Zestoretic Precautions and Warnings

Zestoretic Drug Info

Some Zestoretic Precautions and Warnings

Some precautions and warnings with Zestoretic to be aware of include the following:

There are a number of medicines that may interact with Zestoretic (see Zestoretic Drug Interactions).
Zestoretic is more likely than other drugs to cause allergic reactions. For example, there have been reports of severe allergic reactions occurring in people who were taking Zestoretic during dialysis. There have also been reports of severe reactions in people getting bee or wasp venom to protect against stings. Finally, people with a history of asthma or allergies are also more likely to have an allergic reaction to Zestoretic. Make sure to discuss these risks with your healthcare provider. Also, seek emergency medical attention immediately if you notice things such as hives, an unexplained rash, difficulty breathing, or swelling of the face or throat.

Medicines like Zestoretic that contain an ACE inhibitor may cause swelling (angioedema) of the head and neck, including the tongue, lips, eyes, or throat. This occurs more frequently in African Americans than in Caucasians. Seek emergency medical care immediately if you notice swelling in the head or neck area, experience wheezing, or have difficulty breathing or swallowing.
In addition to head and neck angioedema, medicines like Zestoretic have been known to cause swelling in the intestines. This is known as intestinal angioedema. Symptoms may include, but are not limited to, abdominal pain (or stomach pain), with or without vomiting. Seek medical attention immediately if you develop any of these symptoms.
Zestoretic may cause extreme low blood pressure in some people. Extreme low blood pressure is more likely to occur when people first start taking the medicine or when the dosage is changed. It is also more likely to happen in people who are taking a diuretic, are on dialysis, have congestive heart failure, have diarrhea or vomiting, or sweat a lot. This is why it is important to drink fluids regularly while taking Zestoretic. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, contact your healthcare provider. If you have fainted, stop taking Zestoretic until you have talked to your healthcare provider. Do not drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how Zestoretic affects you.

People on Zestoretic can be at increased risk of infections. Talk to your healthcare provider if you develop any infections, such as a sore throat or fever.
Zestoretic is a pregnancy Category C medicine for the first trimester and a pregnancy Category D medicine for the second and third trimester, meaning that the drug has health risks to your unborn child. Let your healthcare provider know if you are pregnant or thinking of becoming pregnant. If you become pregnant while taking Zestoretic, contact your healthcare provider immediately (see Zestoretic and Pregnancy for more information).

Drugs that contain hydrochlorothiazide, including this medication, can sometimes cause a potentially dangerous eye reaction (a particularly dangerous type of glaucoma). This reaction usually occurs within days to weeks of starting the drug. Because this reaction can permanently damage vision, let your healthcare provider know right away if you develop vision changes and/or eye pain. The main treatment for this reaction is to stop taking this medication, although other treatment, including surgery, may sometimes be necessary.

Medicines like Zestoretic that contain an ACE inhibitor are known to cause a cough. If a cough becomes bothersome, talk to your healthcare provider about alternate options for your condition (see Lisinopril Cough).
While taking Zestoretic, do not use potassium supplements or salt substitutes with potassium unless you have discussed this with your doctor. In some people taking Zestoretic, potassium in the blood can increase or decrease to dangerous levels.

This medication may cause a decrease in kidney function, especially in people who are elderly, have kidney disease, have severe congestive heart failure (CHF), or are taking nonsteroidal anti-inflammatory drugs (NSAIDs) or diuretics (water pills). Your healthcare provider may choose to monitor your kidney function with a blood test while you are taking it. Contact your healthcare provider if you notice a decrease in urination or swelling in your hands, legs, ankles, or feet, which can be signs of kidney problems.

In clinical studies, medicines that contain an ACE inhibitor, including Zestoretic, have rarely been known to cause liver failure. Contact your healthcare provider immediately if you notice things such as nausea, tiredness, lethargy, itchy or yellowing skin, abdominal pain (or stomach pain), or flu-like symptoms.
If you have moderate to severe liver disease (such as cirrhosis), your body may metabolize the Zestoretic differently than intended. Therefore, your healthcare provider may start you on a lower dose of Zestoretic and monitor your situation more closely or recommend another blood pressure medicine.
Zestoretic may affect electrolytes in the blood (including sodium, potassium, magnesium, and chloride). Therefore, your healthcare provider will regularly check these levels. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider. These symptoms may include:

A dry mouth
Increased thirst
Weakness
Tiredness
Restlessness
Seizures
Confusion
Muscle pain or cramps
Decrease in urine output
Weak or irregular heartbeat
Nausea
Vomiting.

Because of the hydrochlorothiazide in Zestoretic, the medication is more likely to worsen systemic lupus erythematosus or, in some cases, even cause the condition.
Because of the hydrochlorothiazide it contains, Zestoretic is also known to worsen gout.
Zestoretic may cause high blood sugar (hyperglycemia) in people with diabetes or, in some cases, even cause diabetes in people without a history of the condition.
Zestoretic may increase levels of cholesterol and triglycerides in the blood.
If you are nursing, certain parts of Zestoretic will pass through your milk. Therefore, if you are nursing, talk with your healthcare provider about whether you should discontinue Zestoretic or stop breastfeeding.

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