Side effects of lisinopril with hctz
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Side Effects of Lisinopril with Hydrochlorothiazide (HCTZ)
Common Side Effects of Lisinopril-HCTZ Combination
The combination of lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, and hydrochlorothiazide (HCTZ), a thiazide diuretic, is commonly used to treat hypertension. However, this combination can lead to several side effects. Studies have shown that adverse effects are more frequent in patients receiving the combination therapy compared to those on monotherapy with either drug alone Kochar1987Lang1991Pathé1991.
Cardiovascular Side Effects
One of the notable cardiovascular side effects observed with the combination therapy is a significant change in heart rate. Patients treated with HCTZ alone experienced a significant increase in heart rate, whereas those treated with lisinopril alone saw a significant decrease in heart rate during long-term treatment . Additionally, the combination therapy has been associated with a statistically significant reduction in heart rate compared to HCTZ alone .
Metabolic Side Effects
The combination of lisinopril and HCTZ has been shown to affect various metabolic parameters. For instance, this combination significantly increases plasma uric acid levels compared to lisinopril alone . It also decreases potassium levels, whereas lisinopril alone tends to increase potassium levels . Furthermore, the combination therapy has been associated with a decrease in cholesterol levels, while HCTZ alone tends to increase cholesterol .
Electrolyte Imbalance
Electrolyte imbalances are a common concern with the use of HCTZ. The combination therapy has been shown to cause a significant decrease in serum potassium levels, which is a known side effect of thiazide diuretics Palù1993Pool1987. This decrease in potassium can lead to symptoms such as muscle weakness, cramps, and fatigue.
Lipid Profile Changes
The combination of lisinopril and HCTZ has been observed to affect lipid profiles. Specifically, the combination therapy can lead to an increase in total cholesterol and a decrease in high-density lipoprotein (HDL) cholesterol . These changes in lipid profiles can have long-term implications for cardiovascular health.
General Tolerability and Safety
Overall, the combination of lisinopril and HCTZ is generally well-tolerated, but it does have a higher incidence of adverse effects compared to monotherapy with either drug. Common side effects include dizziness, headache, and fatigue, which are usually mild and tend to subside spontaneously Kochar1987Lang1991Pathé1991. Serious adverse events are rare, but they can occur, necessitating careful monitoring of patients on this combination therapy .
Conclusion
While the combination of lisinopril and HCTZ is effective in controlling hypertension, it is associated with several side effects, including changes in heart rate, metabolic disturbances, electrolyte imbalances, and alterations in lipid profiles. These side effects are generally mild but require monitoring to ensure patient safety and efficacy of the treatment.
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Most relevant research papers on this topic
A 52‐Week Comparison of Lisinopril, Hydrochlorothiazide, and Their Combination in Hypertension
Lisinopril is more effective than hydrochlorothiazide as a step-one drug, and the combination of the two drugs is more effective and safer than either drug alone for controlling blood pressure.
The results of a large multicentre study comparing low-dose lisinopril-hydrochlorothiazide with the monocomponents.
Low-dose lisinopril-hydrochlorothiazide (L/HCTZ) effectively reduces blood pressure and heart rate in mild to moderate hypertensive patients, but has more side effects than lisinopril.
Treating mild-to-moderate hypertension: a comparison of lisinopril-hydrochlorothiazide fixed combination with captopril and hydrochlorothiazide free combination.
Lisinopril-hydrochlorothiazide fixed combination is a well-tolerated, once-daily treatment for mild-to-moderate hypertension with superior efficacy compared to captopril and hydrochlorothiazide free combination.
Lisinopril-hydrochlorothiazide combination vs lisinopril for the treatment of hypertension.
In patients uncontrolled on lisinopril 20 mg, switching to lisinopril-hydrochlorothiazide combination is as effective as increasing lisinopril to 40 mg once daily.
Plasma Lipid Profiles and Antihypertensive Agents: Effects of Lisinopril, Enalapril, Nitrendipine, Hydralazine, and Hydrochlorothiazide
Lisinopril, enalapril, and nitrendipine do not affect plasma lipid concentrations, while hydralazine lowers total and LDL cholesterol.
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