Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor. It is used to treat cases of high blood pressure for conditions such as congestive heart failure. It is also used to improve the chance of survival after a heart attack. Common brand names of this drug include Prinivil, Qbrelis, and Zestril.

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor. This means it blocks the production of angiotensin II. This is a substance that inhibits the angiotensin-converting enzyme and narrows blood vessels. Angiotensin II also releases hormones such as aldosterone and norepinephrine.

It is used to decrease the levels of these substances in the body. This improves blood flow and relieves pressure on the kidneys. Lisinopril also increases bradykinin production. Bradykin is another substance that dilates the blood vessels in the body.

Lisinopril Precautions and Warnings

Lisinopril has a boxed warning. This is the highest category of serious warnings issued by the Food and Drug Administration (FDA). Boxed warnings for this drug include:

  • Lisinopril should be avoided during pregnancy as it can be harmful or even fatal to the unborn child.
  • Lisinopril has been associated with swelling in the face, arms, legs, mouth, and intestines, which can be life-threatening. Individuals who are Black or have a history of angioedema are at a higher risk of experiencing this swelling.
  • Within the initial days of lisinopril treatment, low blood pressure may occur. Dehydration, excessive sweating, diarrhea, vomiting, heart failure, dialysis, or the use of diuretics can increase the likelihood of this side effect.
  • A persistent cough may develop while taking lisinopril. This typically resolves once the medication is discontinued.

Lisinopril Side Effects

Lisinopril can cause a range of both common and severe side effects.

Common Side Effects

Common symptoms typically resolve within a few days to a couple of weeks. Some of the most common side effects of lisinopril include:

  • Headache
  • Dizziness
  • Persistent cough
  • Low blood pressure
  • Chest pain

Sever Side Effects

Severe adverse effects may include:

  • Signs of a hypersensitivity allergic reaction, such as facial swelling, lip swelling, tongue swelling, throat swelling, breathing difficulties, swallowing difficulties, and abdominal pain
  • Kidney issues characterized by fatigue, breathlessness, weight gain, or swelling in the limbs
  • Liver failure characterized by jaundice, elevated liver enzymes, abdominal pain, nausea, and vomiting
  • Elevated potassium levels that could result in irregular heartbeats

Drug Interactions with Lisinopril

Lisinopril has the potential to interact with various medications, herbs, or vitamins that you may be taking. These interactions can alter the way lisinopril works and may have harmful effects or reduce the effectiveness of the drugs you are taking.

Blood Pressure Medication

Taking certain blood pressure medications along with lisinopril can increase the risk of low blood pressure, high blood potassium levels, and kidney problems, including kidney failure. These drugs include angiotensin receptor blockers (ARBs) such as:

ACE/Renin Inhibitors

It may also interact with angiotensin-converting enzyme (ACE) inhibitors such as:

  • Benazepril
  • Captopril
  • Enalapril
  • Fosinopril
  • Moexipril
  • Perindopril
  • Quinapril
  • Ramipril
  • Trandolapril

Diabetes Medication

Combining diabetes medications with lisinopril may further lower your blood sugar levels. These drugs include insulin and oral diabetes medications.

Water Pills

Taking water pills along with lisinopril can cause your blood pressure to drop too low. Examples of these diuretics include:

  • Hydrochlorothiazide
  • Chlorthalidone
  • Furosemide
  • Bumetanide

Potassium Supplements

The use of potassium supplements or potassium-sparing diuretics along with lisinopril can lead to increased levels of potassium in your body. Lisinopril can also enhance the effects of lithium, potentially resulting in an increased occurrence of side effects. Examples of these drugs include:

  • Spironolactone
  • Amiloride
  • Triamterene

Pain Medication

Taking certain pain medications alongside lisinopril can decrease your kidney function. These drugs include nonsteroidal anti-inflammatory drugs (NSAIDs) such as:

  • Ibuprofen
  • Naproxen
  • Diclofenac
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Sulindac
  • Flurbiprofen

Other Drug Interactions

The combination of injectable gold (sodium aurothiomalate) with lisinopril can raise the risk of a nitritoid reaction. Symptoms of this reaction may include flushing, nausea, vomiting, and low blood pressure.

Drugs commonly prescribed for heart failure, such as neprilysin inhibitors, should not be used at the same time as lisinopril. It is recommended to avoid taking lisinopril within 36 hours of starting or stopping a neprilysin inhibitor. Combining these drugs increases the risk of angioedema, which is characterized by sudden swelling of various body parts. An example of a neprilysin inhibitor is sacubitril.

The risk of angioedema, a severe allergic reaction, is increased when taking drugs used to prevent rejection of organ transplants with lisinopril. These drugs include:

  • Temsirolimus
  • Sirolimus
  • Everolimus

Strengths and Dosages of Lisinopril

The typical dosing for lisinopril is determined by age, weight, and reason for which the medication is described. Typical doses include:

Reason PrescribedAge GroupTypical Dose
High Blood PressureAdultStarting dose of 5mg to 10 mg once daily

Maintenance dose of 20 mg to 40 mg once daily

High Blood PressureChild (6 years or older)tarting dose of 0.07 mg/kg of body weight for up to 5 mg once daily

Maximum dose of 0.61 mg/kg for up to 40 mg daily

Heart FailureAdultStarting dose of 5 mg daily

Maximum dose of 40 mg once daily

Heart AttackAdultDose of 5 mg by mouth once daily for 2 days

Follow-up doses of 10 mg daily for a minimum of 6 weeks

Diabetic Nephropathy (Off-Label Use)AdultStarting dose of 10 mg

Maximum dose of 40 mg

Lisinopril Alternatives

Alternatives to lisinopril may be prescribed depending on the reason the drug is being taken.

Alternatives for High Blood Pressure

Alternative medications for high blood pressure include:

Alternatives for Heart Failure

Alternative medications for heart failure include:

Alternatives for Heart Attack

Alternative medications for heart attack include:

Lisinopril FAQs

What is lisinopril used for?

Lisinopril is used to treat conditions such as high blood pressure and heart failure. It is also used to increase the chance of survival after a heart attack. It may be used alone or in combination with other drugs.

How long does it take for lisinopril to work?

The effects of lisinopril can begin kicking in as soon as within an hour of taking the dose. The drug should be taken at the same time every day for best results.

How long does it take for lisinopril side effects to go away?

Most people who take lisinopril do not experience any side effects. If side effects do occur, they are usually mild and go away quickly. Symptoms usually resolve within a few days or weeks.

How long does lisinopril stay in your system?

Lisinopril has a half-life of approximately 12 hours. This means it can be detected in your system for up to 48 to 60 hours after the last dose.

Why does lisinopril make you cough?

Clinical studies have shown that a cough is one of the most common side effects of lisinopril. This may occur when the dose is started or months later.

Why use lisinopril and metoprolol together?

Lisinopril is an ACE inhibitor while metoprolol is a beta blocker. The combination of these two types of drugs has been shown to have complementary effects for reducing heart problems.

What should I avoid while taking Lisinopril?

Patients prescribed lisinopril are advised to avoid consuming foods with moderately high or high potassium content. Excessive potassium intake may lead to high levels of potassium in the blood. Use of salt substitutes or potassium supplements should be avoided while taking lisinopril unless instructed by a healthcare provider.

Why can’t you eat bananas with lisinopril?

Consumption of bananas or other potassium-rich foods in conjunction with ACE inhibitor use may lead to excessive potassium levels in the body. This may potentially result in severe heart complications.

Which is stronger losartan or lisinopril?

The usual dose of losartan ranges from 25 mg to 100 mg daily. The usual dose for lisinopril is 5 mg to 40 mg daily. Both drugs are proven to be effective. However, losartan is often given in higher daily doses.

When is the best time to take lisinopril?

The suggested time of day to take lisinopril may depend on the patient and provider. While the time of day may vary, the drug should be taken at the same time each day for best results.

What happens if you take too much lisinopril?

Excessive consumption of this lisinopril can lead to a decrease in blood pressure. This may lead to fainting. In the event that you suspect an overdose, take immediate action by contacting your physician, local Poison Control Center, or visiting the nearest emergency room.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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