Lisinopril

Key highlights to know about lisinopril include:

• Lisinopril is used to treat high blood pressure in adults and children (ages 6 years and over), treat heart failure, and improve survival after a heart attack.
• Lisinopril is administered by mouth and is usually administered once per day.
• Lisinopril is typically a low cost drug, which is defined in this article as costing less than $30 per month.
• Lisinopril is available as an oral tablet and solution. The oral solution is available as a brand-name medication only (Qbrelis), while the tablet is available as a brand-name (Zestril, Prinivil) and generic medication.

People who use lisinopril should be aware of these safety warnings:

• Fetal toxicity warning: Lisinopril may cause harm to an unborn baby. Administration of lisinopril during the second and third trimesters of pregnancy can worsen kidney function and potentially increase the risk of death in an unborn baby. Stop lisinopril as soon as possible if you become pregnant.
• Angioedema warning: Lisinopril can cause abrupt swelling of the face, arms, leg, lips, tongue, throat, and intestines (angioedema). This can be fatal. Tell your doctor right away if you have swelling or abdominal pain, and discontinue lisinopril. You may be administered medication to reduce your swelling. Swelling can occur at any time while taking lisinopril. Your risk may be higher if you have a history of angioedema.
• Kidney function warning: Lisinopril may cause changes in kidney function. For this reason, periodic monitoring is recommended. If kidney function significantly declines, your doctor may withhold or stop lisinopril.
• Hypotension warning: Lisinopril can cause low blood pressure (hypotension), especially if you have heart or kidney diseases. If you have these conditions, blood pressure should be monitored closely for the initial 2 weeks of treatment and whenever the lisinopril dose is increased.
• Hyperkalemia warning: Lisinopril can lead to an increase in potassium levels in your blood (hyperkalemia). Potassium levels should be monitored periodically.
• Liver failure warning: Lisinopril may cause jaundice (yellowing of the skin or eyes) or an increase in liver enzymes. If this occurs, lisinopril should be stopped and the appropriate treatment administered.

Talk with your doctor about these warnings in the context of your individual treatment plan and medical history.

This medication is used to:

• treat high blood pressure in adults and children 6 years of age and older, and this may be alone or in combination with other medications
• treat heart failure in combination with other medications
• improve survival after a heart attack

Doctors sometimes prescribe medications for different uses. Ask your doctor or pharmacist for information about other uses for this medication.

Lisinopril is a prescription drug that belongs to a class of medications called angiotensin-converting enzyme (ACE) inhibitors. Lisinopril relaxes the blood vessels in your body, resulting in a lowering of blood pressure and less stress on your heart.

It comes as an oral tablet and an oral solution that are both taken by mouth. The oral solution is available as a brand-name medication only (Qbrelis), while the tablet is available as a brand-name (Zestril, Prinivil) and generic medication.

Lisinopril side effects are possible and may go away with continued use. Serious side effects are rare.

The more common side effects that occur with lisinopril include:

• headache
• dizziness
• cough
• low blood pressure
• chest pain

Call your doctor right away if you have serious side effects. Seek emergency care (call 911) if you experience life threatening symptoms, such as:

• difficulty breathing
• chest pain
• a loss of consciousness
• sudden vision changes
• swelling of the face, mouth, tongue, or throat

Serious side effects and their symptoms can include the following:

• Angioedema. Symptoms can include:
  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, intestines, or lower legs
  • difficulty breathing or swallowing
  • hoarseness
• Liver failure. Symptoms can include:
  • yellowing of the skin or eyes
  • nausea
  • upper right abdominal pain
• Low blood pressure. Symptoms can include:
  • lightheadedness
  • fainting
• Leukopenia/neutropenia (low blood levels of cells that fight infection). Symptoms can include:
  • fever
  • a sore throat
  • chills

Other side effects are possible. Talk with your doctor or pharmacist if you have any side effects that bother you or that do not go away.

Without insurance, lisinopril is considered a low cost drug, which is defined in this article as costing less than $30 per month. You can check the out-of-pocket cash pay price for lisinopril on prescription drug discount websites.

With insurance, prices can vary considerably. Individual health plans may have preferred drugs with better pricing. If the price of lisinopril on your health plan is too expensive, ask your doctor or pharmacist if there is an equivalent drug you can substitute.

