Note: This document contains side effect information about hydrochlorothiazide / lisinopril. Some dosage forms listed on this page may not apply to the brand name Zestoretic.

Summary

More frequent side effects include: dizziness and headache. Continue reading for a comprehensive list of adverse effects.

Applies to hydrochlorothiazide / lisinopril: oral tablet.

Serious side effects of Zestoretic

Along with its needed effects, hydrochlorothiazide / lisinopril may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking hydrochlorothiazide / lisinopril:

Less common

• Blurred vision
• body aches or pain
• chills
• confusion
• cough
• diarrhea
• difficulty breathing
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• ear congestion
• fever
• headache
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• loss of voice
• nausea
• runny or stuffy nose
• sneezing
• sore throat
• sweating
• unusual tiredness or weakness
• vomiting

Incidence not known

• Persistent non-healing sore
• pink growth
• reddish patch or irritated area
• shiny bump
• white, yellow or waxy scar-like area

Other side effects of Zestoretic

Some side effects of hydrochlorothiazide / lisinopril may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Belching
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• decreased interest in sexual intercourse
• feeling of constant movement of self or surroundings
• heartburn
• inability to have or keep an erection
• indigestion
• lack or loss of strength
• loss in sexual ability, desire, drive, or performance
• muscle cramps
• rash
• sensation of spinning
• sleepiness or unusual drowsiness
• stomach discomfort, upset, or pain

For Healthcare Professionals

Applies to hydrochlorothiazide / lisinopril: oral tablet.

General

The most common adverse reactions were dizziness, headache, cough, fatigue, and orthostatic effects.^[Ref]

Nervous system

Common (1% to 10%): Dizziness, headache, paresthesia

Uncommon (0.1% to 1%): Syncope

Frequency not reported: Vertigo, somnolence, tinnitus

Hydrochlorothiazide:

Frequency not reported: Paresthesia, lightheadedness, vertigo

Lisinopril:

Common (1% to 10%): Dizziness, headache, syncope

Uncommon (0.1% to 1%): Paresthesia, vertigo, taste disturbance

Rare (less than 0.1%): Olfactory disturbance

Frequency not reported: Transient ischemic attacks, ataxia, memory impairment, tremor, stroke, peripheral neuropathy, hypersomnia^[Ref]

Respiratory

Common (1% to 10%): Cough, upper respiratory tract infection

Frequency not reported: Common cold, nasal congestion, bronchitis, pharyngeal pain, dyspnea, pulmonary congestion, chronic sinusitis, allergic rhinitis, pharyngeal discomfort

Hydrochlorothiazide:

Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema

Lisinopril:

Common (1% to 10%): Cough

Uncommon (0.1% to 1%): Rhinitis

Very rare (less than 0.01%): Bronchospasm, sinusitis, allergic alveolitis/eosinophilic pneumonitis

Frequency not reported: Pulmonary embolism, pulmonary infarction, paroxysmal nocturnal dyspnea, malignant lung neoplasms, hemoptysis, pulmonary edema, pulmonary infiltrates, asthma, pleural effusion, pneumonia, wheezing, orthopnea, painful respiration, epistaxis, laryngitis, pharyngitis, rhinorrhea^[Ref]

Other

Common (1% to 10%): Fatigue, asthenia

Frequency not reported: Chest pain, chest discomfort, fever, trauma, otalgia

Hydrochlorothiazide:

Frequency not reported: Fever, weakness, cramping

Lisinopril:

Uncommon (0.1% to 1%): Asthenia, fatigue

Frequency not reported: Malaise, edema, facial edema, pain, chills, peripheral edema, chest sound abnormal, breast pain^[Ref]

Cardiovascular

Common (1% to 10%): Orthostatic effects, hypotension

Frequency not reported: Palpitation, flushing

Hydrochlorothiazide:

Frequency not reported: Postural hypotension, necrotizing angiitis, vasculitis

Lisinopril:

Common (1% to 10%): Orthostatic effects

Uncommon (0.1% to 1%): Myocardial infarction or cerebrovascular accident, palpitation, tachycardia, Raynaud's syndrome

Frequency not reported: Flushing, cardiac arrest, worsening heart failure, arrhythmias, angina pectoris, decreased blood pressure, vasculitis^[Ref]

Gastrointestinal

Common (1% to 10%): Diarrhea, nausea, vomiting, dyspepsia

Frequency not reported: Abdominal pain, gastrointestinal cramps, dry mouth, constipation, heartburn, intestinal angioedema

Hydrochlorothiazide:

Frequency not reported: Sialadenitis, gastric irritation, diarrhea, constipation, pancreatitis

Lisinopril:

Common (1% to 10%): Diarrhea, vomiting

Uncommon (0.1% to 1%): Nausea, abdominal pain, indigestion

Rare (0.01% to 0.1%): Dry mouth

Very rare (less than 0.01%): Pancreatitis, intestinal angioedema

Frequency not reported: Gastritis, flatulence, salivation increased^[Ref]

