Hydrochlorothiazide / Lisinopril Side Effects

Medically reviewed by Drugs.com. Last updated on May 20, 2024.

Applies to hydrochlorothiazide / lisinopril: oral tablet.

Important warnings This medicine can cause some serious health issues

Oral route (tablet)

Discontinue lisinopril/hydrochlorothiazide as soon as possible when pregnancy is detected, as drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

Serious side effects

Along with its needed effects, hydrochlorothiazide / lisinopril may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking hydrochlorothiazide / lisinopril:

Less common side effects

• blurred vision
• body aches or pain
• chills
• confusion
• cough
• diarrhea
• difficulty breathing
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• ear congestion
• fever
• headache
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• loss of voice
• nausea
• runny or stuffy nose
• sneezing
• sore throat
• sweating
• unusual tiredness or weakness
• vomiting

Incidence not known

• persistent non-healing sore
• pink growth
• reddish patch or irritated area
• shiny bump
• white, yellow or waxy scar-like area

Other side effects

Some side effects of hydrochlorothiazide / lisinopril may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common side effects

• belching
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• decreased interest in sexual intercourse
• feeling of constant movement of self or surroundings
• heartburn
• inability to have or keep an erection
• indigestion
• lack or loss of strength
• loss in sexual ability, desire, drive, or performance
• muscle cramps
• rash
• sensation of spinning
• sleepiness or unusual drowsiness
• stomach discomfort, upset, or pain

For healthcare professionals

Applies to hydrochlorothiazide / lisinopril: oral tablet.

General adverse events

The most common adverse reactions were dizziness, headache, cough, fatigue, and orthostatic effects.^[Ref]

Nervous system

• Common (1% to 10%): Dizziness, headache, paresthesia
• Uncommon (0.1% to 1%): Syncope
• Frequency not reported: Vertigo, somnolence, tinnitus

Hydrochlorothiazide:

• Frequency not reported: Paresthesia, lightheadedness, vertigo

Lisinopril:

• Common (1% to 10%): Dizziness, headache, syncope
• Uncommon (0.1% to 1%): Paresthesia, vertigo, taste disturbance
• Rare (less than 0.1%): Olfactory disturbance
• Frequency not reported: Transient ischemic attacks, ataxia, memory impairment, tremor, stroke, peripheral neuropathy, hypersomnia^[Ref]

Respiratory

• Common (1% to 10%): Cough, upper respiratory tract infection
• Frequency not reported: Common cold, nasal congestion, bronchitis, pharyngeal pain, dyspnea, pulmonary congestion, chronic sinusitis, allergic rhinitis, pharyngeal discomfort

Hydrochlorothiazide:

• Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema

Lisinopril:

• Common (1% to 10%): Cough
• Uncommon (0.1% to 1%): Rhinitis
• Very rare (less than 0.01%): Bronchospasm, sinusitis, allergic alveolitis/eosinophilic pneumonitis
• Frequency not reported: Pulmonary embolism, pulmonary infarction, paroxysmal nocturnal dyspnea, malignant lung neoplasms, hemoptysis, pulmonary edema, pulmonary infiltrates, asthma, pleural effusion, pneumonia, wheezing, orthopnea, painful respiration, epistaxis, laryngitis, pharyngitis, rhinorrhea^[Ref]

Other

• Common (1% to 10%): Fatigue, asthenia
• Frequency not reported: Chest pain, chest discomfort, fever, trauma, otalgia

Hydrochlorothiazide:

• Frequency not reported: Fever, weakness, cramping

Lisinopril:

• Uncommon (0.1% to 1%): Asthenia, fatigue
• Frequency not reported: Malaise, edema, facial edema, pain, chills, peripheral edema, chest sound abnormal, breast pain^[Ref]

Cardiovascular

• Common (1% to 10%): Orthostatic effects, hypotension
• Frequency not reported: Palpitation, flushing

Hydrochlorothiazide:

• Frequency not reported: Postural hypotension, necrotizing angiitis, vasculitis

Lisinopril:

• Common (1% to 10%): Orthostatic effects
• Uncommon (0.1% to 1%): Myocardial infarction or cerebrovascular accident, palpitation, tachycardia, Raynaud's syndrome
• Frequency not reported: Flushing, cardiac arrest, worsening heart failure, arrhythmias, angina pectoris, decreased blood pressure, vasculitis^[Ref]

Gastrointestinal

• Common (1% to 10%): Diarrhea, nausea, vomiting, dyspepsia
• Frequency not reported: Abdominal pain, gastrointestinal cramps, dry mouth, constipation, heartburn, intestinal angioedema

Hydrochlorothiazide:

• Frequency not reported: Sialadenitis, gastric irritation, diarrhea, constipation, pancreatitis

Lisinopril:

• Common (1% to 10%): Diarrhea, vomiting
• Uncommon (0.1% to 1%): Nausea, abdominal pain, indigestion
• Rare (0.01% to 0.1%): Dry mouth
• Very rare (less than 0.01%): Pancreatitis, intestinal angioedema
• Frequency not reported: Gastritis, flatulence, salivation increased^[Ref]

