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Zestoretic

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Zestoretic is a combination medication containing lisinopril and hydrochlorothiazide used to treat hypertension. It combines an ACE inhibitor with a diuretic to relax blood vessels and remove excess fluid, effectively lowering blood pressure in adults.


Availability
In Stock
Delivery Time
Airmail (14-21 days) | EMS trackable (5-9 days)
Product is shipped in a fully discreet envelope with no content disclosure, including all required documentation inside

Product Sheet

Active Ingredient(s)
Lisinopril, Hydrochlorothiazide
Reference Brand
Zestoretic
Manufacturer
Atnahs Pharma / AstraZeneca
Product Form
Tablet
Regulatory Classification
Rx
Primary Category
Blood Pressure
Product Category
Cardiovascular System, Agents acting on the Renin-Angiotensin System, ACE Inhibitors and Diuretics
Pharmacological Class
ACE Inhibitor and Thiazide Diuretic Combination
Manufacturer Description
A combination medicine used when one medicine alone is not enough to control high blood pressure.
Mechanism of Action
This medicine contains two active ingredients. Lisinopril relaxes blood vessels to lower pressure, while hydrochlorothiazide is a 'water pill' that helps the kidneys remove excess salt and water from the body. Together, they provide a more powerful blood pressure-lowering effect.
Route of Administration
Oral
Onset Time
1-2 hours
Duration
24 hours
Contraindications
Pregnancy, Anuria (inability to urinate), History of angioedema, Severe kidney or liver impairment
Severe Adverse Events
Electrolyte imbalance, Angioedema, Kidney failure, Pancreatitis
Common Side Effects
Dry cough, Dizziness, Headache
Uncommon Side Effects
Low blood pressure, Fatigue, Muscle cramps, Increased blood sugar
Drug Interactions
Lithium, Potassium supplements, NSAIDs, Insulin
Pregnancy Safety Warnings
Do not use. Can cause fetal injury or death.
Age Restrictions
Safety and efficacy in children has not been established
Storage Guidelines
Store at room temperature and protect from light.
Related Products
Lisinopril, Co-diovan, Ramipril

Zestoretic FAQ

Can I take Zestoretic if I have a history of gout?

Hydrochlorothiazide can increase serum uric acid, potentially worsening gout. Discuss alternative antihypertensives with your prescriber if gout attacks are a concern.

What should I do if I develop a persistent dry cough while on Zestoretic?

A dry cough is a common side effect of lisinopril. Inform your healthcare provider; they may switch you to a different class of blood-pressure medication.

Is Zestoretic compatible with travel vaccinations?

Yes, Zestoretic does not interfere with most vaccinations. However, keep the medication in its original container and carry a copy of the prescription for security checks.

Will Zestoretic affect my blood-type test results?

No, Zestoretic does not influence blood-type determination. Routine blood-type testing can be performed without any special preparation.

How can I identify genuine Zestoretic tablets?

Authentic Zestoretic tablets are round, white, and imprinted with “ZEST” followed by the dosage code. Verify the batch number and expiry date on the packaging.

Can Zestoretic be taken alongside over-the-counter cold medicines?

Most OTC cold remedies are safe, but avoid those containing decongestants that raise blood pressure (e.g., pseudoephedrine). Check the label or ask a pharmacist.

Does Zestoretic have any impact on cholesterol levels?

Zestoretic primarily lowers blood pressure; it does not have a clinically significant effect on cholesterol. Separate lipid-lowering therapy may be needed if indicated.

Is Zestoretic detectable in workplace drug testing?

Neither lisinopril nor hydrochlorothiazide are substances screened for in standard workplace drug tests, so Zestoretic should not cause a positive result.

What are the differences between Zestoretic and separate lisinopril and hydrochlorothiazide tablets?

The combination pill simplifies dosing by delivering both agents in a single tablet, improving adherence. Pharmacologically, the effects are the same as taking each drug separately.

Can I store Zestoretic in a travel pill organizer?

Yes, as long as the tablets are kept dry and protected from heat. Ensure the organizer is kept out of direct sunlight and away from moisture.

Zestoretic: What Is It?

