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The potassium losing effect of thiazide diuretics is usually attenuated by the potassium conserving effect of lisinoprilThe use of potassium supplementspotassium-sparing agents or potassium-containing salt substitutes and other medicinal products that may increase serum potassium levelsparticularly in patients with impaired renal function or diabetes mellitusmay lead to a significant increase in serum potassiumIf concomitant use of lisinopril/hydrochlorothiazide and any of these agents is requiredthey should be used with caution and with frequent monitoring of serum potassiumsee section 4.4

Hydrochlorothiazide and lisinopril can pass into breast milk and may harm a nursing babyTell your doctor if you are breast-feeding a baby.

Drinking alcohol can further lower your blood pressure and may increase certain side effects of this medicine.

In some patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidneywho have been treated with ACE inhibitorsincreases in blood urea and serum creatinineusually reversible upon discontinuation of therapyhave been seenThis is especially likely in patients with renal insufficiencyIf renovascular hypertension is also present there is an increased risk of severe hypotension and renal insufficiencyIn these patientstreatment should be started under close medical supervision with low doses and careful dose titrationSince treatment with diuretics may be a contributory factor to the aboverenal function should be monitored during the first few weeks of lisinopril/hydrochlorothiazide therapy.

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