Prescription Clinical MonographAngiotensin-Converting Enzyme (ACE) Inhibitor

Verified Evidence Sources: openFDA & NLM MedlinePlus

Lisinopril and Hydrochlorothiazide

ACE inhibitors suppress the conversion of angiotensin I to angiotensin II, decreasing systemic arteriolar resistance and reducing aldosterone secretion.

Generic Active Chemical: Lisinopril and Hydrochlorothiazide

Brand Formulations:PrinzideZestoretic

Quick Jump:Kitchen Foods (2)Drug Red Flags (2)Supplements & Herbs (1)Administration Timing (0)Pairwise Combos (5)

Kitchen Food, Drink & Dietary Conflicts

Biochemical interactions with common foods, beverages & cooking ingredients

2 Flagged Foods

Official Patient Dietary Instruction (NLM MedlinePlus)

Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, or an exercise program, follow these directions carefully.

CRITICAL

Potassium-Enriched Salt Substitutes (Low-Sodium Table Salt)

NutriDive Kitchen Food Biochemical Ontology & openFDA

Bioactive Compound:Potassium Chloride (KCl)

Biological Target:Renal Cortical Collecting Duct Electrophysiology

Clinical Mechanism:

Provides 500-1400 mg potassium per 1/4 teaspoon. When renal potassium excretion is suppressed by ACE inhibitors, ARBs, or aldosterone antagonists (spironolactone), acute severe hyperkalemia (>6.5 mEq/L) can trigger sudden flaccid paralysis and fatal ventricular fibrillation.

Patient Actionable Rule:Strictly verify ingredients of low-sodium seasonings. Avoid potassium-chloride based salt alternatives completely if taking Lisinopril, Losartan, or Spironolactone.

HIGH

Alcoholic Beverages (Beer, Wine, Spirits)

NutriDive Kitchen Food Biochemical Ontology & openFDA

Bioactive Compound:Ethanol

Biological Target:GABA-A Receptors, Hepatic CYP2E1 & Gluconeogenesis

Clinical Mechanism:

Multiplies respiratory depression and profound sedation with opioids and sedatives; blocks hepatic lactate uptake with metformin (lactic acidosis); triggers acute disulfiram-like vomiting and tachycardia with metronidazole; and accelerates dose-dumping in extended-release capsules.

Patient Actionable Rule:Completely abstain from alcohol while taking metronidazole, cephalosporins, prescription sedatives, or empty-stomach metformin.

Prescription & OTC Drug Interactions (DDI)

Documented pharmacological conflicts & contraindicated co-prescriptions

2 Warning Classes

HIGH RISK

NSAIDs (Ibuprofen, Naproxen) & Non-Cardioprotective Analgesics

openFDA SPL Section 7 (Drug Interactions)

Mechanism: Inhibition of renal vasodilatory prostaglandins (PGI2, PGE2) causes afferent arteriolar vasoconstriction, blunts blood pressure control, and increases risk of acute kidney injury (AKI).

Clinical Consequence: Loss of blood pressure reduction, fluid retention, or acute renal hemodynamic compromise.

Physician Precaution: Consult your physician before taking OTC pain relievers. Acetaminophen may be preferred for occasional pain depending on liver status.

CRITICAL RISK

Dual RAAS Blockers (ACE Inhibitors, ARBs, Direct Renin Inhibitors)

FDA Drug Safety Communication & Black Box Warnings

Mechanism: Additive suppression of the renin-angiotensin-aldosterone axis produces profound systemic hypotension, acute renal dysfunction, and hyperkalemia without added cardiovascular benefit.

Clinical Consequence: Severe hypotension, syncope, and hyperkalemic cardiac events.

Physician Precaution: Concomitant use of aliskiren with ARBs or ACE inhibitors is contraindicated in patients with diabetes or moderate-to-severe renal impairment.

Dietary Supplements, Herbs & Minerals (DNI)

Interactions with over-the-counter vitamins, minerals, and herbal preparations

1 Monitored

CRITICAL

Potassium Supplements (Potassium Chloride, Gluconate, Citrate)

NIH Office of Dietary Supplements (ODS) & NLM MedlinePlus

Biological Target: Myocardial Resting Membrane Potential & Cardiac Conduction

Direct renin inhibition suppresses downstream aldosterone secretion, preventing physiological urinary potassium excretion. Exogenous potassium supplements directly provoke dangerous serum hyperkalemia.

Guidance & Spacing:Do not take oral potassium supplements unless specifically prescribed and monitored by your physician.

Chronotherapy & Meal Administration Protocols

Optimal absorption, meal-timing rules & GI tolerability protocols

0 Protocols

Frequently Researched Drug-Substance Combinations

Explore pairwise interaction dossiers and laboratory safety analyses

HIGH→

Multi-Substance Interactive Radar

Taking Lisinopril and Hydrochlorothiazide alongside daily coffee, supplements, or other medications?

Add all your daily medications, foods (Dairy, Spinach, Coffee, Grapefruit), and botanicals (Ashwagandha, Curcumin, Melatonin) into the SafeStack interactive engine to run full multi-way synergy collision analysis in real time.

Launch SafeStack Radar with Lisinopril and Hydrochlorothiazide→

Authoritative Clinical Evidence & Regulatory Sources

Data on this clinical monograph is compiled from the U.S. National Library of Medicine (MedlinePlus), openFDA Structured Product Labeling (SPL Section 7 Drug Interactions), the NIH Office of Dietary Supplements (ODS), and Krause and Mahan's Food & Nutrition Care Process.

View Original NLM MedlinePlus Monograph·Clinical & Legal Disclaimers