Musculoskeletal

• Common (1% to 10%): Muscle cramps
• Frequency not reported: Back pain, shoulder pain, knee pain, back strain, myalgia, foot pain

Hydrochlorothiazide:

• Frequency not reported: Systemic lupus erythematosus, muscle spasm, muscle weakness

Lisinopril:

• Frequency not reported: Pelvic pain, flank pain, arthritis, arthralgia, neck pain, hip pain, joint pain, leg pain, arm pain, lumbago^[Ref]

Genitourinary

• Common (1% to 10%): Impotence
• Frequency not reported: Urinary tract infection

Hydrochlorothiazide:

• Frequency not reported: Glycosuria

Lisinopril:

• Uncommon (0.1% to 1%): Impotence
• Frequency not reported: Dysuria^[Ref]

Dermatologic

• Frequency not reported: Pruritus, skin inflammation, diaphoresis, cutaneous pseudolymphoma, angioedema

Hydrochlorothiazide:

• Frequency not reported: Cutaneous vasculitis, photosensitivity reactions, rash, cutaneous lupus erythematosus-like reactions, reactivation of cutaneous lupus erythematosus, urticaria, toxic epidermal necrolysis, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, alopecia, purpura

Lisinopril:

• Uncommon (0.1% to 1%): Rash, pruritus
• Rare (0.01% to 0.1%): Angioedema, urticaria, alopecia, psoriasis
• Very rare (less than 0.01%): Diaphoresis, pemphigus, toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, cutaneous pseudolymphoma
• Frequency not reported: Photosensitivity, skin lesions, skin infections^[Ref]

Ocular

• Frequency not reported: Xanthopsia, transient blurred vision, acute myopia, acute angle-closure glaucoma

Hydrochlorothiazide:

• Frequency not reported: Xanthopsia

Lisinopril:

• Frequency not reported: Visual loss, diplopia, photophobia^[Ref]

Hematologic

• Frequency not reported: Hemoglobin decreased, hematocrit decreased, anemia

Hydrochlorothiazide:

• Frequency not reported: Leukopenia, neutropenia/agranulocytosis, thrombocytopenia, aplastic anemia, hemolytic anemia, bone marrow depression

Lisinopril:

• Rare (0.01% to 0.1%): Hemoglobin decreased, hematocrit decreased
• Very rare (less than 0.01%): Bone marrow depression, anemia, thrombocytopenia, leukopenia, neutropenia, agranulocytosis, hemolytic anemia, lymphadenopathy^[Ref]

Renal

• Frequency not reported: BUN increased, serum creatinine increased

Hydrochlorothiazide:

• Frequency not reported: Renal dysfunction, interstitial nephritis, renal failure

Lisinopril:

• Common (1% to 10%): Renal dysfunction
• Uncommon (0.1% to 1%): Blood urea increased, serum creatinine increased
• Rare (0.01% to 0.1%): Uremia, acute renal failure
• Very rare (less than 0.01%): Oliguria/anuria
• Frequency not reported: Progressive azotemia, pyelonephritis^[Ref]

Psychiatric

• Frequency not reported: Libido decreased, depression

Hydrochlorothiazide:

• Frequency not reported: Restlessness, depression, sleep disturbance

Lisinopril:

• Uncommon (0.1% to 1%): Sleep disturbance, mood alteration, depressive symptoms
• Rare (less than 0.1%): Mental confusion
• Frequency not reported: Hallucination, insomnia, nervousness, irritability^[Ref]

Hepatic

• Frequency not reported: Liver enzymes elevated, bilirubin elevated

Hydrochlorothiazide:

• Frequency not reported: Intrahepatic cholestatic jaundice

Lisinopril:

• Uncommon (0.1% to 1%): Liver enzymes elevated, bilirubin elevated
• Very rare (less than 0.01%): Hepatitis, jaundice, hepatic failure^[Ref]

Immunologic

• Frequency not reported: Viral infection, influenza

Hydrochlorothiazide:

• Frequency not reported: Anaphylactic reactions

Lisinopril:

• Very rare (less than 0.01%): Autoimmune disease
• Frequency not reported: Anaphylactoid reactions, herpes zoster^[Ref]

Metabolic

Hydrochlorothiazide:

• Frequency not reported: Anorexia, hyperglycemia, hyperuricemia, hyponatremia, hypokalemia, hypochloremic alkalosis, hypomagnesemia, cholesterol increased, triglycerides increased, gout, appetite lost

Lisinopril:

• Uncommon (0.1% to 1%): Hyperkalemia
• Rare (0.01% to 0.1%): Hyponatremia
• Very rare (less than 0.01%): Hypoglycemia
• Frequency not reported: Anorexia, gout, weight loss, dehydration, fluid overload, weight gain^[Ref]

Endocrine

Lisinopril:

• Rare (less than 0.1%): Syndrome of inappropriate antidiuretic hormone secretion, gynecomastia
• Frequency not reported: Diabetes mellitus^[Ref]

Further information

Hydrochlorothiazide/lisinopril side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer