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Can Lisinopril and Hydroxyzine interaction lower blood pressure?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have been suffering from vertigo for the last week and have discovered a very high BP. The doctor did an MRI, and it is all clear. He primarily started me on Lisinopril. Also, have Hydroxyzine for intense anxiety. I took Hydroxyzine around 8 pm and Lisinopril at 10 pm. I woke up very dizzy and lightheaded, with a BP of 70/53 mmHg and a heart rate of 44, which passed in a couple of minutes. Is this cause for concern? Is it the interaction of the two medicines? Please help.

Thank you.

Hello,

Welcome to icliniq.com

I understand your concern.

Lisinopril and Hydroxyzine may have additive effects in lowering your blood pressure. You may experience headaches, dizziness, lightheadedness, fainting, and changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. What dose of Lisinopril do you take?

I hope this helps.

Please revert so I can assist you further.

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply.

It is a Lisinopril tablet 12.5 mg and Hydroxyzine 50 mg.

Thank you.

Hi,

Welcome back to icliniq.com

Lisinopril is always started at a low dose and preferably at night before going to bed because Lisinopril causes lower blood pressure. During 1st few days, take Lisinopril and Hydroxyzine for 10 mg or 12.5 mg. Hydroxyzine is a diuretic that also lowers blood pressure. The side effect is postural hypotension, which means lowering blood pressure when standing from a lying position. Hydroxyzine and Lisinopril both have additive effects. So, due to all this, your blood pressure dropped.

Depending upon your blood pressure level, take Lisinopril 5 mg at night. If it does not normalize blood pressure in a week, the dose can be increased to 10 mg. If this also does not normalize blood pressure, then take Lisinopril 10 mg and Hydroxyzine 12.5 mg. So, in this way, the dose should be gradually escalated. I practice this in most patients to keep them on the lowest anti-hypertensive amounts and save them from side effects.

I hope this helps.

Please revert so I can assist you further.

Thank you.

Medically reviewed byDr. K. Shobana
Published At October 21, 2022
Reviewed AtOctober 14, 2024

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