hydrochlorothiazide/lisinopril

Dual Blockade of the Renin-Angiotensin System (RAS) Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. Do not co-administer aliskiren with ZESTORETIC in patients with diabetes. Avoid use of aliskiren with ZESTORETIC in patients with renal impairment (GFR < 60 mL/min).

Mechanism: Combining these medications puts too much stress on the system that regulates blood pressure, increasing the risk of fainting and kidney damage.

What to do: Do not use these drugs together if you have diabetes, and your doctor should check your kidney function and potassium levels closely.

Drug Interactions Lisinopril Hypotension - Patients on Diuretic Therapy: Patients on diuretics and especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with lisinopril. The possibility of hypotensive effects with lisinopril can be minimized by either discontinuing the diuretic or increasing the salt intake prior to initiation of treatment with lisinopril. If it is necessary to continue the diuretic, initiate therapy with lisinopril at a dose of 5 mg daily, and provide close...

Mechanism: Taking these medicines together can cause your blood pressure to drop to an unsafe level, especially when you first start the treatment.

What to do: Your doctor may need to adjust your salt intake or change your dose to prevent your blood pressure from falling too low.

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 mL/min 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...

Mechanism: Combining these two drugs can cause your potassium levels to rise and may lead to serious kidney problems without providing extra benefits.

What to do: Your doctor will likely avoid this combination or monitor your kidney function and blood levels very closely.

No meaningful clinically important pharmacokinetic interactions occurred when lisinopril was used concomitantly with propranolol, digoxin, or hydrochlorothiazide. Hydrochlorothiazide When administered concurrently the following drugs may interact with thiazide diuretics. Cholestyramine and colestipol resins - Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins.

Mechanism: There are no major negative interactions when these two medicines are used together, and they are often found in the same pill.

What to do: You can continue taking these medicines together as directed by your healthcare provider.

Use of lisinopril with potassium-sparing diuretics (e.g., spironolactone, eplerenone, triamterene, or amiloride), potassium supplements, or potassium-containing salt substitutes may lead to significant increases in serum potassium.

Mechanism: Both of these medicines can cause your body to keep too much potassium, which can lead to dangerously high levels in your blood.

What to do: Your doctor will need to perform regular blood tests to check your potassium levels while you take these drugs.