the body. At the same time, lisinopril works by relaxing blood vessels to facilitate smoother blood flow. 

Uses and Dosage 

Before starting treatment with Zestoretic and with every prescription refill, carefully review the medication guide and patient information leaflet provided by your pharmacist. If you have any queries, do not hesitate to consult with your doctor or pharmacist. 

The appropriate dosage of Zestoretic is determined by considering the patient’s medical condition and response to the treatment. 

Typically, Zestoretic is taken once daily in the morning, with or without food, as prescribed by the doctor. 

For optimal results, take this medication exactly as directed at around the same time(s) daily. Refrain from altering the prescribed dosage or frequency of intake unless instructed otherwise by your doctor. 

Continue taking Zestoretic even if you feel well, as individuals with hypertension often remain unaware of their condition. Cease its usage only after consulting your doctor. 

Side Effects 

Listed below are the potential adverse effects of Zestoretic. Immediately inform your doctor if any of these symptoms persist or worsen. 

Common Side Effects 

• Cough 
• Headache 
• Dizziness 
• Fatigue 

Serious Side Effects 

• Lightheadedness, potential fainting 
• Eye pain, vision problems 
• Reduced or absent urination 
• Weakness, drowsiness, restlessness 
• Fever, chills, sore throat, mouth sores, difficulty swallowing 
• Jaundice (yellowing of skin/eyes) 
• High potassium signs:  
  • Nausea 
  • Tingling 
  • Chest pain 
  • Irregular heartbeats 
  • Loss of mobility 
• Low potassium symptoms: 
  • Leg cramps 
  • Constipation 
  • Irregular heartbeats 
  • Chest fluttering 
  • Increased thirst/urination 
  • Numbness/tingling 
  • Muscle weakness 
• Indication of low sodium: 
  • Headache 
  • Confusion 
  • Slurred speech 
  • Severe weakness 
  • Vomiting 
  • Lack of coordination 
  • Unsteadiness 

Promptly notify your doctor if you experience any of the above-listed serious side effects. 

Allergic Reactions 

In rare cases, Zestoretic may trigger a serious allergic response, particularly among individuals of African-American origin. Promptly seek medical help if you observe any indications of an allergic reaction, such as: 

• Hives 
• Severe abdominal pain 
• Breathing difficulties 
• Swelling of the face, lips, tongue, or throat 

Not all side effects of Zestoretic are included in this list. Inform your doctor of any additional side effects that may occur. 

Cautions 

Before starting treatment with Zestoretic, inform your doctor if you have any known allergies, particularly to lisinopril, hydrochlorothiazide, or to other ACE inhibitors (e.g., captopril, benazepril). 

Consult your pharmacist for further details on Zestoretic, as it may contain inactive ingredients that elicit allergic reactions or other complications. 

To ensure Zestoretic is safe for you, disclose to your doctor your medical background, especially if you have a history of: 

• Allergic reaction involving face/lips/tongue/throat swelling (angioedema) 
• Blood-filtering procedures (e.g., LDL apheresis, dialysis) 
• Desensitizing therapy for bee/wasp sting allergy 
• Gout 
• Lupus 
• Kidney disease 
• Liver disease 
• Skin cancer 

Inform your healthcare providers about all your medications, including prescription and nonprescription drugs, vitamins, and herbal supplements, to lower the risk of drug interaction with Zestoretic. 

Some of the products that may interact with Zestoretic include: 

• Aliskiren 
• Dofetilide 
• Medications that weaken the immune system or raise infection risk (e.g., everolimus, sirolimus) 
• Lithium 
• Drugs potentially elevating blood potassium levels (e.g., ARBs like losartan/valsartan, birth control pills with drospirenone) 
• Sacubitril 

Certain products contain ingredients that may increase blood pressure or exacerbate heart failure. Inform your pharmacist of the products you are using and inquire about safe usage, particularly for cough-and-cold remedies, diet aids, or NSAIDs like ibuprofen and naproxen. 

If you are prescribed cholesterol-lowering drugs like cholestyramine or colestipol, take Zestoretic either at least 4 hours before or at least 4 to 6 hours after these medications. 

Avoid the use of potassium supplements or salt substitutes unless instructed by your healthcare provider while taking Zestoretic. 

The use of Zestoretic may potentially affect specific laboratory tests, such as those assessing parathyroid function, leading to inaccurate results. Inform laboratory personnel and all healthcare providers about your current use of this medication. 

Regularly monitor your blood sugar levels if you have diabetes and are taking Zestoretic. Share the results with your doctor, who may need to make changes to your diabetes medication, exercise routine, or dietary plan. 

Zestoretic may result in dizziness, lightheadedness, and fainting upon sudden transition from lying down, particularly when initiating the treatment. To mitigate these symptoms, take care to slowly rise from bed and allow your feet to rest on the floor for a few minutes before fully standing up. 

Contact your doctor in cases of persistent vomiting, diarrhea, or excessive sweating, as dehydration can occur during Zestoretic use. Dehydration may result in significantly low blood pressure, electrolyte imbalances, or kidney issues. 

Hydrochlorothiazide heightens the likelihood of developing skin cancer. Avoid sunlight and tanning beds, and don appropriate clothing and sunscreen (SPF 30 or above) when outdoors during treatment with Zestoretic. Regular skin check-ups may be advised by your doctor. 

Older individuals may exhibit heightened sensitivity to this medication’s side effects, particularly dizziness, and alterations in urine output (related to kidney issues). 

Zestoretic is contraindicated during pregnancy. If you become pregnant while on this medication, discontinue its use immediately and inform your doctor, as lisinopril may pose a risk of harm or even fatality to the fetus during the second or third trimester. 

The transfer of lisinopril into breast milk is uncertain. While hydrochlorothiazide does enter breast milk, it is unlikely to harm a nursing infant. Seek guidance from your healthcare provider before breastfeeding.