Zestoretic is a prescription pill that combines two active ingredients: lisinopril and hydrochlorothiazide. It belongs to the heart-and-blood-pressure therapeutic class and is used to treat high blood pressure (hypertension). The medication is available in a fixed-dose tablet containing 5 mg of lisinopril and 12.5 mg of hydrochlorothiazide. In the United Kingdom, Zestoretic is regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) and is supplied only with a prescription.

How Zestoretic Works in the Body

Zestoretic’s blood-pressure-lowering effect comes from the complementary actions of its two components.

  • Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor. By blocking the ACE enzyme, lisinopril reduces the formation of angiotensin II, a hormone that narrows blood vessels. Less angiotensin II means blood vessels relax and widen, lowering the pressure required to pump blood.

  • Hydrochlorothiazide is a thiazide-type diuretic. It acts on the kidneys to increase the excretion of sodium and water, which reduces blood volume. The lower fluid volume lessens the force against vessel walls, contributing further to blood-pressure reduction.

Together, the two agents produce a faster, more consistent drop in blood pressure than either drug alone, helping patients reach target levels sooner.

Conditions Treated with Zestoretic

Zestoretic is approved in the UK for the treatment of essential hypertension when monotherapy does not achieve the desired blood-pressure control. It may be prescribed for adults who need both an ACE inhibitor and a diuretic to manage their blood pressure effectively. The medication is not indicated for heart failure, kidney disease, or other cardiovascular conditions unless a healthcare professional decides it is appropriate off-label.

Patient Suitability and Contraindications

Who Should Use Zestoretic?

  • Adults (≥ 18 years) with diagnosed hypertension who have not reached target blood-pressure goals with a single agent.
  • Patients who can tolerate both an ACE inhibitor and a thiazide diuretic.

Absolute Contraindications

  • Known hypersensitivity to lisinopril, hydrochlorothiazide, or any component of the tablet.
  • History of angio-edema related to previous ACE-inhibitor therapy.
  • Pregnancy (ACE inhibitors can harm the developing fetus) - Zestoretic should not be used during pregnancy.
  • Severe renal impairment (eGFR < 30 mL/min/1.73 m²) or patients on dialysis.

Relative Contraindications

  • Moderate renal impairment (eGFR 30-60 mL/min/1.73 m²) - dose adjustment and close monitoring are required.
  • Hyperkalemia (high blood potassium) - lisinopril can raise potassium levels.
  • Gout - hydrochlorothiazide can increase serum uric acid.
  • Diabetes mellitus - thiazides may affect blood-glucose control.
  • Elderly patients - increased sensitivity to blood-pressure changes and electrolyte disturbances.

Special Populations

  • Pregnancy & Lactation: Contraindicated in pregnancy. Women planning pregnancy should discuss alternative therapies. Limited data exist for lactation; use only if benefits outweigh risks.
  • Geriatric Patients: Start at the lowest available dose and titrate slowly; monitor kidney function and electrolytes closely.
  • Patients with Liver Disease: No specific dose adjustment is required, but overall health status should guide prescribing.

Safety Profile: Side Effects and Interactions

Common Side Effects

  • Cough: A dry, persistent cough occurs in some people taking ACE inhibitors.
  • Dizziness or Light-headedness: Often related to the blood-pressure-lowering effect, especially after the first few doses.
  • Increased Urination: Result of the diuretic component.
  • Mild Headache: Frequently reported during the initial treatment period.
  • Electrolyte Changes: Slight reductions in potassium or sodium may occur; usually asymptomatic.

Serious Adverse Events

  • Angio-edema: Swelling of the face, lips, tongue, or throat that can obstruct breathing. Seek emergency care immediately.
  • Severe Hyperkalemia: High potassium levels can cause cardiac arrhythmias. Watch for muscle weakness or irregular heartbeat.
  • Acute Kidney Injury: Sudden rise in creatinine may indicate renal impairment; requires prompt medical evaluation.
  • Severe Hypotension: Markedly low blood pressure causing fainting or shock.

Drug Interactions

  • Potassium-sparing diuretics or supplements: Increase risk of hyperkalemia when combined with lisinopril.
  • Non-steroidal anti-inflammatory drugs (NSAIDs): May reduce the antihypertensive effect and worsen kidney function.
  • Other ACE inhibitors or ARBs: Concomitant use can lead to excessive blood-pressure reduction and kidney injury.
  • Lithium: Thiazide diuretics can raise lithium levels, risking toxicity.
  • Antidiabetic medications: Hydrochlorothiazide may increase blood-glucose, potentially requiring dosage adjustments.

