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As with other ACE inhibitors.lisinopril may be less effective in lowering blood pressure in black patients than in non-black patients.possibly because of a higher prevalence of low-renin states in the black hypertensive population.

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Thiazides may decrease urinary calcium excretion and may cause intermittent and slight elevation of serum calciumMarked hypercalcaemia may be evidence of hidden hyperparathyroidismThiazides should be discontinued before carrying out tests for parathyroid function.

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Concomitant use of certain anaesthetic medicinal productstricyclic antidepressants and antipsychotics with ACE inhibitors may result in further lowering of blood pressuresee section 4.4

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As with other antihypertensiveslisinopril/hydrochlorothiazide combination products may have a mild to moderate influence on the ability to drive and use machinesEspecially at the start of the treatment or when the dose is modifiedand also when used in combination with alcoholbut these affects depend on the individual’s susceptibility

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