Generic Medication guide:
What is the medication named Zestoretic?
Zestoretic is a commercial name for the combination medication based on two substances - Lisinopril and Hydrochlorothiazide. The brand is owned by the British pharmaceutical company AstraZeneca but it is also available under other names. So if you wish to get the same formulation cheaper, you should look buy generic Zestoretic, i.e. the same product manufactured by another company.
The formulation contains two active substances Lisinopril, an ACE inhibitor, and hydrochlorothiazide, a water pill. Both exhibit a supplementary blood tension-lowering effect. The medication is prescribed for individuals with elevated arterial tension and any heart conditions in which elevated blood tension is observed. Worth noting that it is a mixed medication so it is usually advised to begin the management of tension with one formulation and add another tension-lowering agent only if the effect of one medication is insufficient.
Lisinopril, the ACE inhibitor contained in the formulation prevents transformation of angiotensin hormone into an active form that induces blood tension raise. It has a number of positive effects on heart the including lowering of the systemic vascular resistance, preload on the myocardium, causes an elevation in the minute volume of blood and improved tolerance to physical activity in chronic heart failure. The continuous use diminishes the hypertrophy of myocardium, betters blood delivery to ischemic myocardium. The formulations from the group extend the life expectancy of sufferers of chronic heart failure and slow down the aggravation of ventricular dysfunction in individuals after myocardial infarction.
The blood tension-lowering effect develops within six hours and is maintained for twenty-four hours. The effect starts to manifest in the first days of the medication use and the stable action is recorded within one to two months of uninterrupted use.
Hydrochlorothiazide is a water pill which effect is due to the disrupted repeated absorption of sodium, and other ions, water in the nephron. It has an arterial tension-lowering effect which is due to the dilation of arteriole. The formulation is effective only in elevated blood tension and doesn’t have an effect in a regular arterial tension. The water pill effect is developed within 1-2 hours and the peak is reached in four hours. The sufficient tension-lowering effect is maintained within six to twelve hours. To see the stable blood-tension lowering effect, a month of uninterrupted use is needed.
If you want to buy Zestoretic cheaper, you should look for the formulation with the same compound made by other manufacturers.
When is the use of Zestoretic prohibited?
Even if you have the symptoms eligible for the formulation use, it can be prohibited for you if you have/are:
- Intolerance of the active ingredients of the medication or other ACE inhibitors or thiazide diuretics;
- History of swelling related to ACE inhibitors use;
- Idiopathic angioedema;
- Severe kidney failure;
- Severe liver dysfunction;
- Pregnant or breastfeeding;
- Gout flare up;
- no urine flow to the bladder;
- High content of uric acid in the blood;
- Overproduction of aldosterone;
- Kidney artery stenosis;
- Cardiogenic shock;
- After recent myocardial infarction;
- The use is prohibited along with Aliskiren-based formulations in individuals with diabetes or renal failure.
The cautious use is possible upon a doctor’s approval in:
- Aortic and/or mitral stenosis;
- After a kidney transplant;
- Moderate chronic renal failure;
- Primary hyperaldosteronism;
- Conditions accompanied by a decrease in fluids in the body;
- Lupus and other connective tissue disorders;
- Liver failure;
- Brain circulation disorders;
- Severe chronic heart failure;
- Elderly age;
- Need of hemodialysis.
What adverse reactions can Zestoretic cause?
- Dry mouth, nausea, stool disorders, pancreas dysfunction, abdominal pain, loss of appetite, gastritis, hepatitis, liver failure, and yellowing of the skin.
- Drop of arterial tension below the norm, chest pain; tachycardia, aggravation of chronic heart failure, impaired AV conduction, myocardial infarction or impaired cerebral circulation due to drop of arterial tension.
- Dizziness, headache; mood fluctuations, inability to focus, fatigue, drowsiness, sleep disorders, depression.
- Dry cough; bronchospasm, nasal congestion or runny nose, shortness of breath, apnea, allergic pneumonia.
- Low sex drive; urination disorders, kidneys dysfunction.
- Skin rash, sensitivity to bright light; enhanced sweating, vasculitis, psoriasis.
- Swelling of the face, lips, tongue, pharynx and/or larynx, extremities, hypersensitivity reactions.
- Muscle weakness, arthralgia/arthritis.
- Transient visual impairment.
- General weakness, enlargement of mammary glands, exacerbation of gout, impaired kidney development, hypoglycemia.
