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Procardia XL vs. Zestoretic

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Nifedipine ER (Procardia XL) and Zestoretic (lisinopril/hydrochlorothiazide) are both used to treat high blood pressure, but they work in different ways and belong to different drug classes. Nifedipine ER is a calcium channel blocker (CCB) that relaxes blood vessels to improve blood flow and is also used to treat chest pain (angina). It is available in both extended-release and immediate-release forms, though the latter is rarely prescribed due to more side effects. On the other hand, Zestoretic combines an angiotensin-converting enzyme (ACE) inhibitor (lisinopril) and a diuretic (hydrochlorothiazide) to lower blood pressure by relaxing blood vessels and removing excess water and electrolytes through the kidneys. Zestoretic is taken once daily and is known to cause a dry cough, a common side effect of ACE inhibitors, whereas nifedipine ER can cause swelling in the legs and feet. Additionally, Zestoretic is not safe for use during pregnancy, while nifedipine ER is considered one of the recommended medications for high blood pressure in pregnancy. Both medications are available in generic forms, making them more affordable options.

Nifedipine ER

(Procardia XL)

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Zestoretic

(lisinopril / hydrochlorothiazide)

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Summary for Procardia XL

Prescription only

Nifedipine (Procardia, Procardia XL) is a calcium channel blocker (CCB). It's used to treat certain heart conditions, such as chest pain (angina) and high blood pressure in adults. It mainly works by relaxing your blood vessels, making it easier for blood to flow. Nifedipine is available as an extended-release pill (ER) that's taken by mouth once daily, and a immediate-release pill (IR) that's taken three times a day. Keep in mind the nifedipine IR is rarely prescribed. Some side effects of nifedipine include swelling in the legs, dizziness, tiredness, and headache.

Indications for Procardia XL

  • Chest pain (angina)
  • High blood pressure (hypertension) - extended-release tablets only

Pros and Cons for Procardia XL

Pros

  • Lowers risk of heart attack and stroke in people with high blood pressure
  • Can take it alone or with other medications to help with blood pressure or chest pain
  • Calcium channel blockers, such as nifedipine ER (Procardia XL), work especially well for Black people to lower blood pressure
  • The extended-release tablets are taken once daily
  • Available as a lower-cost, generic form

Cons

  • Often causes swelling in the legs and feet
  • Not a good choice if you have heart failure because of risk for swelling
  • If you have severe heart disease, it can raise your risk of having a heart attack or worsening chest pain
  • The immediate-release capsule needs to be taken 3 to 4 times a day

Common Side Effects for Procardia XL

Extended-release tablets:

  • Swelling (edema) in the legs, feet, or hands (10-30%)
  • Headache (16%)
  • Fatigue (6%)
  • Dizziness (4%)

Immediate-release capsules:

  • Dizziness or lightheadedness (27%)
  • Flushing (25%)
  • Headache (23%)
  • Weakness (12%)
  • Nausea (11%)
  • Swelling (10%)

Warnings for Procardia XL

  • Low blood pressure
  • Risk of worsening chest pain or heart attack
  • Risk of heart failure
  • Swelling in legs and feet
  • Stomach or intestinal injury (extended-release form only)

Summary for Zestoretic

Prescription only

Zestoretic is a combination blood pressure medication for adults. It contains lisinopril (an angiotensin-converting enzyme (ACE) inhibitor) and hydrochlorothiazide (a thiazide diuretic). It comes as a tablet that's taken by mouth once per day. Your prescriber will determine your dosage based on how high your blood pressure is and if you're taking other blood pressure medications. Some of the more common side effects it can cause include dizziness, headache, and cough. Zestoretic (lisinopril / hydrochlorothiazide) is available as a generic.

Indications for Zestoretic

Pros and Cons for Zestoretic

Pros

  • Combines two medications in one pill
  • Taken by mouth
  • Taken once daily

Cons

  • Can make you urinate more often
  • Might not be appropriate for someone with a sulfa allergy
  • Shouldn't take during pregnancy or breastfeeding

Common Side Effects for Zestoretic

  • Dizziness (8%)
  • Headache (5%)
  • Cough (4%)
  • Extreme tiredness (4%)
  • Feeling lightheaded when standing after sitting or lying down (3%)

Warnings for Zestoretic

  • Not for use during pregnancy
  • Angioedema (swelling)
  • Low blood pressure
  • Kidney damage
  • Changes in electrolyte, blood sugar, and cholesterol levels
  • Vision problems
  • Lupus

Prices with our coupons for Procardia XL vs. Zestoretic

Price Card Drug Icon
Nifedipine ER (Procardia XL)30 tablets / 30mg
$13.60$44.85
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Price Card Drug Icon
Lisinopril/HCTZ90 tablets / 20mg/12.5mg
$16.90$68.24
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