Taking Metoprolol, Hydrochlorothiazide and Lisinopril Together

In our latest question and answer, the pharmacist discusses whether or not metoprolol, hydrochlorothiazide and lisinopril can all be taken together safely.

Question

Should Metoprolol hct 50MG/ 25mg be taken together with Lisinopril 40 MG?

Asked by bobo On Feb 26, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Feb 28, 2018

Metoprolol/HCTZ is a two drug combination and consists of:

  • Metoprolol
  • Hydrochlorothiazide


Metoprolol/HCTZ can safely be taken with lisinopril and there is no interaction between the drugs.


Taking Metoprolol/HCTZ With Lisinopril

All three drugs (metoprolol, hydrochlorothiazide and lisinopril) are in different classes of medication. There could certainly be situations where all three are utilized in one individual. Below, we provide some more detailed information regarding each drug.


Metoprolol

Metoprolol is classified as a cardioselective beta blocker. It works to decrease both resting and non-resting heart rate and also can decrease cardiac output and blood pressure. While it can solely be used for blood pressure control, it more commonly is used to prevent heart failure and angina.


Hydrochlorothiazide

Hydrochlorothiazide is a "thiazide" diuretic and is also colloquially known as a "water pill". Thiazide diuretics are used in the management of high blood pressure and edema. It can also be used for heart failure.


Lisinopril

Lisinopril is classified as an ACE-Inhibitor, which are used for a variety of indications. Most commonly they are used to treat high blood pressure but can also be used for heart failure and heart attack prophylaxis.


Discussion

While metoprolol, hydrochlorothiazide and lisinopril are all classified as "blood pressure medications", they are grouped into 3 distinct classes:

  • Beta blockers (metoprolol)
  • Thiazide diuretics (hydrochlorothiazide)
  • ACE-Inhibitors (lisiniopril)


It is not uncommon for an individual to be on more than one blood pressure medication and all three (metoprolol, hydrochlorothiazide and lisinopril) can be taken together safely in certain individuals. One common situation where someone is taking more than one blood pressure medication is for the treatment of hypertension (i.e. high blood pressure).


Sometimes, one blood pressure medication doesn't control hypertension well enough. This is a common problem. In these situations, an additional anti-hypertensive medication, from a different class, is added on for additional control.


The 2014 JNC8 guidelines for the treatment of hypertension offers many possible solutions when it comes to medication. Initial therapy recommendations include:

  • Calcium channel blockers
  • ACE-Inhibitors
  • Angiotensin receptor blockers
  • Thiazide diuretics


Aside from lifestyle changes, the guidelines recommend to increase the dose of your initial therapy when blood pressure goals aren't reached or add a second (or third agent) from different classes as needed. If you have additional disease states being treated (e.g. heart failure), that may necessitate additional medications as well.


Summary

Metoprolol, hydrochlorothiazide and lisinopril are all considered "blood pressure medications" but are in distinct medication classes. There are situations where all can be used safely together.


About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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