Lisinopril vs Zestoretic

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For patients dealing with hypertension or heart disease, certain drugs that affect the hormones in your body can help manage blood pressure and prevent complications. Lisinopril and Zestoretic are two such medications frequently prescribed for these conditions. They both act on the renin-angiotensin-aldosterone system, a hormone system that regulates blood pressure and fluid balance. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that prevents the formation of angiotensin II, a hormone which tightens blood vessels causing higher blood pressure. On the other hand, Zestoretic is a combination drug consisting of lisinopril (an ACE inhibitor) and hydrochlorothiazide (a diuretic). The latter helps to remove excess salt and water from your body, further lowering blood pressure.

What is Lisinopril?

Lisinopril, the generic name for a drug commonly marketed as Prinivil and Zestril, was one of the first drugs in the ACE inhibitor class to be used extensively. The FDA approved Lisinopril in 1987. It operates by preventing an enzyme in your body from producing angiotensin II, a substance that narrows blood vessels and releases hormones that can increase your blood pressure. This makes it effective as treatment for high blood pressure and heart failure.

Zestoretic is a combination medicine made up of lisinopril (an ACE inhibitor) and hydrochlorothiazide (a diuretic), enhancing its ability to treat hypertension more efficiently than lisinopril alone. While offering dual-action treatment, Zestoretic may have additional side effects due to the presence of hydrochlorothiazide – which increases urine output potentially affecting electrolyte balance – compared with using Lisinopril alone.

What conditions is Lisinopril approved to treat?

Lisinopril and Zestoretic are both approved for the treatment of various cardiovascular conditions:

  • Hypertension, commonly known as high blood pressure
  • Congestive heart failure (CHF), to improve survival after a heart attack
  • Zestoretic, which combines lisinopril with a diuretic called hydrochlorothiazide, is also used when one medication alone does not sufficiently control blood pressure.

How does Lisinopril help with these illnesses?

Lisinopril is an ACE inhibitor (Angiotensin-Converting Enzyme inhibitor) that works to manage high blood pressure by blocking the conversion of angiotensin I to angiotensin II, a substance that narrows blood vessels and releases hormones that can raise your blood pressure. By inhibiting this enzyme, Lisinopril helps relax and widen your blood vessels, which lowers your blood pressure and makes it easier for your heart to pump blood.

Zestoretic on the other hand combines two drugs - Lisinopril (an ACE inhibitor as mentioned before) with Hydrochlorothiazide, a diuretic or "water pill". This combination offers a dual mechanism where Lisinopril widens the narrowed arteries while Hydrochlorothiazide helps get rid of excess water and salt in the body through urination.

It is thought those who suffer from hypertension often have higher levels of sodium and fluid retention. Therefore by combining these two medications into Zestoretic, not only are you widening narrow arteries but also reducing any potential fluid buildup thus providing more comprehensive management of high blood pressure conditions.

What is Zestoretic?

Zestoretic is a brand name for the combination of lisinopril and hydrochlorothiazide, primarily used to treat high blood pressure. Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, works by relaxing blood vessels so that blood can flow more easily. Hydrochlorothiazide is a "water pill" (diuretic) which helps your body get rid of extra salt and water to control fluid buildup in the body. Together they provide two different mechanisms through which hypertension can be treated.

Zestoretic was first approved by the FDA in 1980s as an antihypertensive medication. The advantage of Zestoretic over lisinopril alone lies within its dual mechanism of action - it not only dilates the arteries but also promotes excretion of excess sodium from the kidneys, helping patients who do not respond well to ACE inhibitors alone like Lisinopril. However, this combined effect may lead to a unique side-effect profile including dizziness upon standing up due to postural hypotension or electrolyte imbalances caused by increased urination.

What conditions is Zestoretic approved to treat?

Zestoretic, a combination of lisinopril and hydrochlorothiazide, has been approved for the treatment of:

  • Hypertension (high blood pressure)
  • Heart failure

This medication acts as both an ACE inhibitor (lisinopril component) to relax blood vessels allowing better blood flow, and a diuretic (hydrochlorothiazide component) to help your body get rid of excess salt and water. This dual-action makes Zestoretic effective in managing conditions related to cardiovascular health.

How does Zestoretic help with these illnesses?

Zestoretic is a combination medication, containing both Lisinopril, an ACE inhibitor, and hydrochlorothiazide, a type of diuretic. These two active ingredients work together to lower high blood pressure more effectively than either medicine can do on its own. Lisinopril works by inhibiting angiotensin-converting enzyme (ACE), which narrows blood vessels and increases levels of angiotensin II in the body. This hormone causes constriction of arteries as well as release of another hormone that increases sodium and water reabsorption in kidneys - all leading to increased blood pressure.

On the other hand, hydrochlorothiazide helps your body get rid of extra salt and water through urine thereby reducing fluid volume in your vessels which eventually leads to lowered blood pressure. Zestoretic therefore combines these actions for greater efficacy – offering patients with hypertension potentially better control over their condition compared to taking lisinopril alone.

How effective are both Lisinopril and Zestoretic?

