What is a significant box warning for Hydrochlorothiazide and Lisinopril?

Hydrochlorothiazide and Lisinopril both carry a significant box warning regarding pregnancy. This is particularly important because the use of angiotensin-converting enzyme (ACE) inhibitors, like Lisinopril, is known to pose a risk to fetal development, especially during the second and third trimesters. It can lead to severe fetal injury or even death, making it crucial for healthcare providers to advise against the use of these medications in pregnant patients or those who may become pregnant.

In these situations, the potential harm to the unborn child is significant enough to warrant such a warning. Women who are planning to conceive or who become pregnant while on Lisinopril should discuss alternative treatments with their healthcare provider. Hydrochlorothiazide also enters this category, as thiazide diuretics can negatively affect placental blood flow and fetal development, but the specific and prominent warning typically emphasizes the risks associated with Lisinopril.

Understanding this risk helps healthcare professionals ensure patient safety and informs prescribing practices effectively, particularly in vulnerable populations such as pregnant women.