Lisoretic 10mg/12.5mg Tablets
Package Leaflet: Information for the user
LISORETIC ® 10 MG/12.5 MG TABLETS _LISORETIC ® 20 MG/12.5 MG TABLETS_
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
• Keep this leaflet. You may need it again.
• If you have any further questions, please ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet:
1. What this medicine is and what it is used for
2. What you need to know before you take this medicine
3. How to take this medicine
4. Possible side effects
5. How to store this medicine
6. Contents of the pack and other information
_1. What this medicine is and what it is used for_
This medicine is used to treat high blood pressure (hypertension). It contains two medicines called lisinopril (as dihydrate) and hydrochlorothiazide.
• Lisinopril belongs to a group of medicines called ACE inhibitors. It works by making your blood vessels widen.
• Hydrochlorothiazide belongs to a group of medicines called diuretics (water tablets). It helps your body to get rid of water and salts like sodium in your urine.
These medicines work together to lower your blood pressure.
| 2. What you need to know before you take this medicine |
Do not take this medicine if:
• You are allergic to lisinopril or hydrochlorothiazide or any of the other ingredients of this medicine (listed in Section 6).
• You are allergic to ACE inhibitor or sulphonamide medicines. If you are not sure if this applies to you, please ask your doctor.
• You have ever had sudden swelling of the hands, feet, ankles, face, lips, tongue or throat, especially if this followed treatment with an ACE inhibitor. It may also have been difficult to swallow or breathe.
• You have hereditary angioedema (a condition that makes you more prone to the swelling described above). If you are not sure if this applies to you, please ask your doctor.
• You have severe kidney problems.
• You have a specific type of heart disease called aortic stenosis.
• You have high levels of potassium in the blood.
• You have stopped passing water (urine).
• You have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren.
• You have severe liver problems.
• You are more than 3 months pregnant (It is also better to avoid this medicine in early pregnancy - see pregnancy section).
Do not take this medicine if any of the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking this medicine.
Warnings and precautions
Talk to your doctor or pharmacist before taking this medicine if:
• You have a narrowing (stenosis) of the aorta (an artery in your heart), the heart valves (mitral valves) or the kidney artery.
• You have an increase in the thickness of the heart muscle (known as hypertrophic cardiomyopathy).
• You have problems with your blood vessels (collagen vascular disease).
• You have low blood pressure. You may notice this as feeling dizzy or light-headed, especially when standing up.
• You have kidney problems or you are having kidney dialysis or you have had a kidney transplant.
• You have liver problems.
• You have diabetes.
• You have recently had diarrhoea or vomiting (being sick).
• Your doctor has told you to control the amount of salt in your diet.
• You have high levels of cholesterol and you are having a treatment called 'LDL apheresis'.
• You have ever had a condition called systemic lupus erythematosus (SLE).
• You are of black origin as this medicine may be less effective. You may also more readily get the side effect 'angioedema' (a severe allergic reaction with swelling of the hands, feet, ankles, face, lips, tongue or throat).
• You are taking any of the following medicines used to treat high blood pressure:
- an angiotensin II receptor blocker (ARBs) (also known as sartans) for example valsartan, telmisartan, irbesartan), in particular if you have diabetes-related kidney problems.
- aliskiren
Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.
See also information under the heading ”Do not take this medicine"
You must tell your doctor if you think you are (or might become) pregnant. This medicine is not recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used at that stage (see pregnancy, breast-feeding and fertility section).
If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before taking this medicine.
Treatment for allergies such as insect stings
Tell your doctor if you are having or are going to have treatment to lower the effects of an allergy such as insect stings (desensitisation treatment).
If you take this medicine while you are having this treatment, it may cause a severe allergic reaction.
Operations
If you are going to have an operation (including dental surgery) tell the doctor or dentist that you are taking this medicine. This is because you can get low blood pressure (hypotension) if you are given certain local or general anaesthetics while you are taking this medicine.
Other medicines and this medicine
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines that you buy without a prescription and herbal medicines. This is because this medicine can affect the way some medicines work and some medicines can have an effect on this medicine. Your doctor may need to change your dose and/or to take other precautions.
In particular, tell your doctor or pharmacist if you are taking any of the following medicines:
• Other medicines for treatment of high blood pressure (antihypertensives).
• Water tablets (diuretic medicines).