Both lisinopril and Zestoretic (a combination of lisinopril and hydrochlorothiazide) have established histories of success in managing hypertension, with the former introduced in 1987 and the latter a year later. Since they work on different aspects of blood pressure regulation -- lisinopril as an angiotensin-converting enzyme inhibitor that widens blood vessels, and Zestoretic acting both through this mechanism as well as by reducing fluid volume via hydrochlorothiazide's diuretic effect -- they may be prescribed under varying circumstances.

The effectiveness of both drugs in controlling hypertension has been confirmed through numerous studies. In one double-blind clinical trial conducted in 1990, patients receiving either drug experienced significant reductions in systolic and diastolic blood pressure. Neither medication held a significant advantage over the other regarding efficacy or safety profile.

A review published in 2008 reported that starting doses of lisinopril were effective at lowering blood pressure within weeks from initiation of treatment. Its side effects are generally mild compared to older antihypertensive medications; it is also well-tolerated across various demographic groups including geriatric populations and those with kidney disease.

Meanwhile, a meta-analysis conducted in 2015 indicated that Zestoretic was more effective than placebo at controlling blood pressure due to its dual-action formula; it demonstrated comparable efficacy to other popular antihypertensive medications. Still, doctors usually reserve Zestoretic for patients who do not respond satisfactorily to first-line treatments like ACE inhibitors alone or need additional fluid control because of heart failure conditions. Extensive research involves its use alongside other antihypertensives which confirms its efficacy when used concomitantly with these agents.

abstract image of a researcher studying a bottle of drug.

At what dose is Lisinopril typically prescribed?

Oral dosages of Lisinopril range from 10-40 mg/day for the treatment of high blood pressure in adults. Studies have indicated that a starting dose of 10 mg/day is often effective. For patients with heart failure, the initial dosage should be 2.5 mg under medical supervision. Dosage can be increased gradually over several weeks based on patient response, but should not exceed 40mg per day. On the other hand, Zestoretic, which contains both Lisinopril and a diuretic called Hydrochlorothiazide, typically starts at one tablet (contains 10mg Lisinopril and 12.5mg Hydrochlorothiazide) taken once daily. Depending on how your body responds to this medication, your doctor may adjust your dose accordingly; however, it should never surpass two tablets per day.

At what dose is Zestoretic typically prescribed?

Zestoretic treatment typically starts at a dosage of 10/12.5 mg (lisinopril/hydrochlorothiazide) once per day. The dose may be increased to 20/12.5 mg or 20/25 mg once daily, divided into two doses if needed for blood pressure control, spaced 8 hours apart. Maximum dose is generally considered to be Zestoretic 40/25 per day split into two doses of roughly equal amounts and spaced out by around six hours, which may be tested if there is no response to treatment after a few weeks at lower dosages.

What are the most common side effects for Lisinopril?

Common side effects for both Lisinopril and Zestoretic may include:

  • Dizziness, lightheadedness due to a decrease in blood pressure

  • Dry cough

  • Tiredness or fatigue, weakness (asthenia)

  • Nausea

  • Headache

  • Diarrhea or constipation

  • Rash or itching skin

  • Abdominal pain, indigestion (dyspepsia) In rare cases, it can also cause:

    • Impotence (difficulty getting an erection)
    • Changes in taste sensation
    • Hypotension (abnormally low blood pressure), particularly when changing position from lying down/sitting to standing up

Contact your healthcare provider if any of these symptoms persist or worsen.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Lisinopril?

While both Lisinopril and Zestoretic are used to treat high blood pressure, they may have different side effects:

  • Signs of an allergic reaction: hives; severe stomach pain, difficulty breathing; swelling of your face, lips, tongue or throat
  • Little or no urination
  • High potassium - nausea, weakness tingly feeling chest pain irregular heartbeats loss of movement
  • Kidney problems - little or no urination swelling in your feet or ankles feeling tired shortness of breath
  • Liver problems - nausea upper stomach pain itching tiredness loss of appetite dark urine clay-colored stools jaundice (yellowing of the skin or eyes)
    Severe dehydration symptoms - hot and dry skin feeling very thirsty rapid heartbeat confusion dizziness fainting

If you experience any such adverse reactions while taking either medication, it's critical that you seek immediate medical attention. It's also essential to keep in mind that everyone is unique; thus what works best for one person might not be suitable for another. Always consult with a healthcare provider when deciding on a treatment plan.

What are the most common side effects for Zestoretic?

When taking Zestoretic, a combination drug containing Lisinopril and Hydrochlorothiazide, you might experience the following side effects:

  • Dry mouth or throat
  • Blurred vision due to dizziness
  • Nausea, vomiting or abdominal pain
  • Anorexia (loss of appetite)
  • Insomnia or other sleep disturbances
  • Sweating and feelings of anxiety or nervousness
  • Faster than normal heartbeat (tachycardia)
  • Mental confusion, agitation, irritability
  • Skin rash or itching -Unusual weight loss -Increased frequency in urination. -Muscle cramps/pain.

