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Tell your doctor if you have kidney or liver disease, if you have had severe vomiting or diarrhea or think you may be dehydrated, and if you are taking angiotensin-converting enzyme ace inhibitors such as benazepril lotensin , captopril capoten , enalapril vasotec , fosinopril, lisinopril prinivil, zestril , moexipril univasc , perindopril aceon , quinapril accupril , ramipril altace , and trandolapril mavik ; or diuretics water pills .

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Zestril may be used as monotherapy or in combination with other classes of antihypertensive therapysee sections 4.34.44.5 and 5.1

If you experience any of the following reactionsstop taking Zestril and see your doctor immediately:

Like all medicinesthis medicine can cause side effectsalthough not everybody gets them.

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Thiazides may reduce the renal excretion of cytotoxic medicinal productse.gcyclophosphamidemethotrexateand potentiate their myelosuppressive effectssee section 4.4

ACE-inhibitors and angiotensin II receptor blockers should not be used concomitantly in patients with diabetic nephropathy.

Breast-feeding Tell your doctor if you are breast-feeding or about to start breastfeedingZestoretic is not recommended for mothers who are breast-feedingand your doctor may choose another treatment for you if you wish to breast-feedespecially if your baby is newbornor was born prematurely.

Severe sweatingdiarrheaor vomiting can increase the risk for lightheadedness or a serious loss of body waterdehydrationReport prolonged diarrhea or vomiting to your doctorTo prevent dehydrationdrink plenty of fluids unless your doctor directs you otherwise.

In patients receiving thiazideshypersensitivity reactions may occur with or without a history of allergy or bronchial asthmaExacerbation or activation of systemic lupus erythematosus has been reported with the use of thiazides.

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Atrial SeptostomyIf medications don’t control your pulmonary hypertensionthis open heart surgery might be an optionIn an atrial septostomya surgeon will create an opening between the upper left and right chambers of your heartatriato relieve the pressure on the right side of your heartLung TransplantationIn some casesa lung or heart lung transplant might be an optionespecially for younger people who have idiopathic pulmonary arterial hypertension.

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