Musculoskeletal

Common (1% to 10%): Muscle cramps

Frequency not reported: Back pain, shoulder pain, knee pain, back strain, myalgia, foot pain

Hydrochlorothiazide:

Frequency not reported: Systemic lupus erythematosus, muscle spasm, muscle weakness

Lisinopril:

Frequency not reported: Pelvic pain, flank pain, arthritis, arthralgia, neck pain, hip pain, joint pain, leg pain, arm pain, lumbago^[Ref]

Genitourinary

Common (1% to 10%): Impotence

Frequency not reported: Urinary tract infection

Hydrochlorothiazide:

Frequency not reported: Glycosuria

Lisinopril:

Uncommon (0.1% to 1%): Impotence

Frequency not reported: Dysuria^[Ref]

Dermatologic

Frequency not reported: Pruritus, skin inflammation, diaphoresis, cutaneous pseudolymphoma, angioedema

Hydrochlorothiazide:

Frequency not reported: Cutaneous vasculitis, photosensitivity reactions, rash, cutaneous lupus erythematosus-like reactions, reactivation of cutaneous lupus erythematosus, urticaria, toxic epidermal necrolysis, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, alopecia, purpura

Lisinopril:

Uncommon (0.1% to 1%): Rash, pruritus

Rare (0.01% to 0.1%): Angioedema, urticaria, alopecia, psoriasis

Very rare (less than 0.01%): Diaphoresis, pemphigus, toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, cutaneous pseudolymphoma

Frequency not reported: Photosensitivity, skin lesions, skin infections^[Ref]

Ocular

Frequency not reported: Xanthopsia, transient blurred vision, acute myopia, acute angle-closure glaucoma

Hydrochlorothiazide:

Frequency not reported: Xanthopsia

Lisinopril:

Frequency not reported: Visual loss, diplopia, photophobia^[Ref]

Hematologic

Frequency not reported: Hemoglobin decreased, hematocrit decreased, anemia

Hydrochlorothiazide:

Frequency not reported: Leukopenia, neutropenia/agranulocytosis, thrombocytopenia, aplastic anemia, hemolytic anemia, bone marrow depression

Lisinopril:

Rare (0.01% to 0.1%): Hemoglobin decreased, hematocrit decreased

Very rare (less than 0.01%): Bone marrow depression, anemia, thrombocytopenia, leukopenia, neutropenia, agranulocytosis, hemolytic anemia, lymphadenopathy^[Ref]

Renal

Frequency not reported: BUN increased, serum creatinine increased

Hydrochlorothiazide:

Frequency not reported: Renal dysfunction, interstitial nephritis, renal failure

Lisinopril:

Common (1% to 10%): Renal dysfunction

Uncommon (0.1% to 1%): Blood urea increased, serum creatinine increased

Rare (0.01% to 0.1%): Uremia, acute renal failure

Very rare (less than 0.01%): Oliguria/anuria

Frequency not reported: Progressive azotemia, pyelonephritis^[Ref]

Psychiatric

Frequency not reported: Libido decreased, depression

Hydrochlorothiazide:

Frequency not reported: Restlessness, depression, sleep disturbance

Lisinopril:

Uncommon (0.1% to 1%): Sleep disturbance, mood alteration, depressive symptoms

Rare (less than 0.1%): Mental confusion

Frequency not reported: Hallucination, insomnia, nervousness, irritability^[Ref]

Hepatic

Frequency not reported: Liver enzymes elevated, bilirubin elevated

Hydrochlorothiazide:

Frequency not reported: Intrahepatic cholestatic jaundice

Lisinopril:

Uncommon (0.1% to 1%): Liver enzymes elevated, bilirubin elevated

Very rare (less than 0.01%): Hepatitis, jaundice, hepatic failure^[Ref]

Immunologic

Frequency not reported: Viral infection, influenza

Hydrochlorothiazide:

Frequency not reported: Anaphylactic reactions

Lisinopril:

Very rare (less than 0.01%): Autoimmune disease

Frequency not reported: Anaphylactoid reactions, herpes zoster^[Ref]

Metabolic

Hydrochlorothiazide:

Frequency not reported: Anorexia, hyperglycemia, hyperuricemia, hyponatremia, hypokalemia, hypochloremic alkalosis, hypomagnesemia, cholesterol increased, triglycerides increased, gout, appetite lost

Lisinopril:

Uncommon (0.1% to 1%): Hyperkalemia

Rare (0.01% to 0.1%): Hyponatremia

Very rare (less than 0.01%): Hypoglycemia

Frequency not reported: Anorexia, gout, weight loss, dehydration, fluid overload, weight gain^[Ref]

Endocrine

Lisinopril:

Rare (less than 0.1%): Syndrome of inappropriate antidiuretic hormone secretion, gynecomastia

Frequency not reported: Diabetes mellitus^[Ref]