1 What is Prinzide?

Brand: Prinzide, Zestoretic

Generic: Lisinopril and hydrochlorothiazide

Prinzide is used to treat hypertension. Lisinopril is an ACE (angiotensin-converting enzyme) inhibitor. By inhibiting ACE it causes relaxation of vessels and also decreases absorption of water by the kidney, both helps in reducing pressure on vessels and thus increasing the supply of blood and oxygen to the heart.

Hydrochlorothiazide is a thiazide diuretic (water pill). It prevents absorption of salt in kidney and increases excretion of water in urine and so decreasing amount of water (fluids) in the body. It is available in a tablet form and only with your doctor’s prescription.

2 What to Know Before Using

Your doctor will inform you of what you need to know before using Prinzide.

Before starting the treatment your doctor should be informed about condition such as:

Allergy: Inform your doctor if you are allergic to any food, preservatives, dyes, or had an allergic reaction when you used this drug before.

Children: Combination of Lisinopril and Hydrochlorothiazide should be used with extreme caution in children. Safety and efficacy have not been established.

Elderly: It should be used with caution if there are kidney problems as these patients are more sensitive to its effects.

Pregnancy: It is a category D drug. It should not be used in pregnancy. It can cause harm or death to an unborn baby.

Breast Feeding: It is found in breast milk. If you are using Lisinopril and Hydrochlorothiazide combination while nursing, discuss it with your doctor for possible risk factors.

Drug Interactions: Lisinopril and Hydrochlorothiazide combination may interact with other drugs. Your doctor should be informed of any other medicines which you are taking. He may want to change the dosage or drug.

Some of them are listed below:

Digoxin, dofetilide, and ketanserin: They increase the risk of irregular heartbeats.

Everolimus or sirolimus: They increase the risk of angioedema.

Eplerenone, potassium preparations, potassium-sparing diuretics (triamterene), salt substitutes containing potassium, and trimethoprim as they increase the risk of high blood potassium levels.

Nonsteroidal anti-inflammatory drugs (NSAIDs) (celecoxib, ibuprofen, Indomethacin): They may decrease its effectiveness and the risk of serious kidney problems may be increased.

Adrenocorticotropic hormone (ACTH), barbiturates (phenobarbital), corticosteroids (prednisone), dextran sulfate, diazoxide, diuretics (furosemide), narcotic pain medicine (codeine), or other medicines for high blood pressure because the risk of low blood pressure may be increased.

Aliskiren or angiotensin receptor blockers (ARBs) (losartan): The risk of certain side effects such as kidney problems, high blood potassium levels, and low blood pressure may be increased.

Certain gold-containing medicines (sodium aurothiomalate): Increases risk of flushing, nausea, vomiting, and low blood pressure.

Cholestyramine, colestipol, or salicylates (aspirin): There is a risk that they may decrease its effectiveness.

Lithium or thiopurines (azathioprine): Risk of their side effects may be increased by Lisinopril and hydrochlorothiazide.

Insulin or other diabetes medicines (glyburide): There effectiveness may be decreased by Lisinopril and Hydrochlorothiazide.

Several other conditions may reduce its effectiveness.

Make sure you inform your doctor of conditions such as:

  • Angioedema (swelling of the face, lips, tongue, throat, arms, or legs) with other ACE inhibitors.
  • Kidney or liver diseases,
  • Diabetes,
  • High level of potassium in the blood.
  • Collagen vascular disease (an autoimmune disease).
  • Heart or blood vessel problems (aortic stenosis, hypertrophic cardiomyopathy).
  • Glaucoma.
  • Asthma or allergies.
  • Gout.
  • An allergy to sulfa drugs and penicillin.
  • Hypercholesterolemia (high cholesterol in the blood).
  • Systemic lupus erythematosus.

3 Proper Usage

Proper usage of Prinzide requires strict adherence to your doctor’s orders. Prinzide only helps in reducing blood pressure. It does not cure blood pressure related problems.

It is very important to continue to take medicine as directed in order to keep blood pressure within normal range. You may need to use it for the rest of your life.

With Lisinopril and Hydrochlorothiazide, you should also control your weight and diet. Avoid foods which are rich in sodium (salt).

Dosage: It is different for different patients. Dosage mentioned below is an average dose. You must follow your doctor’s command.

For high blood pressure:

Adults: 1 or 2 tablets once a day.

Missed Dose: If you miss a dose, take it as soon as you remember it. If it almost a time for your next dose skips the missed dose and continue your daily schedule. Do not double the dose.

Storage: Store it at room temperature. Keep it away from children.

4 Precautions to Take

Before using Prinzide, there are some precautions you must take. Your doctor should check your daily progress at regular visits.

Tell your doctor or dentist that you take Lisinopril and Hydrochlorothiazide combination before you receive any medical or dental care, emergency care, or surgery.

It can cause anaphylactic reactions. Inform your doctor immediately if you start having a rash, itching, fainting, palpitation, trouble breathing and swelling of hand face and mouth.

Use an effective form of birth control methods as Lisinopril and Hydrochlorothiazide can harm an unborn baby.

It can cause intestinal angioedema. Inform your doctor immediately if you have a severe stomach pain.

You can become dehydrated easily while using this medicine. Inform your doctor if you are having ongoing diarrhea, vomiting as they can cause severe electrolyte imbalance and can cause death.

Lisinopril and Hydrochlorothiazide combination may cause drowsiness, dizziness, blurred vision, or light-headedness. These effects may be worse if you take it with alcohol or certain medicines.

Use it with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

It can cause hyperkalemia (high potassium in the blood). Inform your doctor right away if you have symptoms such as abdominal or stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, shortness of breath, or weakness or heaviness of the legs.

Do not use supplements or salt substitutes containing potassium or without first checking with your doctor. 

It can cause serious eye problems such as blurred vision, eye pain, and difficulty in reading. Your doctor may refer you to an eye doctor.

It can cause damage to the liver. Go to your doctor if you experience a headache, stomach pain, vomiting, dark-colored urine, loss of appetite, weight loss, general feeling of tiredness or weakness, light-colored stools, upper right stomach pain, or yellow eyes or skin.

It may alter your blood sugar levels. Keep a track on your blood sugar level.

It may decrease your white blood cells. Inform your doctor if you have signs of infection such as fever, chills, and sore throat.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Prinzide. Some people may experience none or minor side effects.

Consult with your doctor if they become problematic or frequent:

More common are:

Less common are:

  • Blurred vision
  • Body aches or pain
  • Chills
  • Confusion
  • Cough
  • Diarrhea
  • Acid or sour stomach
  • Belching
  • Decreased interest in sexual intercourse

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.