hydrochlorothiazide
Brand names: Microzide
Lisinopril and hydrochlorothiazide is a drug that lowers high blood pressure. It helps to prevent strokes and heart attacks.
Drug Shortage Alert
hydrochlorothiazide is currently listed as to be discontinued by the FDA. Affected manufacturer: Teva Pharmaceuticals USA, Inc..
View all drug shortages →Drug Pricing (NADAC)
Generic Price
$0.03/unit
Generic Available
Yes (15 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
This medicine treats high blood pressure.
Common side effects
Dizziness, Headache, Cough
Key warnings
This medicine can harm your unborn baby.
How It Works
This medicine contains two drugs that work together to lower blood pressure. Lisinopril is an ACE inhibitor that widens blood vessels. Hydrochlorothiazide is a diuretic that helps your body get rid of extra salt and water.
How to Take It
Take this medicine exactly as your doctor tells you. Your doctor may change your dose based on how you respond to the medicine. Do not take more than 80 mg of lisinopril and 50 mg of hydrochlorothiazide per day. If you have kidney problems, talk to your doctor before taking this medicine.
Pregnancy & Breastfeeding
Do not take this medicine if you are pregnant. It can cause serious harm or death to your unborn baby. Talk to your doctor about other blood pressure medicines if you are breastfeeding.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store at room temperature (68-77°F) away from light and moisture.
Side Effects (from patient reports)
Based on 79,221 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 140,497 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 1998–2025.
Total Reports
140,497
Death-Related Reports
9,873
Hospitalization Reports
48,508
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | FATIGUE | 10,014 |
| 2 | NAUSEA | 9,709 |
| 3 | DRUG INEFFECTIVE | 9,357 |
| 4 | DIARRHOEA | 8,311 |
| 5 | PAIN | 7,663 |
| 6 | DYSPNOEA | 7,582 |
| 7 | HEADACHE | 7,515 |
| 8 | DIZZINESS | 7,308 |
| 9 | ARTHRALGIA | 6,083 |
| 10 | OFF LABEL USE | 5,679 |
| 11 | ASTHENIA | 5,628 |
| 12 | FALL | 5,543 |
| 13 | VOMITING | 5,513 |
| 14 | MALAISE | 5,202 |
| 15 | ACUTE KIDNEY INJURY | 4,828 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
This medicine can harm your unborn baby. If you become pregnant, stop taking this medicine right away and tell your doctor.
Known Drug Interactions
Dual Blockade of the Renin-Angiotensin System (RAS): Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or direct renin inhibitors (such as aliskiren) is associated with increased risk of hypotension, syncope, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. Do not coadminister aliskiren with lisinopril and hydrochlorothiazide tablets in patients with diabetes. Avoid use of aliskiren with PRINZIDE in patients with renal impairment (GFR <60 ml/min).
Mechanism: Using these drugs together blocks the body's blood pressure control system too much, which can hurt the kidneys or cause high potassium levels.
What to do: Avoid this combination if you have diabetes or kidney problems, and talk to your doctor about safer options.
Monitor blood pressure, renal function, and electrolytes in patients on lisinopril and hydrochlorothiazide tablets and other agents that affect the RAS. Do not coadminister aliskiren with lisinopril and hydrochlorothiazide tablets in patients with diabetes. No meaningful clinically important pharmacokinetic interactions occurred when lisinopril was used concomitantly with propranolol, digoxin, or hydrochlorothiazide.
Mechanism: Both of these medicines can cause your body to lose too much water and salt, which can lead to dehydration or electrolyte imbalances.
What to do: Your doctor should monitor your blood pressure and salt levels closely to ensure they stay in a healthy range.
Monitor blood pressure, renal function, and electrolytes in patients on lisinopril and hydrochlorothiazide tablets and other agents that affect the RAS. Do not coadminister aliskiren with lisinopril and hydrochlorothiazide tablets in patients with diabetes. No meaningful clinically important pharmacokinetic interactions occurred when lisinopril was used concomitantly with propranolol, digoxin, or hydrochlorothiazide.
Mechanism: These drugs work in different ways to lower blood pressure and do not interfere with how the body breaks each other down.
What to do: Your healthcare provider should regularly check your blood pressure, kidney function, and salt levels while you are on both medications.
7 DRUG INTERACTIONS Lithium: Risk of lithium toxicity ( 7.2 ) Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic and antihypotensive effects; increased risk of renal toxicity ( 7.3 ) Dual inhibition of the renin-angiotensin system: Increased risk of renal impairment, hypotension, and hyperkalemia ( 7.4 ) Colesevelam hydrochloride: Consider administering olmesartan at least 4 hours before colesevelam hydrochloride dose ( 7.5 ) Antidiabetic drugs: Dosage adjustment may be required ( 7.6 ) Cholestyramine and colestipol: Reduced absorption of thiazides ( 7.6 ) 7.1 Age...
