Lisinopril hctz side effects
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Side Effects of Lisinopril and Hydrochlorothiazide (HCTZ) Combination Therapy
Introduction to Lisinopril and HCTZ
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor commonly used to treat hypertension and heart failure. Hydrochlorothiazide (HCTZ) is a thiazide diuretic that helps prevent the body from absorbing too much salt, which can cause fluid retention. The combination of these two drugs is often prescribed to enhance antihypertensive efficacy.
Common Side Effects of Lisinopril-HCTZ Combination
Increased Frequency of Mild Adverse Effects
Patients receiving the combination of lisinopril and HCTZ tend to experience more frequent side effects compared to those on monotherapy with either drug. However, these side effects are generally mild and tend to subside spontaneously . Common side effects include dizziness, headache, and fatigue.
Electrolyte Imbalances
The combination therapy can lead to significant changes in electrolyte levels. Specifically, HCTZ tends to decrease potassium levels, while lisinopril can increase them. This balancing act can sometimes result in hypokalemia (low potassium levels) or hyperkalemia (high potassium levels) . Additionally, HCTZ can increase plasma uric acid levels, potentially leading to gout in susceptible individuals.
Metabolic Effects
The combination of lisinopril and HCTZ has been shown to affect metabolic parameters. For instance, HCTZ can increase cholesterol levels, whereas lisinopril tends to have a neutral or beneficial effect on lipid profiles . This combination therapy can also lead to changes in glucose metabolism, with some studies noting an increase in fasting glucose levels.
Comparison with Monotherapy
Lisinopril Monotherapy
Lisinopril alone is generally well-tolerated, with fewer adverse effects compared to the combination therapy. Common side effects include cough, dizziness, and elevated potassium levels. Serious adverse events are rare .
HCTZ Monotherapy
HCTZ alone is associated with a higher incidence of adverse effects, including electrolyte imbalances (notably hypokalemia), increased cholesterol levels, and elevated uric acid levels. These side effects are more pronounced compared to lisinopril monotherapy .
Conclusion
The combination of lisinopril and HCTZ is effective in controlling hypertension but comes with a higher frequency of mild side effects compared to monotherapy. Patients on this combination therapy should be monitored for electrolyte imbalances and metabolic changes. Despite these side effects, the combination is generally well-tolerated and offers superior blood pressure control compared to either drug alone.
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