Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Fosinopril is an ACE inhibitor. ACE stands for angiotensin converting enzyme. Fosinopril lowers blood pressure and also relieves symptoms of fluid retention.

Hydrochlorothiazide and fosinopril is a combination medicine used to treat hypertension (high blood pressure).

Hydrochlorothiazide and fosinopril may also be used for purposes not listed in this medication guide.

Do not use if you are pregnant. If you become pregnant, stop taking hydrochlorothiazide and fosinopril and tell your doctor right away. Fosinopril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

You should not use this medicine if you are unable to urinate, or if you are allergic to sulfa drugs or any ACE inhibitor.

If you have diabetes, do not use hydrochlorothiazide and fosinopril together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo).

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take hydrochlorothiazide and fosinopril in larger or smaller amounts or for longer than recommended.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking hydrochlorothiazide and fosinopril. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

Your blood pressure will need to be checked often. Your blood and urine may also be tested if you have been vomiting or are dehydrated. Visit your doctor regularly.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

If you need surgery, tell the surgeon ahead of time that you are using hydrochlorothiazide and fosinopril. You may need to stop using the medicine for a short time.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

Usual Adult Dose for Hypertension:

Fosinopril 10 to 40 mg-Hydrochlorothiazide 12.5 to 37.5 mg orally per day

Comments: The effect of fosinopril 10 mg-hydrochlorothiazide 12.5 mg was similar to the effect seen with monotherapy using either fosinopril 40 mg or hydrochlorothiazide 37.5 mg.

Use: Treatment of hypertension when the desired effect has not been achieved with monotherapy or as substitution for the titrated individual components.

You should not use this medicine if you are allergic to hydrochlorothiazide or fosinopril, or if:

• you are unable to urinate;

• you are allergic to sulfa drugs; or

• you are allergic to any other ACE inhibitor, such as benazepril, captopril, enalapril, lisinopril, quinapril, ramipril, trandolapril, and others.

If you have diabetes, do not use hydrochlorothiazide and fosinopril together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo).

You may also need to avoid taking hydrochlorothiazide and fosinopril with aliskiren if you have kidney disease.

To make sure hydrochlorothiazide and fosinopril is safe for you, tell your doctor if you have:

• kidney disease (or if you are on dialysis);

• cirrhosis or other liver disease;

• congestive heart failure;

• gout;

• lupus;

• diabetes; or

• an allergy to sulfa drugs or penicillin.

Do not use if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away. Fosinopril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

Hydrochlorothiazide and fosinopril can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Drinking alcohol can further lower your blood pressure and may increase certain side effects of hydrochlorothiazide and fosinopril.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Do not use potassium supplements or salt substitutes while you are taking hydrochlorothiazide and fosinopril, unless your doctor has told you to.

Get emergency medical help if you have signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat.

Hydrochlorothiazide and fosinopril may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• pale skin, easy bruising or bleeding;

• fever, swollen gums, painful mouth sores, pain when swallowing, cold or flu symptoms;

• high potassium--nausea, slow or unusual heart rate, weakness, loss of movement;

• low potassium--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling;

• low levels of sodium--headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady; or

• severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects of hydrochlorothiazide and fosinopril may include:

• headache, dizziness;

• cough; or

• tired feeling.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other drugs may interact with hydrochlorothiazide and fosinopril, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.