Lisinopril

💊 What is Lisinopril used for?

• •High blood pressure (hypertension) in adults and in children 6 years of age and older
• •Adjunct (added-on) therapy for heart failure
• •Treatment of acute myocardial infarction (heart attack)

How it works

How it is usually taken

• •The label describes lisinopril as a tablet taken by mouth. The label says the usual dosing schedule is once daily. Your prescriber or pharmacist will give you the exact instructions for your situation. Dosing is adjusted based on blood pressure response, according to the label.

Comes as

• •2.5 mg tablets (white to off-white, capsule-shaped)
• •5 mg tablets (yellow, capsule-shaped)
• •10 mg tablets (light pink, capsule-shaped)
• •20 mg tablets (dark pink, capsule-shaped)
• •30 mg tablets (red, capsule-shaped)
• •40 mg tablets (yellow, capsule-shaped)

⚠️ Lisinopril side effects

🛑 Who should not take Lisinopril, and who should be careful

The label says not to take it if

• 🚨You have a history of angioedema or hypersensitivity related to previous treatment with an ACE inhibitor.
• 🚨You have hereditary or idiopathic angioedema.
• 🚨You are taking a neprilysin inhibitor such as sacubitril. The label says lisinopril is contraindicated with this combination.
• 🚨You are switching to or from sacubitril/valsartan. The label says not to give lisinopril within 36 hours of switching.
• 🚨You have diabetes and are taking aliskiren. The label says not to combine these in patients with diabetes.

Tell your doctor before taking it if

• •The label says to tell your prescriber if you are pregnant or might become pregnant.
• •The label says to tell your prescriber if you are breastfeeding, because women are advised not to breastfeed during treatment.
• •Tell your prescriber if you have ever had angioedema, including swelling related to any ACE inhibitor.
• •Tell your prescriber if you have diabetes and take insulin or oral diabetes medicines, because the label says lisinopril may increase blood-glucose lowering.
• •Tell your prescriber about any water pills (diuretics), NSAIDs (pain or anti-inflammatory medicines), lithium, or gold treatments you use.
• •Tell your prescriber if you are on dialysis or have kidney disease, heart disease, or liver problems, since the label lists monitoring for these conditions.
• •The label says not to use salt substitutes that contain potassium without first consulting your physician.
• •The label notes that excessive sweating, dehydration, vomiting, or diarrhea may lead to a larger drop in blood pressure.

🔀 Lisinopril with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Diuretics (water pills): may cause an excessive drop in blood pressure when lisinopril is started. The label says the dose may need to be reduced.
• •Potassium-sparing diuretics (such as spironolactone, amiloride, or triamterene): may increase the risk of high potassium (hyperkalemia).
• •Diabetes medicines (insulins and oral hypoglycemic agents): may increase blood sugar lowering and the risk of low blood sugar (hypoglycemia).
• •NSAIDs, including COX-2 inhibitors: may lead to worsening kidney function and may reduce the blood pressure effect of lisinopril.
• •Other drugs that act on the renin-angiotensin system (angiotensin receptor blockers, aliskiren): the label says combined use increases the risk of low blood pressure, high potassium, and kidney changes.
• •Lithium: may cause symptoms of lithium toxicity.
• •Gold: the label says nitritoid reactions have been reported.
• •mTOR inhibitors (such as temsirolimus, sirolimus, everolimus) or neprilysin inhibitors: may increase the risk of angioedema.

Alcohol and food

The label does not say.

🤰 Lisinopril in pregnancy and breastfeeding

Pregnancy

The label says lisinopril can cause fetal harm when given to a pregnant woman. Use of drugs that act on the renin-angiotensin system during the second and third trimesters reduces fetal kidney function and increases fetal and neonatal illness and death. When pregnancy is detected, the label says to discontinue lisinopril as soon as possible.

Breastfeeding

The label advises women not to breastfeed during treatment with lisinopril.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at 20 °C to 25 °C (68 °F to 77 °F). Protect from light, moisture, and freezing. Keep in a tight, light-resistant container.

If a dose is missed

The label does not say.

If too much is taken

The label says the most likely effect of an overdose is low blood pressure (hypotension). The usual treatment is intravenous infusion of normal saline solution. Lisinopril can be removed by hemodialysis.

🗒️ Questions to ask about Lisinopril

• What blood pressure goal am I aiming for, and how will we know if lisinopril is working?
• What should I do if I become pregnant or think I might be pregnant?
• Do any of my other medicines, such as water pills, diabetes medicines, or pain relievers, interact with lisinopril?
• How often will I need blood tests to check my kidney function and potassium levels?
• What signs of swelling or allergic reaction should make me call for help right away?
• Is it safe for me to use salt substitutes or potassium supplements while taking lisinopril?

❓ Lisinopril: frequently asked questions