Compare hydrochlorothiazide vs. Lisinopril

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Microzide
(hydrochlorothiazide )

Zestril
(lisinopril)

Removes water from the body, which lowers blood pressure. Microzide (hydrochlorothiazide (HCTZ)) is a well-tolerated water pill that's often the first-choice treatment for mild high blood pressure.Lowers blood pressure. Zestril (lisinopril) is a good blood pressure-lowering medicine that protects kidney function.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
4.48hydrochlorothiazide
Reviews for hydrochlorothiazide
47%
of people (All ages) say hydrochlorothiazide is worth it
31%
say it works well
16%
say it's a big hassle
139 reviews
Have you used Microzide (hydrochlorothiazide )?
Worth itNot sureNot worth it
Reviews for Lisinopril
61%
-14% worse vs. hydrochlorothiazide
51%
-20% worse vs. hydrochlorothiazide
14%
-2% worse vs. hydrochlorothiazide
687 reviews
Have you used Zestril (lisinopril)?
Worth itNot sureNot worth it
Side effects
hydrochlorothiazideLisinopril

The hydrochlorothiazide FDA package insert doesn’t have numbers about how common side effects are.

More about hydrochlorothiazide side effects »
  • Headache 4%
  • Dizziness 4%
  • Cough 3%
  • Low blood pressure 4%
  • Chest pain 2%
  • Kidney damage 10%
  • Fainting 7%
  • High potassium 6%
More Lisinopril side effects »
How it works
hydrochlorothiazideLisinopril
Microzide (hydrochlorothiazide (HCTZ)) is a thiazide diuretic (water pill) that makes you urinate more. It works in the kidneys to remove extra water and certain electrolytes, while lowering blood pressure and reducing swelling.Zestril (lisinopril) is an angiotensin converting enzyme (ACE) inhibitor. It blocks a chemical that tightens blood vessels. This makes blood vessels relax, which lowers blood pressure and allows more blood and oxygen to get to your heart and other organs.
Type of medication
hydrochlorothiazideLisinopril
Prescription onlyPrescription only
Available as
hydrochlorothiazideLisinopril
  • Pill
  • Pill
  • Liquid
Used for
hydrochlorothiazideLisinopril
Risk factors for serious side effects
hydrochlorothiazideLisinopril
  • Current electrolyte imbalance
  • Lower kidney function
  • Dehydration
  • History of sulfa allergies
  • History of gout
Detailed Microzide (hydrochlorothiazide ) risks & warnings »
  • Women of childbearing age
  • African descent
  • Current kidney problems
  • Medicines that increase potassium
  • Use of salt substitutes
Detailed Zestril (lisinopril) risks & warnings »
Pregnancy

Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

Research studies with real people found harmful effects on unborn babies, but the benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Kidneys and liver
hydrochlorothiazideLisinopril
  • Requires routine blood tests to check kidney function.
  • You'll need to have blood tests done to check your kidney function.
  • Protects kidney function, which is especially useful for people with diabetes or mild-to-moderate kidney disease.
Upsides and benefits
hydrochlorothiazideLisinopril
  • Does a good job getting rid of extra fluids in your body by making you urinate more.
  • A first-choice blood pressure treatment. Works especially well for people of African descent.
  • Lowers the risk of heart attack and stroke.
  • Good option if you have high blood pressure and heart failure.
  • Most people have very few side effects from Microzide (hydrochlorothiazide (HCTZ)).
  • Can be good for patients with osteoporosis since it raises the body's level of calcium.
  • A first-choice blood pressure treatment for many people.
  • Lowers the risk of heart attack and stroke.
  • Protects kidney function, which is especially useful for people with diabetes or mild-to-moderate kidney disease.
  • Recommended for anyone with heart failure since it lowers the risk of death and further damage to your heart.
  • Very cheap drug, and comes available as a liquid for children over 6 years of age.
Downsides and risks
hydrochlorothiazideLisinopril
  • Makes you urinate more often.
  • Microzide (hydrochlorothiazide (HCTZ)) doesn't work well in people with severe kidney problems.
  • It can increase the risk of gout attacks in people with poor kidney function or a history of gout.
  • People with a sulfa allergy may be allergic to Microzide (hydrochlorothiazide (HCTZ)).
  • Up to 10% of people can get a dry cough while using this medicine. It ranges from a mild tickle in the throat to a persistent hacking cough.
  • Requires a yearly blood test to see how the medicine is affecting your body.
  • Zestril (lisinopril) isn't safe to use if you're pregnant.
  • Doesn't work as well in people of African descent, and can cause a greater chance of face, tongue, or lip swelling.
Tips from our pharmacists for people taking the medication
hydrochlorothiazideLisinopril
  • Microzide (hydrochlorothiazide (HCTZ)) starts working in about 2 hours.
  • It makes you urinate more often, so don't take it at bedtime.
  • Can cause dizziness in the first few days.
  • Check your blood pressure 1 week after starting this medicine, and tell your doctor if it hasn't improved.
  • Tell your doctor about any tiredness or muscle weakness that doesn't go away.
  • Requires routine blood tests to check kidney function.
  • Can cause dizziness the first few days you're taking it.
  • Check your blood pressure about 1 week after starting Zestril (lisinopril), and tell your doctor if it hasn't improved.
  • Let your doctor know about any dizziness, tiredness, cough, or throat irritation that doesn't go away.
  • You'll need to have blood tests done to check your kidney function.
  • Don't take Zestril (lisinopril) if you're pregnant.
Learn more
More about hydrochlorothiazideSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Microzide (hydrochlorothiazide )?
Worth itNot sureNot worth it
More about LisinoprilSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Zestril (lisinopril)?
Worth itNot sureNot worth it