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There is limited experience with hydrochlorothiazide during pregnancyespecially during the first trimesterAnimal studies are insufficient.

Take the missed dose as soon as you rememberSkip the missed dose if it is almost time for your next scheduled doseDo not take extra medicine to make up the missed dose.

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

Elevations in serum potassium have been observed in some patients treated with ACE inhibitorsincluding lisinoprilPatients at risk for the development of hyperkalaemia include those with renal insufficiencydiabetes mellitusor those using concomitant potassium-sparing diureticspotassium supplements or potassium-containing salt substitutesor those patients taking other drugs associated with increases in serum potassiume.gheparinthe combination trimethoprim/sulfamethoxazole also known as co-trimoxazoleIf concomitant use of the above-mentioned agents is deemed appropriateregular monitoring of serum potassium is recommendedsee section 4.5

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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