Zestoretic drug interactions

Drug interactions
Lisinopril Hydrochlorothiazide
 * Lisinopril
 * Alcohol, barbiturates, or narcotics
 * Antidiabetic drugs (oral agents and insulin)
 * Other antihypertensive drugs
 * Cholestyramine and colestipol resins
 * Corticosteroids, ACTH
 * Pressor amines (eg, norepinephrine)
 * Skeletal muscle relaxants, nondepolarizing (eg,tubocurarine)
 * Lithium
 * Non-Steroidal Anti-inflammatory Drugs

Lisinopril
For information on the drug interactions of this drug please refer to Lisinopril drug interactions.

Alcohol, barbiturates, or narcotics
potentiation of orthostatic hypotension may occur. Return to top

Antidiabetic drugs (oral agents and insulin)
dosage adjustment of the antidiabetic drug may be required. Return to top

Other antihypertensive drugs
additive effect or potentiation. Return to top

Cholestyramine and colestipol resins
Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or colestipol resins bind the hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85 and 43 percent, respectively. Return to top

Corticosteroids, ACTH
intensified electrolyte depletion, particularly hypokalemia. Return to top

Pressor amines (eg, norepinephrine)
possible decreased response to pressor amines but not sufficient to preclude their use. Return to top

Skeletal muscle relaxants, nondepolarizing (eg,tubocurarine)
possible increased responsiveness to the muscle relaxant. Return to top

Lithium
should not generally be given with diuretics. Diuretic agents reduce the renal clearance of lithium and add a high risk of lithium toxicity. Refer to the package insert for lithium preparations before use of such preparations with ZESTORETIC. Return to top

Non-Steroidal Anti-inflammatory Drugs
In some patients, the administration of a non-steroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics. Therefore, when ZESTORETIC and non-steroidal antiinflammatory agents are used concomitantly, the patient should be observed closely to determine if the desired effect of ZESTORETIC is obtained. Carcinogenesis, Mutagenesis, Impairment of Fertility Lisinopril and Hydrochlorothiazide Lisinopril in combination with hydrochlorothiazide was not mutagenic in a microbial mutagen test using Salmonella typhimurium (Ames test) or Escherichia coli with or without metabolic activation or in a forward mutation assay using Chinese hamster lung cells. Lisinopril and hydrochlorothiazide did not produce DNA single strand breaks in an in vitro alkaline elution rat hepatocyte assay. In addition, it did not produce increases in chromosomal aberrations in an in vitro test in Chinese hamster ovary cells or in an in vivo study in mouse bone marrow. Return to top