Monograph Details
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Cardiovascular System
> Hypertension
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ZESTORETIC 20-25 |
| Manufacturer |
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AstraZeneca Pharmaceuticals |
| Legal Classification |
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Rx
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| Generic Name |
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Lisinopril 20mg, hydrochlorothiazide 25mg; tabs. |
| Also |
• ZESTORETIC 10-12.5
• ZESTORETIC 20-12.5
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| Indications |
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Hypertension. |
| Children |
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Not recommended. |
| Adults |
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Switching from monotherapy with either component: start with Zestoretic 10/12.5 or 20/12.5 once daily, then adjust. Allow 2–3 weeks for titration of HCTZ component. If on diuretic: if possible, suspend diuretic for 2–3 days, then adjust. Or, substitute for individually titrated components. |
| Contraindications |
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History of ACEI-associated or other angioedema. Anuria. Sulfonamide allergy. Pregnancy (Cat.D in 2nd and 3rd trimesters). |
| Precautions |
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CHF. Coronary or cerebrovascular ischemia. Arrhythmias. Salt/volume depletion. Postsympathectomy. Dialysis (esp. high-flux membrane). Renal or hepatic impairment. Severe renal impairment (CrCl ≤30mL/min or serum creatinine >3mg/dL): not recommended. Diabetes. Gout. Asthma. SLE. Renal artery stenosis. Surgery. Monitor electrolytes, renal and hepatic function. Discontinue if angioedema or laryngeal edema (SC epinephrine should be available), jaundice or elevated liver enzymes occurs. Monitor WBC in renal or collagen vascular disease. Pregnancy (Cat.C in 1st trimester). Nursing mothers: not recommended. |
| Interactions |
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Potentiates tubocurarine, neuromuscular blocking agents. May antagonize sulfonylureas, oral anticoagulants, uricosurics. May be antagonized by NSAIDs, sympathomimetics. May increase digitalis, lithium, insulin, diazoxide toxicity. Hyperkalemia with K+-sparing diuretics, K+ supplements. Hypokalemia with ACTH, corticosteroids. Orthostatic hypotension may be increased by alcohol, CNS depressants. May interfere with parathyroid, urinary acetone tests. Cholestyramine, colestipol inhibit absorption; separate doses by 2–4 hours. |
| Adverse Reactions |
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Dizziness, headache, cough, fatigue, orthostatic hypotension, GI disturbances, upper respiratory infection, muscle cramps, asthenia, paresthesia, rash, electrolyte disturbances (hypo- or hyperkalemia, hyponatremia), hyperuricemia, angioedema; liver dysfunction, blood dyscrasias (rare). |
| How Supplied |
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Tabs—100 |
| Additional Resources |
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• Related Prescribing Note |
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