Mechanism: Both drugs work to lower blood pressure, which can increase the risk of your blood pressure dropping too low or your kidney function changing.
What to do: Your doctor should monitor your blood pressure and kidney health regularly while you are taking this combination.
The VA NEPHRON trial enrolled 1448 patients with type 2 diabetes, elevated urinary-albumin-to-creatinine ratio, and decreased estimated glomerular filtration rate (GFR 30 to 89.9 ml/min), randomized them to lisinopril or placebo on a background of losartan therapy and followed them for a median of 2.2 years. Patients receiving the combination of losartan and lisinopril did not obtain any additional benefit compared to monotherapy for the combined endpoint of decline in GFR, end state renal disease, or death, but experienced an increased incidence of hyperkalemia and acute kidney injury comp...
Mechanism: Combining these types of blood pressure medicines can increase the risk of kidney damage and high potassium levels.
What to do: Your doctor should monitor your kidney function and potassium levels closely if these drugs are used together.
Common Questions
What should I do if I feel dizzy after taking this medicine?
Can I drink alcohol while taking this medicine?
Will this medicine cure my high blood pressure?
Can I take over-the-counter pain relievers with this medicine?
How long does it take for this medicine to start working?
What if I have swelling in my face or tongue?
Can I stop taking this medicine if my blood pressure is normal?
Does this medicine interact with any other medications?
What tests will my doctor do while I'm taking this medicine?
Are there any foods I should avoid while taking this medicine?
What are the common side effects of hydrochlorothiazide?
Does hydrochlorothiazide interact with other medications?
What drug class is hydrochlorothiazide?
Is hydrochlorothiazide safe during pregnancy?
Has hydrochlorothiazide been recalled?
Is hydrochlorothiazide currently in shortage?
Active Recalls
Cross Contamination with Other Products: Testing of reserve samples showed presence of traces of ezetimibe
Glenmark Pharmaceuticals Inc., USA
GCMP Deviations: FDA analysis confirmed presence of trace amounts of an impurity, N-nitrosodiethylamine (NDEA) found in the API used to manufacture the product.
Mylan Laboratories Limited, (Nashik FDF)
GCMP Deviations: FDA analysis confirmed presence of trace amounts of an impurity, N-nitrosodiethylamine (NDEA) found in the API used to manufacture the product.
Mylan Laboratories Limited, (Nashik FDF)
GCMP Deviations: FDA analysis confirmed presence of trace amounts of an impurity, N-nitrosodiethylamine (NDEA) found in the API used to manufacture the product.
Mylan Laboratories Limited, (Nashik FDF)
CGMP Deviations: Carcinogen impurity detected in API used to manufacture drug product.
A-S Medication Solutions LLC.
CGMP Deviations: Carcinogen impurity detected in API used to manufacture drug product.
Teva Pharmaceuticals USA
CGMP Deviations: Carcinogen impurity detected in API used to manufacture drug product.
Teva Pharmaceuticals USA
CGMP Deviations: Carcinogen impurity detected in API used to manufacture drug product.
Teva Pharmaceuticals USA
CGMP Deviations: Carcinogen impurity detected in API used to manufacture drug product.
Prinston Pharmaceutical Inc
CGMP Deviations: Carcinogen impurity detected in API used to manufacture drug product.
Prinston Pharmaceutical Inc
Related Medications in Thiazide Diuretic
Other drugs grouped near hydrochlorothiazide — same-class peers and common alternatives.
acebutolol
Sectral
Acebutolol is a medicine that helps lower blood pressure and control irregular heartbeats.
Compare with hydrochlorothiazide →
aliskiren
Tekturna
Tekturna is a medicine used to treat high blood pressure.
Compare with hydrochlorothiazide →
amiloride
Midamor
Amiloride is a water pill that helps your body hold onto potassium.
Compare with hydrochlorothiazide →
amlodipine
Norvasc
Amlodipine (Norvasc) is a drug that lowers blood pressure and treats chest pain.
Compare with hydrochlorothiazide →
amlodipine/benazepril
Lotrel
Lotrel is a combination medicine that contains amlodipine and benazepril.
Compare with hydrochlorothiazide →
Medication Guides
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FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
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Common Drug Interactions
Dangerous medication combinations and how to protect yourself
Related Health & Safety Data
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What the FDA Data Shows for hydrochlorothiazide
The FDA label for hydrochlorothiazide (sold under brand names such as Microzide) classifies it as a prescription-only medication in the Thiazide Diuretic class. This medicine treats high blood pressure. Official labeling lists 4 commonly reported side effects, including Dizziness, Headache, Cough.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 79,221 voluntary reports. The database also lists 31 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.03.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 10 recall records on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC). Shortage status: FDA Drug Shortages Database.
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: June 29, 2023
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages