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Doctors' Answers to "Frequently Asked Questions" - Zestril

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 08/21/2000]
Question: Hello,

I have been using Zestril 10 mg for over 2 years now.
Last autumn my bloodpressure was back to normal and
I started using only 1 pil per 2 days as my doctor adviced.

Now my bloodpressure is still OK, sometimes lowish (110/70) and I have a cough and mucus which may be related to the Zestril, as I found out on the net.

My question: Is it OK to stop taking Zestril by now?
If so, will there be any bodily reactions I should expect?

Thanks, Rob

Answer: Usually the cough from zestril occurs right away or not at all and there is no mucous formation from the drug. So, I suspect the cough has nothing to do with the zestril. Whether or not your bp is "ok" is easily checked by stopping the zestril, you are on a pretty small dose now anyway. If above 135/85(off the zestril), most would recommend continued treatment, possibly a smaller dosage.

[posted 08/25/2000]
Question: Have been put on zestril for high blood pressure, am expercience light headiness, is this a normal reaction, and will it continue, or is maybe dose to high, on 20mg. Blood pressure last visit was 170/90-thank you

Answer: Not usual unless your bp is too low. Check it yourself at home, 20 mg is higher than most would start. Usually we start at 5 or 10 mg and work up checking bp. If you have bp problems you will be best off having a home cuff(about 60-70$). Most large pharmacies have self actuating cuffs which are the next best alternative.

[posted 07/21/2000]
Question: Can Zestril taken for hypertension also help Prostate
problems? I don't have prostate cancer. I do have a
swollen prostate and have difficulty urinating. My
PSI test is completly normal.

Answer: Not likely.

[posted 06/8/2000]
Question: My doctor recently increased the dosage on my daily Zestril
from 10mg to 20mg. I seem to have trouble concentrating
and remembering details the way I used to. I am 44 and
in otherwise good health. Can Zestril cause memory loss,
inability to concentrate or general sluggishness?

Answer: Not usually unless your blood pressure is too low. Check your bp at home and see if it is too low. Many patients are overtreated if they use the bp at the md's office rather than on their home/office conditions.

[posted 04/4/2000]
Question: i had been on diltiazem er 240 mg. for the past 5 years.my blood pressure has been almost perfect.my doctor has suddenly decided to change my prescription to zestril.after taking this drug for 3 days i am nauseated,light headed,sleepy and tired,numbness on right side of my face.i called the dr,he says to continue taking this medicine .also he has cahnged the type and dosage of my insulin 4 times in the last three months.(4 different kinds of insulin)will these sudden changes in my meds.harm me in some way??right now i feel awful sick .this is due to the medicine im sure.what do i do?

Answer: Why was it changed if it was working? Zestril can decrease diabetic renal problems, but so can the calcium channel blockers. It is not worth the side effects, if you were previously controlled.

[posted 04/6/2000]
Question: After finding small doses of protein in my urine, my doctor has recommended that I begin taking an ACE Inhibitor, Zestril, to keep slow the damage being done on my kidneys. I do not have high blood pressure and am worried about this drug taking my blood pressure to a dangerously low rate. I am also concerned with this drug causing low blood sugar spells and tiredness. Do you have any suggestions? Is the prescription for this drug a death sentence prolonged? Thank you very much!

Answer: Take the Zestril, it does slow renal damage and generally has no side effects. If it lowers your blood pressure excessively it can be decreased or stopped. Depending on your bp, most doctors start low and move up checking renal function as they do.

[posted 04/6/2000]
Question: How does the ACE inhibitor drug "Zestril" work in preventing diabetic kidney damage?

Answer: Not clear but it does(in most patients), probably by decreasing the levels of angiotensin in the blood. Research is in progress.

[posted 03/12/2000]
Question: I am IDDM DIABETIC. I have been on zestril for 2 months now and I have a question of side effects. My periods for the past 2 months have been irregular. The first one was a week late and the second one was another week late. The only thing that I can begin to attribute this to is the zestril. Could this be a side effect of it or no?

Answer: Wouldn't think so.

[posted 02/10/2000]
Question: I have been taking zestril for about 12 months 5 Mg once a day. For the last 3 weeks I have had an extremely bad cough.All mucus coughed up has been for the most part clear. I went to the doctor last week am now taking 500 MG of of Biaxin twice a day for 10 days . The cough was better for a few days but has come back. My doctor told me it could be the Zestril . My father has the same bad cough every winter. I really don't think it is the Zestril but of course I am not a doctor . Your imput is greatly appreciated.

Answer: If it was to be the zestril, it would have occurred when you started the medication, also, the cough of zestril is not productive. This isn't the drug.

[posted 11/21/1999]
Question: Six days ago I started taking Zestril 10mg. This morning I upon awakening, my tongue was swollen on the left side-almost to the point of not being able to talk. It seemed to peak in about an hour and gradually started to go down. I did not take the days dose of Zestril as I thought this might be the cause. My doctor says there is a remote chance. He is changing my medication tomorrow. Have you heard of other reactions like this? Maybe it is just my imagination, but I seemed to feel so much better after taking Zestril for a couple of days -that I hate to stop taking it if the tongue problem was unrelated. Thank you-

Answer: Not a common problem, but the onset after starting the zestril is too suspicious to continue the zestril -especially since there are so many other options. I agree with your doctor.

[posted 11/21/1999]
Question: I, currently, take zestril and toprol to control tachcardia.
The zestril makes me cough, alot. Is there anything, natural or manmade that will help?

Thank you

Answer: Cough medications will help, but a better solution is to switch to the Angiotensin Receptor Blocker Drugs, Cozaar, Avapro and the like. These work in a similar way, but usually produce no cough.

[posted 11/11/1999]
Question: Can taking Hydrochlorothiazide and Zestril, either together or separate, result in depression, mood swings, etc. I have been on one or both for several years and the depression and mood swings are terrible. I never had them until I started all the drugs. Can you help?

Answer: Not usually, but would be easy to have a drug holiday if you coordinate it with your md and check your blood pressure to see if they are the cause.

[posted 08/26/1999]
Question: I have been taking Zestril, 5mg, for 3 weeks. I have been extremly sleepy, fatigued and with no energy. I am usually energetic and always in high spirits. Is this a side effect of the medicatio and if it is what can I do to counter the symtom? Thank you.

Answer: This could be a side effect, but would be very uncommon unless your blood pressure is very low on the medication. If it is the medication, you'll need another mediction.

Zestoretic [posted 11/11/98]
Question: What are the side effects to taking Zestoretic? Could it cause arthritis?

Answer: Zestoretic is a combination of Zestril an ACE inhibitor and hydrochlorothiazide a diuretic. Neither would be prone to cause arthritis unless there was an allergic inflammatory component, very uncommon with either.

Zestral General Information [posted 11/11/98]
Question: Would you please tell me about the drug Zestral. What kind of a drug is it? I know it's for treating blood pressure. Thank you very much.

Answer: Zestril is an ACE inhibitor. This is a class of drugs which inhibits the enzyme responsible for converting renin to angiotensin(a hormone which causes your blood vessels to narrow, and spasm). Since it is selective to the enzyme, there are usually only rare side effects. Renal function must be watched and 4-5% will experience a cough(which will last as long as you take the drug). Very effective drugs used in many problems with blood pressure and circulation with usually beneficial effects.

Zestril and Tiredness [posted 8/12/98]
Question: My boyfriend has been taking 20 mg zestril for high blood pressure for about 6 weeks. For the last three weeks he has been staying extremely tired and usually falls asleep every time he sits down. Do you think he needs to see about having the dosage reduced or could something else be wrong?

Answer: Try stopping the medication for one to two days. If he markedly improves, it is the medication. If not, it is something else. Many men who have mild hypertension suffer from sleep apnea - different problem, but very treatable. Does he snore? Does he stop breathing? Maybe that's the problem.

Zestril Dosage [posted 7/30/98]
Question: 10 mg per day of Zestril does not seem to lower my blood pressure from undesirable 150/95 (age 72). Before discussing with my doctor I would like to know if this is generally considered a low, medium, or high dosage.

Answer: The ACE inhibitors (of which Zestril is one) work to inhibit Angiotensin formation from Renin (a hormone made by the kidney). So, if they are not working you have too low a dose or you do not produce much renin (so called low renin hypertension). 25% of Whites and 75% of Blacks, Indians, etc., have low renin hypertension. So, if the Zestril is not working switch to a drug which is effective in low renin hypertension, diuretics or calcium channel blockers. This is an average dose of Zestril.

Zestril [posted 7/23/98]
Question: I'm taking Zestril and recently started taking 200mcg of Selenium as well as 400iu of Vitamin E. Is there any reason why this combination should result in an elevated heart rate?

Answer: None of these should.

Zestril and PPH
Question: Has anyone made a connection between Zestril and the development of PPH?

Answer: This is not known to me, but you could check with the company Zeneca at 302-886-8000. They will have a complete list of all reported side effects. However, this is rare to non-existent.

Zestril and Atenolol
Question: Could you please give me some information on the drugs Atenolol and Zestril? I need to know what they are used for and the side effects of each. Also, can they be used together?

Answer: Zestril is a "Ace inhibitor". This is a class of drugs which block the conversion of renin to angiotensin by blocking the enzyme in the lung responsible for this conversion. Hence, angiotensin converting enzyme inhibitors (ACE). This class of drugs has remarkably few side effects except for cough. Occasional people develop a rash or other problems, but most don't know they are taking it.
Atenolol is a selective beta-blocker. Beta Blockers are common drugs used to treat many different problems. They are very effective in treating hypertension, angina, rapid heart beats, and have been used to treat stage fright and occasionally anxiety. They also have similar side effects. Beta Blockers come as selective and non-selective. The non-selective beta-blockers can cause some bronchospasm and asthma. The selective blockers can also, but much less frequently. Common side effects to both selective and non-selective beta blockers are fatigue, slow heart rate, nausea, nightmares and difficulty sleeping, impairment of insulin release, depression, and occasional skin rash. These drugs should never be stopped abruptly and require a tapering if discontinued.
Beta-blockers and ACE inhibitors are used together commonly since they act in different manners in treating hypertension.

Question: How can I use another drug instead of "Zestril"?

Answer: Easy tell your doctor the problem and ask to switch. Other classes that are commonly used are beta-blockers, diuretics and calcium channel blockers.

Liver & Kidneys
Question: After a very general search, I found this e-mail opportunity. Can you tell me if the use of Zestril would inhibit the functions of the liver and the kidneys. Specifically, could the Zestril interfere with the body process of eliminating alcohol and give a higher reading on blood-alcohol testing equipment.

Answer: It has no interaction with alcohol or alcohol metabolism. It can occasionally inhibit renal function in occasional patients.

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