How to use Zestoretic?
You should not order generic Zestoretic if you are just being diagnosed with hypertension as it’s not the first line therapy. The formulation can be used only if the single-component medication doesn’t render sufficient effect.
If your doctor prescribes you Zestoretic, you should take one pill a day at the same time daily. If the effect is insufficient after uninterrupted use of the medication for half of the month to a full month, your doctor can prescribe you to take two pills a day.
If you had been using diuretics before starting this formulation use, it is preferable to the use of diuretics two-three days prior to starting Zestoretic use.
Individuals with mild to moderate kidney failure should receive the medication only after the use of the medications separately and their dosages increased till their content in this combined medication.
Individuals over 65 years of age do not require dosage lowering.
The most probable manifestations of overdose are the drop of blood tension, electrolyte imbalance, kidney failure, rapid heartbeat, lightheadedness, anxiety, and cough.
The management of the condition requires symptomatic measures and supportive therapy. The use of the tablets should be ceased and vital functions monitored. In case a severe drop of arterial tension develops, a patient should be lied down on the spine with legs slightly lifted.
The level of electrolytes and creatinine should be observed. For persistent bradycardia, a pacemaker is used.
- Combined with potassium-saving water pills or other formulations that raise the level of potassium in the formulation raises the risk of hyperkalemia particularly in impaired kidney function.
- Antidiabetic medications combined with the medication may need dosage adjustments as their action can be significantly enhanced.
- The arterial tension-lowering effect is enhanced with the use of medicines that cause vessels dilation, barbiturates, phenothiazines, and tricyclic antidepressants.
- NSAIDs and sympathomimetics lower the medication’s effect.
- Zestoretic slows down the washing down of lithium and its negative effects can be potentiated.
- Antipsychotics can enhance the formulations tension-lowering effect.
- Medications used to suppress heartburn (antacids) lower the absorption of the blood pressure medication and can affect its effectiveness.
- Gold salts used with the medication can cause nausea, vomiting, drop in blood pressure, flushing of the skin of the face.
- The danger of leukopenia exists in the same time use of the formulation with Allopurinol, cytostatics, formulations that suppress the immune system.
- The danger of unsafe elevation of potassium in serum exists in the use of the pills with Lovastatin.
- The danger of renal failure and hyperkalemia is raised in the use of Zestoretic with Cyclosporine.
- The concurrent use with Sotalol elevates the risk of arrhythmia.
- When anesthesia is used, an anesthesiologist should be informed that you take Zestoretic as combined with anesthesia it can lower blood tension below the norm.
- The formulation potentiates the effects including negative ones of cardiac glycosides, muscle relaxants, and reduces the washing out of Quinidine.
- The formulation lowers the effect of oral birth control pills.
- Alcohol potentiates the tension-lowering effect of the pills.
- The use of the tablets with methyldopa elevates the risk of destruction of red blood cells.
- In individuals with lowered fluids volume in the organism due to the use of water pills, dialysis, diarrhea or vomiting, the therapy must be started under a thorough control of a doctor with a gradual rise of the dosage.
- Thiazide diuretics must not be used in individuals with kidney dysfunction as they are ineffective in creatinine clearance less than 30 ml per minute.
- If an individual without any signs of kidney dysfunctions develops an elevated level of urea and creatinine in the serum when using Zestoretic, further use must be ceased. The resumption of therapy is possible either in smaller doses or by monotherapy with the active components of the combination.
- The medication contains thiazide diuretic that must be cautiously used by individuals with impaired liver function as even slightly changed electrolyte balance can induce a hepatic coma.
- Individuals who receive hypoglycemic meds for oral administration or insulin, during the first month of the therapy with tension-lowering formulation must control the level of glucose in the blood.
- In some individuals, the use of thiazides can aggravate hyperuricemia and/or aggravate the course of gout.
- The diuretic contained in the formulation can diminish the washing out of calcium with the kidneys and cause a temporary elevation of calcium level in the blood. Severe hypercalcemia can be a manifestation of undiagnosed hyperparathyroidism.
- During the therapy, it is advised to control calcium, potassium, glucose, urea, lipids, and creatinine in the blood plasma.
- Individuals who are on hemodialysis should be given the procedure without high flow membranes as their use along with ACE inhibitors raises the risk of anaphylactic reactions.
- If you have any chronic or acute diseases when you plan to buy Lisinopril and Hydrochlorothiazide, make sure to inform your physician and get proper instructions.
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