Drug & supplement interaction

Potassium + Hydrochlorothiazide, Lisinopril

Hydrochlorothiazide, Lisinopril brand names: Zestoretic, Prinzide.

Moderate Interaction
Medically reviewed by · Updated October 2026
The bottom line Moderate

Potassium has a moderate interaction with Hydrochlorothiazide, Lisinopril. Using ACEIs with high doses of potassium increases the risk of hyperkalemia.

Read the full interaction report
SeverityModerate
LikelihoodLikely
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Potassium and Hydrochlorothiazide, Lisinopril

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

Moderate

ACE INHIBITORS (ACEIs)

Why this applies to Hydrochlorothiazide, Lisinopril

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

Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion. Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia. However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels.
Severity Moderate Likelihood Likely Evidence C

Well-controlled human studies have demonstrated the likely existence of this interaction.

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

Here's the thing to keep an eye on with your Zestoretic. The lisinopril half is an ACE inhibitor, and one of the ways it works is by telling your kidneys to hold onto a little more potassium instead of flushing it out. So if you add a concentrated potassium supplement on top of it, potassium can climb too high in your blood, a condition called hyperkalemia. That can cause muscle weakness, tingling, a slow or irregular heartbeat, and in serious cases dangerous heart rhythm problems.

The good news is that normal potassium from food (fruits and veggies) usually does not cause this. It's the supplement-strength doses that raise the risk. Interestingly, the hydrochlorothiazide part actually tends to lower potassium, but don't count on it to fully cancel things out. Please check with your pharmacist or doctor before starting any potassium pills, since you may need a quick blood test.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Phillips, C. O., Kashani, A., Ko, D. K., Francis, G., and Krumholz, H. M. Adverse effects of combination angiotensin II receptor blockers plus angiotensin-converting enzyme inhibitors for left ventricular dysfunction: a quantitative review of data from ra DOI
  3. Malta D, Arcand J, Ravindran A, Floras V, Allard JP, Newton GE. Adequate intake of potassium does not cause hyperkalemia in hypertensive individuals taking medications that antagonize the renin angiotensin aldosterone system. Am J Clin Nutr 2016 Oct;104(4 PubMed

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

Potassium Also Interacts With Other Medications

Potassium has 61 moderate 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.

Moderate 61 No known interaction 2,769 (incl. Hydrochlorothiazide, Lisinopril)
Taking anything else?

Check Another of Your Medications Against Potassium

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

From our Q&A

Questions About Potassium or Hydrochlorothiazide, Lisinopril

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Potassium or Hydrochlorothiazide, Lisinopril, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Hydrochlorothiazide, Lisinopril

This page covers Potassium 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 Potassium as Part of a Dietary Supplement Product? Check It for Interactions

We hold 22,782 real supplement products containing Potassium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Potassium. Your product may carry other ingredients that interact with Hydrochlorothiazide, Lisinopril too, on top of Potassium — 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 Potassium 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 Potassium
Top 1%

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

29 days ago today
Medication Hydrochlorothiazide, Lisinopril
Top half

#748 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 Potassium

What is Potassium?

  • Preventing or treating low potassium (hypokalemia)
  • Supporting healthy blood pressure
  • Muscle cramps
  • Replacing losses from diuretics or vomiting/diarrhea
  • General electrolyte balance

Potassium is an essential mineral your body needs for nerve signals, muscle function, and a steady heartbeat, and most people get enough from a balanced diet rich in fruits and vegetables. Potassium supplements can help when blood levels are truly low, but too much potassium can be dangerous, especially for people with kidney problems. Always talk with your pharmacist or doctor before taking a potassium supplement.

Read the full Potassium monograph & all interactions
Medication

About Lisinopril and Hydrochlorothiazide

What Is Lisinopril and Hydrochlorothiazide Used For?

Brand names: Zestoretic, Prinzide

Lisinopril and hydrochlorothiazide tablets — sold under the brand name Zestoretic and as the generic combination — are used to treat high blood pressure (hypertension). Lowering blood pressure reduces the risk of serious cardiovascular events, including strokes and heart attacks.

This combination is not intended as a first-line starting treatment. It is typically used when a single blood pressure medication alone has not been enough to reach target blood pressure goals.

See full Lisinopril and Hydrochlorothiazide drug information
Keep checking

Other Drugs & Potassium

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

0Major
61Moderate
0Minor
2,768No known interaction
61 Moderate 2,768 No interaction
Moderate

61 interactions

Showing 60 of 61 moderate interactions — see all 61 on the Potassium page.

No interaction 2,768 drugs checked — show the list

We also checked Potassium against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,768 medications checked with no known interaction — see the full Potassium list.

See the full Potassium interactions page
See every supplement checked against Hydrochlorothiazide, Lisinopril, ranked by severity
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

Keep exploring
Potassium monograph › Uses, safety, and every drug interaction in one place Hydrochlorothiazide, Lisinopril supplement interactions › Every supplement checked against Hydrochlorothiazide, Lisinopril, ranked by severity Lisinopril and Hydrochlorothiazide drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Potassium and Hydrochlorothiazide, Lisinopril Together: Common Questions

Can you take Potassium with Hydrochlorothiazide, Lisinopril?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Potassium and Hydrochlorothiazide, Lisinopril interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Hydrochlorothiazide, Lisinopril and Potassium?

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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.