Uses
This medication is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.
This product contains two medications, cilazapril and hydrochlorothiazide. Cilazapril is called an ACE inhibitor and works by relaxing blood vessels so that blood can flow through the body more easily. Hydrochlorothiazide (or "The thiazide diuretic") increases the amount of urine you make, removing extra water and salt from your body. Getting rid of extra water and salt probably also helps to relax the blood vessels so that blood can flow more easily. These medications are used together when one drug is not controlling your blood pressure.
This medication is not recommended as the first medication for treating high blood pressure. Your doctor will usually start you on the individual medications first, and then switch you over to this combination product if this is the best dose combination for you.
How To Use
Take this medication by mouth with or without food as directed by your doctor, usually once or twice daily. If you take this drug too close to bedtime, you may need to wake up to urinate. It is best to take this medication at least 4 hours before your bedtime. Consult your doctor or pharmacist if you have questions about your dosing schedule.
If you are also taking cholestyramine or colestipol, take cilazapril/hydrochlorothiazide at least 4 hours before or at least 4 to 6 hours after either of those drugs.
The dosage is based on your medical condition and response to therapy.
Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick. It may take up to several weeks before the full benefit of this drug takes effect.
Inform your doctor if your condition worsens (such as your routine blood pressure readings increase).
Side Effects
Dizziness or lightheadedness may occur as your body adjusts to the medication. Nausea or dry cough may also occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.
Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
This product may cause dehydration and electrolyte imbalance. Tell your doctor right away if you have any symptoms of dehydration or electrolyte imbalance, including:
- extreme thirst
- very dry mouth
- muscle cramps/weakness
- fast/slow/irregular heartbeat
- confusion
Tell your doctor right away if you have any serious side effects, including:
- swelling of the hands/feet
- symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat)
- mental/mood changes
- numbness/tingling of the hands/feet
- muscle/joint aches
- decreased sexual ability/interest
- easy bruising/bleeding
- signs of kidney problems (such as change in the amount of urine)
- decrease in vision
- eye pain
This drug may rarely cause serious (possibly fatal) liver problems. Tell your doctor right away if you notice any of the following serious side effects:
- nausea/vomiting that doesn't stop
- unusual tiredness
- yellowing eyes/skin
- dark urine
- severe stomach/abdominal pain
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:
- rash
- itching/swelling (especially of the face/tongue/throat/neck)
- severe dizziness
- trouble breathing
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Precautions
Before taking this product, tell your doctor or pharmacist if you are allergic to either cilazapril or hydrochlorothiazide; or to other ACE inhibitors (such as captopril, lisinopril); or to other thiazides (such as chlorothiazide); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of:
- a history of an allergic reaction that included swelling of the face/lips/tongue/throat (angioedema)
- kidney problems (such as renal artery stenosis, inability to make urine)
- blood exchange procedures (such as apheresis, dialysis)
- liver disease
- gout
- untreated salt imbalance (such as high calcium, high/low potassium, low magnesium)
- dehydration
- lupus
- skin cancer
This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
Drink plenty of fluids while taking this medication to help prevent dizziness. Too much sweating, diarrhea, or vomiting may cause you to feel lightheaded. Avoid heavy exercise. Report prolonged diarrhea or vomiting to your doctor.
Before having surgery, tell your doctor or dentist that you are taking this medication.
This medication may make you more sensitive to the sun. It may also increase your risk for skin cancer, especially if you take it for a long time. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned, have skin blisters/redness, or notice new or changed moles/skin lesions.
This product may affect your potassium levels. Before using potassium supplements or salt substitutes containing potassium, consult your doctor or pharmacist.
If you have diabetes, this product may increase your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high blood sugar, such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.
Older adults may be more sensitive to the side effects of this drug, especially dizziness and change in the amount of urine (kidney problems).
Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using this medication. Cilazapril may harm an unborn baby. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication. (See also Warning section.)
This medication passes into breast milk. Consult your doctor before breast-feeding.
Drug Interactions
See also Precautions section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug are:
- aliskiren
- alpha blockers (such as prazosin, terazosin)
- certain nonsteroidal anti-inflammatory drugs-NSAIDs (such as celecoxib, ibuprofen, indomethacin)
- diazoxide
- dofetilide
- drugs that may increase the level of potassium in the blood (such as ARBs including losartan/valsartan, birth control pills containing drospirenone)
- certain drugs that weaken the immune system/increase the risk of infection (such as everolimus, sirolimus)
- lithium
- probenecid
- gold injections
- sacubitril
A very serious reaction may occur if you are getting injections for bee/wasp sting allergy (desensitization) and are also taking cilazapril with hydrochlorothiazide. Make sure all your doctors know which medicines you are using.
Some products have ingredients that could raise your blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).
This product can affect the results of certain lab tests (such as parathyroid, protein-bound iodide, tyramine and phentolamine tests). Make sure laboratory personnel and your doctors know you use this drug.
Overdose
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Alberta residents can call PADIS (Poison and Drug Information Service) 24 hours a day at 1-800-332-1414. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness.
Notes
Do not share this medication with others. Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.
Lab and/or medical tests (such as complete blood count, blood sodium and potassium levels, kidney function, liver function, skin exams) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
Check your blood pressure regularly while taking this medication, especially when you first start this drug or when your dose is changed. Learn how to monitor your own blood pressure at home, and share the results with your doctor.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
If you have questions about missing a dose or you don't have more medication, contact your healthcare provider or pharmacist.
Storage
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
