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CARDIOVASCULAR SYSTEM › AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM › ACE INHIBITORS, COMBINATIONS › ACE inhibitors and diuretics
lisinopril and diuretics
C09BA03
Forms & Strengths
- Lisinopril/Hydrochlorothiazide 10 mg/12.5 mg tablet
- Lisinopril/Hydrochlorothiazide 20 mg/12.5 mg tablet
- Lisinopril/Hydrochlorothiazide 20 mg/25 mg tablet
Adult Dosing
- Hypertension: Initial 10/12.5 mg to 20/12.5 mg once daily, adjusted based on individual component titration
- Max recommended dose: Lisinopril 80 mg / Hydrochlorothiazide 50 mg once daily
Pediatric Dosing
- Safety and efficacy not established in pediatric patients; use not recommended
Indications
- Management of hypertension, typically as step-up therapy or when combination therapy is appropriate
Mechanism of Action
- Lisinopril: Inhibits angiotensin-converting enzyme (ACE), preventing conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion
- Hydrochlorothiazide: Inhibits sodium reabsorption in the distal renal tubules, increasing excretion of sodium, chloride, and water
Contraindications
- History of angioedema related to previous ACE inhibitor therapy
- Hereditary or idiopathic angioedema
- Anuria or hypersensitivity to sulfonamide-derived drugs
- Concomitant use with aliskiren in patients with diabetes mellitus
- Do not coadminister with neprilysin inhibitors (e.g., sacubitril) within 36 hours
Adverse Reactions
- Dizziness, headache, fatigue
- Hypotension, orthostatic effects
- Hyperkalemia (due to lisinopril) and hypokalemia or electrolyte imbalances (due to HCTZ)
- Persistent dry cough (ACE inhibitor class effect)
- Azotemia, increased serum creatinine
- Photosensitivity, hyperuricemia
Drug Interactions
- Potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium increase hyperkalemia risk
- Lithium: Decreased renal clearance, leading to potential lithium toxicity
- NSAIDs: May diminish antihypertensive efficacy and increase risk of renal impairment
- Other antihypertensive agents: Additive hypotensive effects
- Antidiabetic agents: HCTZ may compromise glycemic control, requiring dose adjustment
Curated Content: Needs Vetting Before Put to Clinical Use