Drug & supplement interaction

Capsicum + Hydrochlorothiazide, Lisinopril

Hydrochlorothiazide, Lisinopril brand names: Zestoretic, Prinzide.

Minor Interaction
The bottom line Minor

Capsicum has a minor interaction with Hydrochlorothiazide, Lisinopril. Theoretically, using topical capsaicin may increase the risk of ACE inhibitor-induced cough.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Capsicum and Hydrochlorothiazide, Lisinopril

Here is the interaction we found between these two, with the evidence behind it.

Minor

ACE INHIBITORS (ACEIs)

Why this applies to Hydrochlorothiazide, Lisinopril

Hydrochlorothiazide, Lisinopril falls under ACE INHIBITORS (ACEIs) — the group Capsicum interacts with.

Theoretically, using topical capsaicin may increase the risk of ACE inhibitor-induced cough.
There is one case report of a topically applied capsaicin cream contributing to the cough reflex in a patient using an ACEI. However, it is unclear if this interaction is clinically significant.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for your Zestoretic (lisinopril with hydrochlorothiazide). One of lisinopril's most common quirks is a dry, nagging cough, which happens because ACE inhibitors let a chemical called bradykinin build up and irritate the airways. Capsaicin (from chili peppers) acts on the same nerve pathways that trigger the cough reflex, so in theory it could nudge that cough along.

I want to be honest about how thin this is. It comes from a single case report involving a topical capsaicin cream, and it's rated minor and unlikely. Eating spicy food almost certainly won't matter. If you use a capsaicin pain cream and notice a new or worsening dry cough, just mention it to your pharmacist or doctor before changing anything.

References
  1. Hakas JF Jr. Topical capsaicin induces cough in patient receiving ACE inhibitor. Ann Allergy 1990;65:322-3.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Capsicum Also Interacts With Other Medications

Capsicum has 215 moderate, 23 minor known drug interactions in our database — the Hydrochlorothiazide, Lisinopril one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Capsicum

Covers the 2,830 medications we’ve checked against Capsicum. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Hydrochlorothiazide, Lisinopril

This page covers Capsicum only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrochlorothiazide, Lisinopril page lists 236 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Dolomite (major).

By severity: 10 major · 199 moderate · 27 minor.

From our pharmacist’s overview on the Hydrochlorothiazide, Lisinopril page

“I would not add a supplement casually alongside hydrochlorothiazide and lisinopril (Zestoretic, Prinzide). This combination lowers blood pressure with a water pill plus an ACE inhibitor, and most interacting ingredients either drag pressure down too far or push back against the drug, while smaller groups strain the kidneys, drain potas…”

Reviewed by 2 · Jul 18, 2026

Open the Hydrochlorothiazide, Lisinopril interaction page

One more smart check

Taking Capsicum as Part of a Dietary Supplement Product? Check It for Interactions

We hold 4,130 real supplement products containing Capsicum, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Capsicum. Your product may carry other ingredients that interact with Hydrochlorothiazide, Lisinopril too, on top of Capsicum — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Capsicum and Hydrochlorothiazide, Lisinopril Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Capsicum
Top 5%

#50 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Hydrochlorothiazide, Lisinopril
Top half

#838 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Capsicum

What is Capsicum?

  • Nerve pain (neuropathy)
  • Muscle and joint pain (arthritis)
  • Back pain
  • Digestive support
  • Cluster headache (intranasal)

Capsicum (chili pepper) contains capsaicin, which is best known and best studied as a topical treatment for certain types of pain. Topical capsaicin products are supported by reasonable evidence for some nerve and joint pain, but oral supplements are far less proven. Use it carefully, follow product directions, and talk to your pharmacist or doctor before starting.

Read the full Capsicum monograph & all interactions
Medication

About Lisinopril and Hydrochlorothiazide

What Is Lisinopril and Hydrochlorothiazide Used For?

Brand names: Zestoretic, Prinzide

Lisinopril and hydrochlorothiazide tablets — sold as the brand Zestoretic and as the generic combination — are used to treat high blood pressure (hypertension). Lowering blood pressure reduces the risk of serious cardiovascular events such as stroke and heart attack.

This is a fixed-dose combination product and is not intended as a first-line (initial) treatment for high blood pressure. It is typically prescribed for patients whose blood pressure is not adequately controlled on a single medication alone.

See full Lisinopril and Hydrochlorothiazide drug information
Keep checking

Other Drugs & Capsicum

Browse every other medication we’ve checked against Capsicum — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
215Moderate
23Minor
2,591No known interaction
Moderate

215 interactions

Showing 60 of 215 moderate interactions — see all 215 on the Capsicum page.

Minor

23 interactions

No interaction 2,591 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Capsicum and Hydrochlorothiazide, Lisinopril Together: Common Questions

Can you take Capsicum with Hydrochlorothiazide, Lisinopril?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Capsicum and Hydrochlorothiazide, Lisinopril interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.