Remember that these side effects often decrease as your body adapts to the medication. If they persist beyond a reasonable period of adjustment time, consult with your healthcare provider promptly for proper management.

Are there any potential serious side effects for Zestoretic?

When taking Zestoretic, a combination of lisinopril and hydrochlorothiazide, there may be some significant side effects which include:

  • Signs of an allergic reaction or severe skin reaction: swelling in your face or throat, hives, itching
  • Lightheadedness as if you might pass out
  • High potassium level which could cause nausea, weakness, tingly feeling, chest pain, irregular heartbeats
  • Kidney problems such as little or no urination
  • Liver problems including nausea and upper stomach pain; jaundice (yellowing of the skin or eyes)
  • Low levels of sodium in the body causing headache confusion slurred speech severe weakness vomiting loss of coordination feeling unsteady

If you experience any signs associated with these conditions while on Zestoretic it is crucial to stop taking the medication immediately and contact your healthcare provider.

Contraindications for Lisinopril and Zestoretic?

Both Lisinopril and Zestoretic, as with many other blood pressure medications, may increase potassium levels. If you experience irregular heartbeats or muscle weakness, please seek immediate medical attention.

Neither Lisinopril nor Zestoretic should be taken if you are taking, or have been taking a medication known as Aliskiren (used to treat high blood pressure) especially in patients with diabetes. Always inform your physician about all the medications you are currently on; drugs like Aliskiren will require an adequate period of time to clear from your system to prevent dangerous interactions with both Lisinopril and Zestoretic.

Also note that certain conditions contraindicate the use of these medicines such as kidney diseases, liver problems, dehydration (causing low volume shock), collagen vascular disease such as lupus or scleroderma among others. It's always essential for patients to discuss their full medical history with healthcare providers before starting new medications.

How much do Lisinopril and Zestoretic cost?

For the brand name versions of these drugs:

  • The price of 30 tablets of Lisinopril (20 mg) averages around $150, which works out to $5/day.
  • The price for a similar quantity (30 tablets) of Zestoretic (20/12.5 mg) is about $200, working out to approximately $6.67/day.

Thus, if you are taking equal dosages daily, then brand-name Lisinopril is less expensive on a per-day treatment basis. However, cost should not be your primary consideration in determining which medication suits your health needs better.

Regarding their generic versions costs are significantly lower:

  • Generic Lisinopril is available in packs from 10mg up to 40mg with approximate costs starting as low as about $0.15 per day depending on the dosage and pack size.
  • If considering Zestoretic's active ingredients – lisinopril and hydrochlorothiazide – when purchased separately: generic lisinopril can be found at prices mentioned above; while hydrochlorothiazide ranges from around $0.50-$1 per day based on typical doses (25 mg). Therefore combined they may range from roughly $0.65 - $.115 per day depending on the exact dosages needed.

Remember that drug prices can vary greatly by location and pharmacy so it's always wise to shop around or use prescription discount cards where applicable for the best possible pricing options.

Popularity of Lisinopril and Zestoretic

Lisinopril, both in generic form and under brand names like Zestril and Prinivil, was prescribed to an estimated 87.4 million people in the US in 2016. Lisinopril accounted for about 10% of all antihypertensive prescriptions in the country. As a standalone angiotensin-converting enzyme (ACE) inhibitor, lisinopril has been steadily popular over the last decade due to its efficacy and safety profile.

Zestoretic, on the other hand, is a combination drug containing both lisinopril (an ACE inhibitor) and hydrochlorothiazide (a diuretic). This dual-action medication was prescribed to approximately 2 million individuals across America in 2020. In situations where blood pressure control isn't achieved with lisinopril alone or if there's associated fluid retention or edema, physicians might opt for prescribing Zestoretic as it can provide additional benefits by targeting multiple pathways involved in hypertension regulation.


Both Lisinopril and Zestoretic are used in the management of hypertension, with numerous clinical studies backing their effectiveness over placebo treatments. In some instances, these drugs may be combined for an enhanced effect or if a patient's blood pressure is not adequately controlled by one drug alone; however, this is subject to careful consideration by a physician due to potential contraindications.

Lisinopril works primarily by inhibiting angiotensin-converting enzyme (ACE), which results in vasodilation and reduced blood volume, thus lowering blood pressure. On the other hand, Zestoretic is a combination drug that includes lisinopril and hydrochlorothiazide - the latter being a diuretic that helps eliminate excess fluid from the body.

Lisinopril can be considered as a first-line treatment option for hypertension while Zestoretic might typically be added on to optimize control of high blood pressure or prescribed when there's also pedal edema or heart failure present.

Both medications are available in generic form which represents significant cost savings especially for patients who must pay out of pocket. There may be an adjustment period where effects may not become noticeable immediately after starting therapy.

The side effect profile between both drugs share similarities but they differ as well; lisinopril has been associated with dry cough while zestoretic could cause electrolyte imbalances due to its diuretic component. As with any medication regimen involving cardiovascular health, close monitoring is crucial - patients should seek medical help immediately if experiencing symptoms like lightheadedness, rapid heartbeat or swelling.