• Non-steroidal anti inflammatory drugs (NSAIDs) such as indomethacin, used to treat pain and arthritis.
• Medicines for depression (tricyclic and tetracyclic antidepressants).
• Medicines for mental problems, including lithium.
• Aspirin (acetylsalicylic acid), if you are taking more than 3 grams each day.
• Medicines that can increase the amount of potassium in the blood such as potassium tablets, potassium sparing diuretics or salt substitutes that have potassium in them.
• Calcium salts.
• Insulin or medicines that you take by mouth for diabetes.
• Medicines to treat asthma.
• Medicines to treat nose or sinus congestion or other cold remedies (including those you can buy in the pharmacy).
• Medicines to suppress the body's immune response (immuno suppressants, such as ciclosporin).
• Allopurinol (for gout).
• Medicines for uneven heart beat problems (such as procainamide).
• Cardiac glycosides- Digoxin (to treat heart failure).
• Medicines that contain gold, such as sodium aurothiomalate, which may be given to you as an injection.
• Amphotericin B injection (to treat fungal infections).
• Carbenoxolone (to treat ulcers or inflammation in the gullet or in and around the mouth).
• Corticosteroids (steroid medicines).
• Corticotropin (a hormone).
• Medicines to treat constipation (stimulant laxatives).
• Colestyramine and colestipol (to lower cholesterol, prevent diarrhoea or reduce itching)
• Muscle relaxants such as tubocurarine.
• Trimethoprim (an antibiotic).
• Sotalol (a beta-blocker).
• Lovastatin (to lower cholesterol).
• Dextran sulphate (used in the treatment called 'LDL apheresis' to lower cholesterol).
• Chemotherapy for cancer (cytostatics).
• Other medicines known to have an effect on the heart called Torsades de pointes.
• An angiotensin II receptor blocker (ARB) or aliskiren (see also information under the headings ”Do not take this medicine" and "Warnings and precautions")
• Antiacids (for indigestion).
• Sedatives (to help you to sleep or reduce anxiety).
• A narcotic pain killer (e.g. codeine, dextropopoxyphene, diamorphine, morphine, pentazocine, pethidine).
• ACTH to test whether your adrenal glands are working properly.
• Pressor amines e.g. epinephrine (adrenaline) for hypertension, shock, heart failure, asthma or allergies.
• An mTOR inhibitor (e.g temsirolimus, sirolimus, everolimus).
Please note that when you are taking this medicine it may affect any tests your doctor may perform on blood or urine samples. Please remind your doctor you are taking this medicine if they ever want to carry out such a test.
Pregnancy, breast-feeding and fertility
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Pregnancy
You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking this medicine before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of this medicine. This medicine is not recommended in early pregnancy, and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.
Breast-feeding
Tell your doctor if you are breast-feeding or about to start breast-feeding. This medicine is not recommended for mothers who are breast-feeding, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your baby is newborn, or was born prematurely.
Taking this medicine with Food and Drink
You can drink alcohol while taking this medicine, however, medicines used to reduce blood pressure taken together with alcohol may cause dizziness or light-headedness. If you are concerned about how much alcohol you can drink while you are taking this medicine you should discuss this with your doctor.
Driving and using machines
• This medicine may cause occasional dizziness or tiredness which may have an effect on your ability to drive or use machines, especially at the start of treatment or when the dose is modified, or in combination with alcohol. If this happens to you, do not drive or use any tools or machines.
• You must wait to see how your medicine affects you before trying these activities.
| 3. How to take this medicine |
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
Once you have started taking this medicine your doctor may take blood tests. Your doctor may then adjust your dose so you take the right amount of medicine for you.
Taking your medicine
• Swallow the tablet with a drink of water.
• Try to take your tablets at the same time each day. It does not matter if you take this medicine before or after food.
• Keep taking this medicine for as long as your doctor tells you to, it is a long term treatment. It is important to keep taking this medicine everyday.
Taking your first dose
• Take special care when you have your first dose of this medicine or if your dose is
increased. It may cause a greater fall in blood pressure than later doses. xxm
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• This may make you feel dizzy or light-headed. If this happens, it may help to lie down. If you are concerned, please talk to your doctor as soon as possible.
Adults
• The recommended dose is one tablet once a day. Your doctor will prescribe the tablet that is the right strength for you.
• If necessary, your doctor may increase your dose to two tablets once a day.
Use in Children
• This medicine is not recommended for use in children.
If you take more of this medicine than you should
If you take more of this medicine than prescribed by your doctor, talk to a doctor or go to a hospital immediately. Take the medicine pack with you so that the tablets can be identified.
If you forget to take this medicine
• If you forget to take a dose, take it as soon as you remember. However, if it is nearly time for the next dose, skip the missed dose.
• Do not take a double dose to make up for a forgotten dose.
If you stop taking this medicine
Do not stop taking your tablets, even if you are feeling well, unless your doctor tells you to. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
| 4. Possible side effects |
Like all medicines, this medicine can cause side effects, although not everybody gets them. This medicine contains two medicines: lisinopril and hydrochlorothiazide. The following side effects have been seen with these individual medicines. This means they could also happen with this medicine.
Your doctor may take blood samples from time to time to check whether this medicine has had any effect on your blood.
Possible side effects with lisinopril
Severe allergic reactions (rare, may affect up to 1 in 1,000 people)
Stop taking this medicine, if you have a severe allergic reaction, see a doctor immediately. The signs may include sudden onset of:
• Swelling of your face, lips, tongue or throat. This may make it difficult to swallow.
• Severe or sudden swelling of your hands, feet or ankles.
• Difficulty breathing.
• Severe itching of the skin (with raised lumps).
Severe liver problems (very rare, may affect up to 1 in 10,000 people)
The signs may include:
• Yellowing of your skin or eyes, (jaundice) dark coloured urine or a loss of appetite.
If this happens to you, see a doctor immediately.
Other possible side effects:
Common (may affect up to 1 in 10 people)
• Headache.
• Feeling dizzy or light-headed, especially if you stand up quickly.
• Fainting.
• Diarrhoea, being sick (vomiting).
• Cough.
• Kidney problems (shown in a blood test).
Uncommon (may affect up to 1 in 100 people)
• Mood changes including feeling depressed.
• Tingling feeling such as 'pins and needles'.
• Spinning feeling (vertigo).
• Changes in the way things taste.
• Difficulty in sleeping.
• Heart attack or stroke, unusual heart beat.
• Change of colour in your fingers or toes.
• Runny nose.
• Feeling sick (nausea).
• Stomach pain and indigestion.
• Changes in blood tests that check how the liver is working.
• Itchiness, rashes
• Being unable to get an erection (impotence).
• Feeling weak or tired
• Increased levels of certain substances in your blood (urea, creatinine or potassium). Rare (may affect up to 1 in 1,000 people)
• Changes to some of the cells or other parts of your blood. The signs may include feeling tired and pale skin.
• Feeling confused.
• Changes in the way things smell, dry mouth.
• Skin rash with dark red, raised, itchy bumps (hives).
• Hair loss (alopecia).
• Psoriasis (a skin problem).
• Infection of the blood.
• Kidney failure.
• Enlarged breasts in men.
• Syndrome of inappropriate antidiuretic hormone secretion (SIADH).
• Low levels of sodium in the blood, which may cause weakness, tiredness, headache, feeling sick, being sick (vomiting) and cramps.
Very rare (may affect up to 1 in 10,000 people)
• Problems with your bone marrow or a reduced number of blood cells and/or platelets in your blood. You may notice tiredness, an infection (which may be serious), fever, sore throat, mouth ulcer, feeling breathless or that you bruise or bleed more easily.
• Swollen glands (lymph nodes).
• Increased immune response (autoimmune disease).
• Low levels of sugar in your blood (hypoglycaemia). The signs may include feeling hungry or weak, sweating and a fast heart beat.
• Suddenly feeling wheezy or short of breath (bronchospasm).
• Lung inflammation (which may make you feel breathless).
• Sinusitis (a feeling of pain and fullness behind your cheeks and eyes).
• Eosinophilic pneumonia. The signs include a combination of the following:
• sinusitis
• feeling like you have flu
• feeling more and more breathless
• pain in the area of your stomach or gut
• skin rash
• a feeling of 'pins and needles' or numbness of your arms or legs.
• Inflammation of the pancreas. This causes moderate to severe pain in the stomach.
• Swelling of the lining of the gut. This may cause sudden stomach pain, diarrhoea or make you be sick (vomit).
• Sweating.
• Severe skin disorder or rash. The symptoms include redness, blistering and peeling of the skin which may develop quickly and may include blistering in the mouth and nose.
• Passing less water (urine) than normal or passing no water.
Not known (frequency cannot be estimated from the available data)
• Seeing, feeling or hearing things that are not there (hallucinations).
• Flushing of your skin.
Possible side effects with hydrochlorothiazide (frequency not known)
• Inflammation of a salivary gland.
• A reduced number of blood cells and/or platelets in your blood. You may notice tiredness, an infection (which may be serious), fever, feeling breathless or that you bruise or bleed more easily.
• Loss of appetite.
• An increase in the amount of sugar (glucose) in your blood (hyperglycaemia).
• Sugar in your urine.
• An increase in the amount of uric acid in your blood.
• Altered levels of substances in your blood (low sodium, low potassium, low magnesium, low chlorides). You may notice muscle weakness, thirst, 'pins and needles', cramps or feeling sick.
• Raised or high levels of fats in your blood (including cholesterol).
• Feeling restless, depression.
• Difficulty sleeping.
• Tingling feelings such as 'pins and needles'.
• Feeling light-headed.
• Changes to your vision that can make things look yellow.
• Problems with your sight for a short time.
• Severe eye pain with redness and sudden blurred vision. If you have a suddenly painful red eye tell your doctor immediately; you may need treatment to avoid permanent loss of vision.
• A spinning feeling (vertigo).
• Feeling faint (especially when standing up).
• Damage to blood vessels causing red or purple spots in the skin.
• Difficulty breathing. You may feel breathless if your lungs get inflamed or have fluid on them.
• Stomach irritation, diarrhoea or constipation
• Inflammation of the pancreas. This causes moderate to severe pain in the stomach.
• Yellowing of your skin or the whites of your eyes (jaundice).
• Skin problems including rash caused by sensitivity to sunlight, rash, severe rash that develops quickly with blistering or peeling of the skin and possibly blistering in the mouth, activating or worsening of existing lupus conditions or a rash of purple spots on the skin or appearance of unusual skin reactions.
• Allergic reactions
• Muscle cramps and muscle weakness.
• Kidney problems which may be severe (shown in blood tests).
• Fever.
• Weakness.
Do not be concerned by this list of possible side effects. You may not get any of them.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.
| 5. How to store this medicine |
• Keep this medicine out of the sight and reach of children.
• Do not use this medicine after expiry date (EXP) which is stated on the carton. The expiry date refers to the last day of that month.
• Do not store above 250C. Store in the original package.
• Do not throw away any medicines via waste water or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
| 6. Contents of the pack and other information |
What this medicine contain
• The active substances are Lisinopril (as dihydrate) and Hydrochlorothiazide.
• This medicine come in two strengths, 10 mg/12.5 mg and 20 mg/12.5 mg.
Each tablet contains either 10 mg of lisinopril (as dihydrate) and 12.5 mg of hydrochlorothiazide or 20 mg lisinopril (as dihydrate) and 12.5 mg of hydrochlorothiazide.
The other ingredients of the tablets are: calcium hydrogen phosphate, mannitol, maize starch, pregelatinised starch and magnesium stearate. 10 mg/12.5 mg tablets also contain ferric oxide red (E172) and ferric oxide yellow (E172).
What this medicine looks like and contents of the pack
• 10 mg/12.5 mg tablets are light pink, circular, biconvex uncoated tablets.
• 20 mg/12.5 mg tablets are white to off white circular, biconvex uncoated tablets.
• This medicine come in packs containing 28 tablets.
Marketing Authorisation Holder and Manufacturer Name and address: Bristol Laboratories Ltd,
Unit 3, Canalside, Northbridge Road, Berkhamsted, Hertfordshire, HP4 1EG, United Kingdom Telephone: 0044 (0)1442 200922
Fax: 0044 (0)1442 873717
Email: info@bristol-labs.co.uk
USORETIC ® 10 mg/12.5 mg Tablets; PL 17907/0073 USORETIC ® 20 mg/12.5 mg Tablets; PL 17907/0074 This leaflet was last revised in June 2016
To request a copy of this leaflet in Braille, large print or audio, please contact the licence holder at the address (or telephone, fax, email) above.
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