Food and Lifestyle Interactions

  • Alcohol: May enhance the blood-pressure-lowering effect and increase dizziness; moderation is advised.
  • High-salt diet: Can counteract the diuretic effect; a low-sodium diet supports treatment goals.
  • Potassium-rich foods (bananas, oranges, tomatoes): Should be consumed in moderation if blood tests show elevated potassium.
  • Driving and machinery: If you feel dizzy, avoid operating vehicles or heavy equipment until you know how the medication affects you.

Note: Patients should disclose all prescription medicines, over-the-counter drugs, herbal products, and supplements to their healthcare provider before starting Zestoretic.

How to Take Zestoretic

  • Standard Dosing: The usual starting dose for adults is one tablet (5 mg lisinopril / 12.5 mg hydrochlorothiazide) taken once daily. Your prescriber may increase the dose based on blood-pressure response, but any increase must stay within the strengths approved for Zestoretic.
  • Timing: Take the tablet at the same time each day, preferably in the morning to match the body’s natural rhythm and to reduce nocturnal urination.
  • With Food: Zestoretic can be taken with or without food. If the tablet causes stomach upset, a light meal may help.
  • Swallowing: Swallow the tablet whole with a full glass of water. Do not crush, split, or chew the tablet unless your pharmacist advises otherwise.
  • Missed Dose: If you miss a dose and it is within 12 hours of the next scheduled dose, take it as soon as you remember. If it is closer to the next dose, skip the missed tablet and continue with your regular schedule. Do not double up.
  • Overdose: Symptoms may include severe dizziness, fainting, rapid heartbeat, or very low blood pressure. Seek emergency medical care immediately; treatment is supportive, and activated charcoal may be used if presentation is early.
  • Discontinuation: Do not stop Zestoretic abruptly without medical guidance, especially if you have been on it for several weeks. Your doctor may taper the dose gradually to avoid rebound hypertension.

Monitoring and Follow-Up

  • Blood Pressure Checks: Initially, monitor weekly until the target is reached, then at least every 3-6 months.
  • Renal Function: Serum creatinine and estimated glomerular filtration rate (eGFR) should be measured before starting therapy and periodically thereafter (typically 1-2 weeks after initiation, then quarterly).
  • Electrolytes: Sodium, potassium, and chloride levels are checked at baseline and during dose adjustments.
  • Blood Glucose: For patients with diabetes, monitor fasting glucose or HbA1c as thiazides can affect glycaemic control.
  • Pregnancy Test: Women of child-bearing potential should have a negative pregnancy test before starting therapy and be advised to use effective contraception.

Storage and Handling

  • Store Zestoretic tablets at room temperature (15-25 °C) away from moisture, heat, and direct sunlight.
  • Keep the container tightly closed and out of reach of children.
  • Do not use the medication after the expiry date printed on the packaging.
  • Dispose of unused tablets via a pharmacy take-back program or according to local waste-disposal guidelines; do not flush them down the toilet.

Medication-Specific Glossary

ACE Inhibitor
A drug class that blocks the conversion of angiotensin I to angiotensin II, leading to vasodilation and lowered blood pressure.
Thiazide Diuretic
A kidney-acting medication that promotes sodium and water excretion, reducing blood volume and helping control hypertension.
Hyperkalemia
An elevated level of potassium in the blood, which can cause cardiac rhythm disturbances.
Angio-edema
Rapid swelling beneath the skin, often affecting the lips, tongue, or airway; a rare but serious side effect of ACE inhibitors.
eGFR (Estimated Glomerular Filtration Rate)
A calculation used to assess kidney function; important for dosing adjustments of Zestoretic.

Medical Disclaimer

This article provides educational information about Zestoretic and is not a substitute for professional medical advice. Treatment decisions, including use for unapproved indications, must be made under the guidance of a qualified healthcare provider. The content is intended for informational purposes and does not constitute medical recommendations. Always consult a physician before starting, stopping, or changing any medication regimen.

Information for Zestoretic is sourced from established medical standards and updated frequently. It is provided for general guidance and should be confirmed with a healthcare professional before use.
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