Lisinopril and hydrochlorothiazide and Sulfamethoxazole and trimethoprim interaction

Lisinopril and hydrochlorothiazide and Sulfamethoxazole and trimethoprim: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Lisinopril and hydrochlorothiazide (Zestoretic) label · effective 2025-03-31

Major

Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs.

Contraindicationsby drug classView label on DailyMed
Moderate

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy.

Warningsby drug classView label on DailyMed
Minor

Hydrochlorothiazide Acute Myopia and Secondary Angle-Closure Glaucoma: Hydrochlorothiazide, a sulfonamide, can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma.

Warningsby drug classView label on DailyMed

From the Sulfamethoxazole and trimethoprim (SULFATRIM) label · effective 2026-01-05

Moderate

Drug Interactions In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported.

Drug interactionsby drug classView label on DailyMed
Moderate

In the literature, three cases of hyperkalemia in elderly patients have been reported after concomitant intake of sulfamethoxazole/trimethoprim and an angiotensin converting enzyme inhibitor.

Drug interactionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.