Lisinopril: 7 things you should know
Medically reviewed by Carmen Pope, BPharm. Last updated on March 31, 2023.
1. How it works
- Lisinopril may be used to treat high blood pressure and heart failure, or to lower the risk of death after a heart attack.
- Lisinopril works by inhibiting an enzyme called angiotensin-converting enzyme (ACE). This enzyme is involved in the production of angiotensin II, a powerful vasoconstrictor (a substance that narrows the arteries), which also stimulates the release of the hormone, aldosterone, from the adrenal glands (aldosterone increases blood pressure). By inhibiting this enzyme, lisinopril dilates (opens up) the arteries, and reduces how hard the heart has to work to pump blood around the body which lowers blood pressure.
- Lisinopril belongs to a group of medicines known as angiotensin-converting enzyme (ACE) inhibitors.
- May be used to treat high blood pressure in adults and children over the age of six. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events (such as strokes and heart attacks).
- Effective at reducing the signs and symptoms of heart failure.
- May increase survival odds when given within 24 hours of a heart attack (myocardial infarction).
- Generic lisinopril is available.
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- A headache and dizziness (the dizziness may be due to the blood pressure-lowering effect of lisinopril and may be more apparent when going from lying down to a sitting or standing position). Dizziness may also increase the risk of falls
- A dry, persistent cough. Blurred vision, sweating, urine changes, and increases in creatinine and potassium may also occur
- Rarely, lisinopril may adversely affect kidney function. Monitoring of kidney function and potassium levels should occur periodically in those receiving lisinopril.
- Allergic reactions, including angioedema (swelling of airways and facial areas), are rare, but possible after lisinopril administration. The risk may be increased in people who have already experienced angioedema unrelated to ACE inhibitor administration, and in people of African-American descent
- Dosages greater than 80mg may not be associated with a greater effect
- The dosage of lisinopril may need adjusting in people with moderate-to-severe kidney disease
- May interact with some other medications including other antihypertensives, medicines that also retain potassium, diuretics, NSAIDs, lithium, injectable sodium aurothiomalate, and aliskiren.
- Should not be given to pregnant women because it can cause harm to the fetus.
Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects
4. Bottom Line
Lisinopril can be used to treat high blood pressure and heart failure, and to increase survival following a heart attack. However, the development of a dry, hacking cough attributable to the drug may force discontinuation.
- Can be taken without regard to meals.
- Treatments that lower blood pressure, such as lisinopril, should always be part of a comprehensive cardiovascular risk reduction plan that also targets, if appropriate, cholesterol-lowering, diabetes risk reduction, exercise, weight loss, and smoking cessation.
- Ensure adequate hydration before starting lisinopril.
- Lisinopril may make you feel dizzy, especially in the first few weeks of therapy and when going from a sitting or lying down position to standing. Always take your time when standing up. Talk with your doctor if this feeling persists.
- Call emergency services if your throat, face, or lips show signs of swelling.
- Your doctor should monitor your kidney function and potassium levels regularly.
- For high blood pressure, continue this medication even if you feel well. High blood pressure does not usually have symptoms.
- Do not use salt substitutes or potassium supplements while taking lisinopril, unless recommended by your doctor.
- If you also have diabetes, you may need to monitor your blood sugar levels more closely during the first few weeks of lisinopril therapy.
- Do not use lisinopril if you are pregnant or trying to become pregnant.
6. Response and effectiveness
- Starts to lower blood pressure within an hour of administration with peak effects seen within 6 hours.
- Lower doses may be needed for kidney impairment.
Medicines that interact with lisinopril may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with lisinopril. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with lisinopril include:
- allopurinol (may enhance the potential for allergic reactions)
- antipsychotic agents (may enhance the blood pressure-lowering effect)
- NSAIDs, such as ibuprofen, diclofenac, and naproxen
- other ACE inhibitors (such as captopril or enalapril) or ARBs (such as candesartan or irbesartan)
- potassium supplements.
Lisinopril may also cause blood sugar levels to drop more than expected when taken with diabetes medication, including insulin. Increased blood sugar monitoring may be required.
Note that this list is not all-inclusive and includes only common medications that may interact with lisinopril. You should refer to the prescribing information for lisinopril for a complete list of interactions.
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- Lisinopril. Updated 08/2022. Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc. https://www.drugs.com/pro/lisinopril.html
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use lisinopril only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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