Lisinopril hydrochlorothiazide side effects
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Some studies suggest that lisinopril-hydrochlorothiazide is well-tolerated and effective in reducing blood pressure, while other studies note common side effects such as dizziness, headache, fatigue, and potential risks like malignant ventricular arrhythmias.
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Side Effects of Lisinopril-Hydrochlorothiazide Combination Therapy
Common Side Effects of Lisinopril-Hydrochlorothiazide
The combination of lisinopril and hydrochlorothiazide is generally well-tolerated, but like all medications, it can cause side effects. The most frequently reported adverse effects include dizziness, headache, cough, fatigue, orthostatic effects (such as lightheadedness upon standing), diarrhea, nausea, and upper respiratory tract infections. These side effects are typically mild and often resolve on their own without the need for discontinuation of the medication.
Metabolic Side Effects
The combination therapy can also lead to several metabolic side effects. Notably, it can cause increases in serum glucose, triglycerides, uric acid, serum creatinine, and blood urea nitrogen levels, while decreasing serum potassium levels. However, the addition of lisinopril to hydrochlorothiazide treatment can mitigate some of the adverse metabolic effects typically associated with diuretics.
Serious Side Effects and Discontinuation Rates
Serious side effects are rare but can occur. In clinical trials, the most common reasons for discontinuation of the therapy were dizziness, headache, cough, and nausea. The incidence of serious clinical side effects such as hypotension and orthostatic effects was low, occurring in about 1.3% of hypertensive patients and 4.8% of patients with congestive heart failure.
Long-Term Safety and Tolerability
Long-term studies have shown that the combination of lisinopril and hydrochlorothiazide is well-tolerated over extended periods. In a 52-week study, side effects were more frequent in patients receiving the combination therapy compared to those receiving either drug alone, but these side effects were generally mild and subsided spontaneously. The combination therapy was found to be more effective in controlling blood pressure than either drug alone, making it a valuable option for long-term management of hypertension.
Specific Observations in Different Populations
In obese hypertensive patients, lisinopril was found to be as effective as hydrochlorothiazide in lowering blood pressure, but with fewer metabolic disturbances. Specifically, hydrochlorothiazide was associated with a significant increase in plasma glucose levels and a decrease in serum potassium levels, whereas lisinopril did not have these effects. This suggests that lisinopril may be a preferable option for patients at high risk of metabolic disorders.
Conclusion
The combination of lisinopril and hydrochlorothiazide is effective in managing hypertension and is generally well-tolerated. Common side effects include dizziness, headache, and cough, while metabolic side effects such as changes in serum glucose and potassium levels can occur. Long-term use is safe, with most side effects being mild and self-limiting. This combination therapy offers a balanced approach to blood pressure management, particularly in patients who may be at risk for metabolic complications.
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