Composition
Each tablet contains:
20 mg Lisinopril 12.5 mg Hydrochlorothiazide

Properties
Lisinopril belongs to a group of medicines called “ACE Inhibitors “. These work by widening blood vessels, which makes it easier for the heart to pump blood through them, to all parts of the body. This helps to reduce raised blood pressure. Hydrochlorothiazide belongs to a group of medicines called thiazide diuretics. These work by increasing the amount of urine made by the kidneys. Each reduces blood pressure in a different way.

Indications
“Zestoretic” is used to treat high blood pressure.

Contraindications
You must not take the tablets if:
- You are pregnant, or planning to become pregnant.
- You are breast feeding or planning to breast.
- You have had an allergic reaction in the past to “Zestoretic” or to certain diuretics, those similar to sulphonamides (antibiotic) or any other of the ingredients of “Zestoretic”.
- You have been treated before with medicine in the same group of drugs as “Zestoretic” (ACE Inhibitors) and have had allergic reactions involving difficulty with swallowing or breathing, swelling of the hands, feet or ankles, face or lips, tongue or throat or if you or a member of your family has had a similar reaction for any other reason.
- You have had kidney problems that your doctor does not know about. “Zestoretic” should not be given to children. If you think that any of these apply to you, do not take the tablets. Tell your doctor and follow the advice given.

Drug Interactions
Tell your doctor about all the medicines you are taking, including those you have bought, but in particular prescribed medicines such as:
- Diuretics.
- Other treatment for high blood pressure.
- Indomethacin (for arthritis or muscle pain).
- Lithium (for depression).

Precautions
You should also tell you doctor if:
- You know that you have aortic stenosis or hypertrophic cardiomyopathy (HOCM) or renal artery stenosis.
- You have any other heart problems e.g. angina, problems with your liver or kidneys or are undergoing dialysis.
- You are on a low –salt diet and you use potassium containing salt substitutes or supplements.
- You suffer from diarrhea or vomiting.
- You are going to have desensitization treatment (e.g. treatment to reduce the effects of an allergy to bee or wasp stings)
- You have diabetes, as you may need a different dose of your antidiabetic medicines (including insulin) whilst you are taking “Zestoretic”.
- You have ever had an allergic reaction, which involved difficulty with swallowing or breathing, swelling of the hands, feet or ankles, face or lips, tongue or throat.
Your tablets are unlikely to affect your ability to drive a car or operate machinery. However, you should not perform such tasks, which need special attention, until you know how your medicine affects you. If you are having an operation, tell the dentist and the medical staff, especially the anesthetic that you are taking “Zestoretic”.

Administration and Dosage
You must keep taking “Zestoretic” even if you are feeling well, because regular treatment is most effective. The dose you take will depend on your conditions and whether you are taking any other medicines.
* The usual dose is one or two tablets once a day.
* If you are taking “Zestoretic“ for the first time you may feel light-headed or dizzy for a short time and it may help to sit or lie down. This is unlikely to happen when you are taking the tablets regularly. If you are worried, contact your doctor.
* Take the tablets with a glass of water. This makes it easier to swallow.
* Try to take your tablets at the same time each day .Many patients prefer to take “Zestoretic” in the morning so that the effects of the diuretic( passing more water than usual) occur during the daytime.
* If you miss a dose, just carry on with the next dose when it is due. Do not take an extra tablet to make up.
* If you take more than your normal dose. Contact your doctor or nearest hospital.

Side Effects
“Zestoretic” is generally well tolerated, but like all medicines, can occasionally cause unwanted effects in some patients. Do not be alarmed at this list - you may not have any of them. One of the most frequent undesirable events is dizziness. Other possible but less frequent events include dizziness or light-headedness when standing up quickly, headache, cough, tiredness. Other possible, but less frequent undesirable events are diarrhea, nausea, vomiting, dry mouth, fever, rash, psoriasis, sensitivity to sun light, gout, palpitations, chest discomfort, joint, and muscle pain, muscle cramp, weakness, pins and needless in the fingers and toes, impotence, changes in the way things taste, feeling sleepy or having difficulty in going to sleep, strange dreams, vertigo,running nose or sinus pain. Rarely, other undesirable events may occur such as jaundice (yellow skin and / or eyes), the production of less or no urine, severe abdominal pain or indigestion. Rarely there may be changes to some cells or other parts of your blood. It is possible that your doctor may occasionally take blood samples to check whether “Zestoretic” has had any effect on your blood – sometimes these changes may show themselves as tiredness or sore throat. If you are diabetic and you have the symptoms of low blood sugar (hypoglycemia) whilst taking “Zestoretic” you should tell your doctor. You should STOP TAKING ZESTORETIC and contact your doctor immediately if you begin to itch, get wheezy or have difficulty in breathing or swallowing, develop swelling of the hands, feet or ankles, face or lips, tongue or throat. Tell your doctor or pharmacist if you notice any other troublesome effects which you think are related to the tablets.

Storing Zestoretic
Keep your tablets in the pack in which they were supplied. Keep your tablets below 25 ° C and protected from light. Keep your tablets in a safe place where children cannot see or reach them. Do not take you tablets after the expiry date on the container. If you have any tablets left over when your doctor tells you to stop taking them, return them to your pharmacist, who will destroy them safely.

Remember
THESE TABLETS ARE FOR YOU. DO NOT GIVE THEM TO ANYONE ELSE EVEN IF THEY HAVE THE SAME SYMPTONS AS YOUR.

Packing
Zestoretic 10 tablets – 20 tablets.