Teeneg asked
What are some medications that can be substituted for lisinopril/hydrochlorothiazide?
Answer
Lisinopril-Hydrochlorothiazide (Zestoretic) is a blood
pressure medication containing two ingredients. There are several other blood
pressure medications that can be used as alternatives. The individual
ingredients are also available to be used.
Information About Lisinopril
Lisinopril (Zestril) is an angiotensin converting enzyme (ACE) inhibitor. There are several other ACE inhibitors that work in a similar fashion, including enalapril, captopril, and benazepril. Lisinopril is the most commonly used ACE inhibitor and is inexpensive (sometimes free).
ACE inhibitors can cause a persistent dry cough, hyperkalemia (high potassium), and rarely angioedema—swelling of the tongue, lips, and throat.
Another option for ACE Inhibitor alternatives are Angiotensin Receptor Blockers (ARBs), which are less likely to cause this dry cough.
Although these medication classes work in a similar fashion, ARBs do not inhibit kinase II which is thought to be responsible for the cough. Switching from lisinopril to losartan may help reduce the likelihood of developing a dry cough. ARBs may also have slightly less risk of causing angioedema. Examples of ARBs include:
Information About Hydrochlorothiazide (HCTZ)
Hydrochlorothiazide (HCTZ) is a thiazide diuretic that works by increasing the amount of sodium, chloride, and water excreted in the urine. Other thiazide diuretics include chlorthalidone and chlorothiazide.
Thiazide diuretics are commonly used for blood pressure management, but can also be used for its diuretic effects to reduce swelling or help with heart failure symptoms.
Side effects for HCTZ include increased urination,
electrolyte imbalances, and low blood pressure. Other types of diuretics
include loop diuretics (e.g. furosemide) and potassium-sparing diuretics (i.e.
spironolactone). The other types of
diuretics are not commonly used for blood pressure unless there are other
reasons to use the medications (e.g. heart failure).
Summary
There are several alternatives for Lisinopril-HCTZ including the individual components. The closest alternative to lisinopril and other ACE inhibitors would be ARBs like losartan. The closest alternative to HCTZ would be other diuretics, but these are generally not used for blood pressure alone.
Other blood pressure medicines include calcium channel
blockers (i.e. amlodipine), beta blockers (i.e. metoprolol), and clonidine. Choice
of treatment is based on several factors including other medical conditions, kidney
and liver function, age, sex, and even race.