Lisinopril may interact with other prescription and over-the-counter medications, vitamins, or herbal supplements you may be taking. To help avoid harmful interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbal supplements you are taking. To find out how this drug might interact with something else you are taking, talk with your doctor or pharmacist.

This is not a complete list of drugs that may interact with lisinopril. However, examples of drugs that may interact with lisinopril include the following.

• hydrochlorothiazide (Microzide, Esidrix)
• furosemide (Lasix)
• chlorthalidone (Hygroton, Thalitone)
• bumetanide (Bumex)
• torsemide (Demadex)

Diuretics are often used in combination with lisinopril to treat cardiac disease. It is important that people taking this combination monitor their symptoms and report any changes to their healthcare professional. Taking these medications with lisinopril can result in blood pressure that is too low.

These include:

• spironolactone (Aldactone)
• amiloride (Midamor)
• triamterene (Dyrenium)

People taking the medications above in conjunction with lisinopril should monitor their symptoms and report any changes to their doctor. Taking these medications with lisinopril can increase potassium in your body.

These include:

• angiotensin II receptor blockers, such as:
  • azilsartan (Edarbi)
  • candesartan (Atacand)
  • eprosartan (Teveten)
  • irbesartan (Avapro)
  • losartan (Cozaar)
  • olmesartan (Benicar)
  • telmisartan (Micardis)
  • valsartan (Diovan)
• ACE inhibitors, such as:
  • benazepril (Lotensin)
  • captopril (Capoten)
  • enalapril (Epaned, Vasotec)
  • fosinopril (Monopril)
  • moexipril (Univasc)
  • perindopril (Aceon)
  • quinapril (Accupril)
  • ramipril (Altace)
  • trandolapril (Mavik)
• renin inhibitors, such as aliskiren (Tekturna)

Taking these medications with lisinopril may increase your risk of developing low blood pressure, high blood potassium (hyperkalemia), and kidney problems. If you are taking one of the medications listed above along with lisinopril, you should bring it to the attention of your healthcare professional.

These include:

• insulin
• oral diabetes medications

In rare cases, taking these medications with lisinopril can lower your blood sugar too much.

These include:

• nonsteroidal anti-inflammatory drugs (NSAIDs)
• aspirin (Bayer Plus, Bufferin)
• celecoxib (Celebrex)
• diclofenac (Voltaren, Cambia)
• ibuprofen (Advil, Motrin)
• indomethacin (Indocin, Tivorbex)
• naproxen (Aleve, Naprosyn)
• sulindac (Clinoril)

Taking these medications with lisinopril can reduce your kidney function. NSAIDs can also reduce the effectiveness of lisinopril.

Disclaimer: Since drugs interact differently in each person, this information is not guaranteed to include all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare professional about possible interactions with all prescription drugs, vitamins, herbal supplements, and over-the-counter drugs you are taking.

This drug comes with alerts and warnings.

If your doctor has recommended lisinopril, it is worth being aware of these warnings:

• For people with kidney disease: Lisinopril may affect kidney function. Your doctor may monitor your kidney function during therapy. If you have worsening kidney function, you may require a reduced dose of lisinopril.
• For Black patients: Lisinopril may not work as well as in non-Black people to reduce blood pressure.
• For children: Lisinopril has not been studied in children younger than 6 years of age with high blood pressure.

Call your doctor right away if you have serious side effects. Seek emergency care (call 911) if you experience life threatening symptoms, such as:

• difficulty breathing
• chest pain
• a loss of consciousness
• sudden vision changes
• swelling of the face, mouth, tongue, or throat

The following sections provide useful information to know if you are pregnant or breastfeeding.

Lisinopril may cause harm to an unborn baby. Administration of lisinopril during the second and third trimesters of pregnancy can worsen kidney function and potentially increase the risk of death in an unborn baby. Stop lisinopril as soon as possible if you become pregnant.

It is unknown if this drug passes into human breast milk or if this drug has effects on the breastfed infant or on milk production. Because no information is available on the use of lisinopril during breastfeeding, a different drug should be considered. You should not breastfeed during treatment with lisinopril.

Lisinopril is administered by mouth and typically taken once daily.

The tablet is available in the following strengths:

• 2.5 milligrams (mg)
• 5 mg
• 10 mg
• 20 mg
• 30 mg
• 40 mg

The oral solution is available in a strength of 1 mg per milliliter.

