Hydrochlorothiazide / Lisinopril Dosage

Medically reviewed by Drugs.com. Last updated on Jan 22, 2025.

Usual Adult Dose for Hypertension

Initial dose: Hydrochlorothiazide 12.5 mg-Lisinopril 10 to 20 mg orally once a day, depending on the current monotherapy dose

Maximum dose: Hydrochlorothiazide 50 mg-Lisinopril 80 mg per day

Comments:

• May increase dose every 2 to 3 weeks.
• If blood pressure is controlled with monotherapy hydrochlorothiazide 25 mg per day, but significant potassium loss occurs, then similar or greater blood pressure control without electrolyte disturbance may be achieved with hydrochlorothiazide 12.5 mg-lisinopril 10 mg orally once a day.

Renal Dose Adjustments

Mild to moderate renal dysfunction (CrCl greater than 30 mL/min): No adjustment recommended.
Severe renal dysfunction (CrCl less than 30 mL/min): Not recommended; loop diuretics preferred over thiazides

Liver Dose Adjustments

Caution recommended

Precautions

US BOXED WARNING:

• FETAL TOXICITY: If pregnancy is detected, discontinue this drug as soon as possible. Drugs that act directly on the renin-angiotensin system (RAS) can cause injury and death to the developing fetus.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Monitoring:

• Monitor serum electrolytes periodically.
• Monitor renal function during the first few weeks of therapy.
• Consider monitoring white blood cell counts periodically in patients with collagen vascular disease, especially if the disease is associated with impaired renal function.

Patient advice:

• Advise patients to immediately report any signs or symptoms of angioedema (breathing difficulty or swelling of face, eyes, lips, or tongue) and to stop taking this drug until consulting a physician.
• Encourage patients to report any lightheadedness that may occur during treatment initiation and to stop taking this drug until consulting a physician.
• Caution patients to consult their physician if excessive perspiration, dehydration, vomiting, or diarrhea occurs as it may lead to excessive blood pressure reduction due to reduced fluid volume.
• Advise patients against using potassium-sparing diuretics, potassium supplements or potassium-containing salt substitutes without consulting their physician.
• Tell patients to promptly report any sign of infection (e.g., sore throat, fever), which may be a sign of neutropenia.
• Females of childbearing age should be informed of the consequences of exposure to this drug during pregnancy; ask these patients to report pregnancies as soon as possible.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer