Drug interactions
Hydrochlorothiazide-lisinopril + Tizanidine
Severity: Moderate
Hydrochlorothiazide-lisinopril and Tizanidine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Tizanidine is a centrally acting alpha-2 agonist that lowers blood pressure, so adding it to an ACE inhibitor and thiazide may cause additive hypotension. Dizziness, syncope and bradycardia can occur, especially at initiation.
What this interaction means in plain words
Hydrochlorothiazide-lisinopril and Tizanidine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Hydrochlorothiazide-lisinopril belongs to Cardiovascular; Tizanidine belongs to Musculoskeletal.
Why it happens
Additive blood pressure lowering from central alpha-2 agonism plus diuretic and ACE inhibitor effects.
What to do
Monitor blood pressure and heart rate when starting or increasing tizanidine, and reduce the dose or antihypertensives if symptomatic hypotension occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Hydrochlorothiazide-lisinopril
- Dofetilide + Hydrochlorothiazide-lisinopril Contraindicated
- Hydrochlorothiazide-lisinopril + Sacubitril / valsartan Contraindicated
- Amifostine + Hydrochlorothiazide-lisinopril Major
- Amiloride + Hydrochlorothiazide-lisinopril Major
- Benazepril + Hydrochlorothiazide-lisinopril Major
- Bendroflumethiazide + Hydrochlorothiazide-lisinopril Major
Other interactions of Tizanidine
- Ciprofloxacin + Tizanidine Contraindicated
- Fluvoxamine + Tizanidine Contraindicated
- Pefloxacin + Tizanidine Contraindicated
- Pipemidic acid + Tizanidine Contraindicated
- Benzhydrocodone / acetaminophen + Tizanidine Major
- Brexanolone + Tizanidine Major
Frequently asked questions
Can I take Hydrochlorothiazide-lisinopril with Tizanidine?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-lisinopril and Tizanidine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Tizanidine is a centrally acting alpha-2 agonist that lowers blood pressure, so adding it to an ACE inhibitor and thiazide may cause additive hypotension. Dizziness, syncope and bradycardia can occur, especially at initiation.
How serious is the interaction between Hydrochlorothiazide-lisinopril and Tizanidine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure and heart rate when starting or increasing tizanidine, and reduce the dose or antihypertensives if symptomatic hypotension occurs.
What other medicines interact with Hydrochlorothiazide-lisinopril?
MediHelp also lists interactions of Hydrochlorothiazide-lisinopril with, for example, Dofetilide, Sacubitril / valsartan, Amifostine. The full list is on the Hydrochlorothiazide-lisinopril page.
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