Compare Hydrochlorothiazide vs. Lisinopril

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

Microzide
(Hydrochlorothiazide )

Zestril
(Lisinopril)

Lowers blood pressure. Removes extra water from your body. 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.
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Reviews & ratings
Button Group. All currently active
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4.467153284671533Hydrochlorothiazide
Reviews for Microzide (Hydrochlorothiazide (Hctz))
47%
of people say Microzide (Hydrochlorothiazide (Hctz)) is worth it
31%
say it works well
15%
say it's a big hassle
Reviews for Zestril (Lisinopril)
61%
+14% vs. Microzide (Hydrochlorothiazide (Hctz))
51%
+20% vs. Microzide (Hydrochlorothiazide (Hctz))
13%
+2% vs. Microzide (Hydrochlorothiazide (Hctz))
Side effects
HydrochlorothiazideLisinopril

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

More about Hydrochlorothiazide side effects »
  • Dizziness 7%
  • Headache 4%
  • Cough 3%
  • Diarrhea 2%
  • Chest pain 2%
  • Fatigue 2%
  • Upper respiratory infection 1%
More Lisinopril side effects »
How it works
HydrochlorothiazideLisinopril
Microzide (Hydrochlorothiazide (Hctz)) is a thiazide diuretic (water pill). It works in the kidneys to make you urinate more, which removes extra water and certain electrolytes. This lowers blood pressure and 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
Antihypertensive
Diuretic
Prescription only
Antihypertensive
ACE inhibitor
Prescription only
Available as
HydrochlorothiazideLisinopril
  • Pill
  • Pill
Used for (click to learn more)
HydrochlorothiazideLisinopril
Risk factors for serious side effects
HydrochlorothiazideLisinopril
  • Current electrolyte imbalance
  • History of sulfa allergies
  • History of gout
  • Current kidney problems
    Detailed Microzide (Hydrochlorothiazide (Hctz)) risks & warnings »
    • Women of childbearing age
      • African descent
      • Current kidney problems
      • Medicine that increase potassium
      • Use of salt substitute
      Detailed Zestril (Lisinopril) risks & warnings »
      Pregnancy category
      HydrochlorothiazideLisinopril
      BFDA pregnancy category (Probably safe)

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

      See the FDA package insert
      DFDA pregnancy category (Weigh risks vs. benefits)

      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.

      See the FDA package insert
      Alcohol
      No specific alcohol-related info.No specific alcohol-related info.
      Food
      No specific food-related info.No specific food-related info.
      Kidneys and liver
      • Doesn't work well in people with severe kidney problems.
      • Requires routine blood tests to check kidney function.
      • Protects kidney function, which is especially useful for people with diabetes or mild-to-moderate kidney disease.
      • Requires routine blood tests to check kidney function.
      Sex
      No specific sex-related info.No specific sex-related info.
      Sleep
      No specific sleep-related info.No specific sleep-related info.
      Weight
      No specific weight-related info.No specific weight-related info.
      Upsides and benefits
      HydrochlorothiazideLisinopril
      • Works well to get rid of extra fluids in your body through urination.
      • A first-choice blood pressure treatment for many people. Works especially well for African Americans.
      • Good option if you have both high blood pressure and heart failure.
      • Raises calcium levels in the body, so it can be good for people with osteoporosis to slow down bone loss and even help with new bone formation.
      • Most people have very few side effects.
      • Lowers the risk of heart attack and stroke.
      • A first-choice blood pressure treatment for many people.
      • 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.
      • Lowers the risk of heart attack and stroke.
      Downsides and risks
      HydrochlorothiazideLisinopril
      • Makes you urinate more often.
      • Doesn't work well in people with severe kidney problems.
      • Up to 1 in 10 people can get a dry cough with 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.
      • Not safe to use if you're pregnant.
      Tips from our pharmacists for people taking the medication
      HydrochlorothiazideLisinopril
      • Starts working in about 2 hours.
      • Makes you urinate more often, so avoid taking it at bedtime.
      • Tell your doctor about any dizziness, fatigue, or muscle weakness that doesn't go away.
      • 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.
      • Requires routine blood tests to check kidney function.
      • Tell your doctor about any dizziness, fatigue, cough, or throat irritation that doesn't go away.
      • Don't take it if you're pregnant.
      • 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.
      • Requires routine blood tests to check kidney function.
      Learn more
      More about HydrochlorothiazideSide effectsReviews & ratingsAlternativesFDA package insert
      More about LisinoprilSide effectsReviews & ratingsAlternativesFDA package insert