Zestoretic: Effective Dual-Action Hypertension Management
| Product dosage: 17.5mg | |||
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Synonyms | |||
Zestoretic is a prescription medication combining two antihypertensive agents, lisinopril and hydrochlorothiazide, into a single tablet for the comprehensive management of hypertension. This fixed-dose combination therapy is designed for patients whose blood pressure is not adequately controlled on monotherapy, offering a simplified treatment regimen that may improve adherence. By leveraging complementary mechanisms of action, Zestoretic provides a potent approach to achieving target blood pressure goals, thereby reducing the overall cardiovascular risk profile in appropriate patient populations.
Features
- Contains lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, and hydrochlorothiazide, a thiazide diuretic
- Available in multiple strength combinations (e.g., lisinopril 10 mg/hydrochlorothiazide 12.5 mg, lisinopril 20 mg/hydrochlorothiazide 12.5 mg, lisinopril 20 mg/hydrochlorothiazide 25 mg)
- Oral tablet formulation for once-daily administration
- Bioequivalent to co-administered individual components
- Manufactured under strict pharmaceutical quality control standards
Benefits
- Provides synergistic blood pressure lowering through dual mechanisms of action
- Reduces pill burden compared to taking two separate medications, potentially improving treatment adherence
- May be more effective in achieving blood pressure targets than monotherapy in selected patients
- Helps decrease the risk of major cardiovascular events associated with uncontrolled hypertension
- Offers dosing convenience with once-daily administration
- Cost-effective compared to purchasing two separate prescription medications
Common use
Zestoretic is indicated for the treatment of hypertension in patients for whom combination therapy is appropriate. This medication is typically prescribed when blood pressure remains uncontrolled with either lisinopril or hydrochlorothiazide monotherapy, or when the physician determines that initial combination therapy is warranted in patients with stage 2 hypertension or those with high cardiovascular risk. The combination may be particularly beneficial for patients requiring additional blood pressure reduction beyond what can be achieved with single-agent therapy.
Dosage and direction
The dosage of Zestoretic should be individualized based on the patient’s blood pressure response and prior antihypertensive therapy. For patients not adequately controlled on lisinopril or hydrochlorothiazide alone, the usual starting dose is one tablet of Zestoretic 10/12.5 (lisinopril 10 mg/hydrochlorothiazide 12.5 mg) once daily. Dosage may be titrated upward after 2-3 weeks of therapy based on blood pressure response. The maximum recommended daily dose is lisinopril 80 mg/hydrochlorothiazide 50 mg. Tablets should be taken orally, with or without food, at approximately the same time each day. Dose adjustment may be necessary for patients with renal impairment or elderly patients.
Precautions
Patients should be monitored for hypotension, especially after the initial dose or following dosage increases. Renal function and serum electrolytes (particularly potassium, sodium, and magnesium) should be assessed prior to initiating therapy and periodically during treatment. Use with caution in patients with impaired renal function, hepatic disease, or pre-existing electrolyte imbalances. Patients should be advised to avoid dehydration and excessive perspiration, which may precipitate hypotension. Angioedema may occur at any time during treatment, requiring immediate discontinuation and appropriate medical management. Photosensitivity reactions may occur due to the hydrochlorothiazide component.
Contraindications
Zestoretic is contraindicated in patients with known hypersensitivity to lisinopril, hydrochlorothiazide, or other sulfonamide-derived drugs. It is contraindicated in patients with a history of angioedema related to previous ACE inhibitor therapy and in patients with hereditary or idiopathic angioedema. Use is contraindicated in patients with anuria and in those with demonstrated hypersensitivity to other ACE inhibitors. Concomitant use with aliskiren-containing products is contraindicated in patients with diabetes. The medication is contraindicated during pregnancy due to potential fetal harm.
Possible side effect
Common adverse reactions may include dizziness (6.5%), headache (5.2%), cough (3.9%), fatigue (3.0%), and orthostatic effects (1.4%). Less frequently reported side effects include hyperkalemia, hypokalemia, hyponatremia, increased serum creatinine, impotence, diarrhea, nausea, rash, and photosensitivity. Serious but rare side effects may include angioedema, pancreatitis, hepatic failure, renal impairment, neutropenia/agranulocytosis, and anaphylactoid reactions. Patients should report any signs of infection (sore throat, fever) or symptoms suggesting liver dysfunction.
Drug interaction
Zestoretic may interact with several medication classes. Concomitant use with other antihypertensive agents may result in additive hypotensive effects. Potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium may increase the risk of hyperkalemia. Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the antihypertensive effect and increase the risk of renal impairment. Lithium levels may increase with concomitant use. Alcohol, barbiturates, or narcotics may potentiate orthostatic hypotension. The hypoglycemic effect of insulin and oral antidiabetic agents may be enhanced. Cholestyramine and colestipol may reduce absorption of hydrochlorothiazide.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. However, if it is almost time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed dose. Consistency in daily administration is important for maintaining stable blood pressure control, so patients should establish a routine for medication administration.
Overdose
Symptoms of overdose may include severe hypotension, electrolyte disturbances, dehydration, and renal impairment. Bradycardia, tachycardia, and circulatory shock may occur. Lisinopril overdose may manifest as hypotension, while hydrochlorothiazide overdose may cause excessive diuresis with electrolyte depletion. Management should include supportive measures with correction of electrolyte imbalances and hydration. Gastric lavage or activated charcoal may be considered if ingestion was recent. Hemodialysis may be effective for removing lisinopril and hydrochlorothiazide. Treatment should be directed toward supporting blood pressure and correcting fluid and electrolyte abnormalities.
Storage
Store at controlled room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in the original container with the lid tightly closed to protect from moisture and light. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly dispose of any unused or expired medication according to local regulations, preferably through medication take-back programs.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Zestoretic is available by prescription only and should be used under the supervision of a qualified healthcare professional. Patients should not initiate, discontinue, or change dosage without consulting their physician. The prescribing information provided here may not include all possible uses, directions, precautions, or interactions. Healthcare providers should reference the complete prescribing information before initiating therapy.
Reviews
Clinical studies have demonstrated that Zestoretic provides effective blood pressure control in a significant majority of hypertensive patients. In comparative trials, the combination therapy showed superior efficacy compared to monotherapy components alone. Many patients report satisfaction with the convenience of a single-tablet regimen. Healthcare providers often note improved adherence rates with fixed-dose combination therapy compared to free combinations. Some patients may experience side effects that require dosage adjustment or discontinuation, though most tolerate the medication well when appropriately selected and monitored.