The dosages for hypertension are as follows.

• The adult dosage is as follows:
  • initial: 10 mg once daily
  • usual range: 20–40 mg once daily
• The pediatric dosage (for those ages 6 years and older) is based on body weight and administered daily.

The dosages for heart failure are as follows.

• When administered with diuretics, the adult dosage is as follows:
  • initial: 5 mg once daily, unless low sodium levels are present, in which case it is 2.5 mg once daily
  • maximum: 40 mg once daily

The dosages for improving survival after a heart attack are as follows.

• When given within 24 hours after onset of heart attack symptoms, the adult dosage is as follows:
  • The person will take 5 mg orally, followed by 5 mg after 24 hours, 10 mg after 48 hours, and then 10 mg once daily.
  • They must continue taking this medication for at least 6 weeks.
  • If low blood pressure is present, the initial dose is 2.5 mg for the first 3 days.

If you miss a dose of lisinopril, take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

If you skip or miss doses, your blood pressure or heart failure may not improve. It may even worsen.

If you take too much lisinopril, you have a higher risk of having side effects caused by this drug. Symptoms of overdose may include lightheadedness or fainting. If you think you have taken too much of this drug, call your doctor or local poison control center at 800-222-1222.

Seek emergency care (call 911) if you experience life threatening symptoms, such as:

• difficulty breathing
• chest pain
• a loss of consciousness
• sudden vision changes
• swelling of the face, mouth, tongue, or throat

Keep these considerations in mind if your doctor prescribes lisinopril for you.

• To remember to take lisinopril, take it around the same time each day.
• For the oral solution, use an oral syringe made especially for liquid medication. Do not use a household spoon to measure your dose.
• In most situations, your lisinopril dose will start low and gradually be increased by your doctor.
• Do not use salt substitutes containing potassium without talking with your doctor.
• Report lightheadedness, especially during the first few days of lisinopril therapy, to your doctor.

• Store lisinopril at room temperature of 68°F to 77°F (20°C to 25°C).
• Do not freeze this drug.
• Protect this drug from excessive heat.

The use of alcohol can increase the blood pressure-lowering effects of lisinopril. This may cause you to feel dizzy or faint. If you are concerned about taking lisinopril while drinking alcohol, talk with your doctor.

Your doctor will write the number of authorized refills on your prescription. Talk with your pharmacist if you have questions about refills.

When planning to travel, keep these tips in mind for packing your medication:

• Bring enough medication for the full number of days of your trip, plus at least 2 days to be safe.
• When flying, keep your medication with you in a purse or a carry-on bag. Do not put it into a checked bag in case you are separated from your luggage.
• Liquid, gel, cream, and aerosol medications are exempt from the 3-1-1 liquid rule for flying.
• Keep your medications in their original containers, if possible, to reduce delays during airport or security screening. Keep all your medications together to quicken the process.
• Avoid leaving your medication in a parked car for extended periods to protect it from extreme temperatures.

Before starting and during your treatment with lisinopril, your doctor may check the following to see if this drug is working or to monitor for side effects:

• blood pressure
• liver function
• kidney function
• blood potassium

This medication is commonly stocked at pharmacies.

Insurance companies may require a prior authorization for lisinopril, particularly for brand-name versions (Prinivil, Zestril, Qbrelis). This means that your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Lisinopril is classified as an ACE inhibitor. There are several ACE inhibitors available that work similarly to lisinopril. These include:

• benazepril (Lotensin)
• captopril (Capoten)
• enalapril (Epaned, Vasotec)
• fosinopril (Monopril) 
• moexipril (Univasc)
• perindopril (Aceon)
• quinapril (Accupril)
• ramipril (Altace) 
• trandolapril (Mavik)  

Do not stop taking this drug unless instructed by your doctor.

This information is for educational purposes only. It should not be interpreted as medical advice, diagnosis, or treatment. Healthgrades takes every effort to ensure this information is accurate and up to date. This content is not intended to cover all possible uses, side effects, warnings, precautions, allergic reactions, or drug interactions. Do not assume that the absence of such information means the medication is safe for your personal use. Always consult your doctor, pharmacist, or healthcare professional before taking or discontinuing any medication.