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Lisinopril: Side effects, dosage, uses, and more

Important warnings

  • Angioedema (swelling): This drug can cause abrupt swelling of your face, arms, legs, lips, tongue, throat, and intestines. This can be fatal. Tell your doctor right away if you have swelling or abdominal pain. You’ll be taken off of this drug and possibly given medication to reduce your swelling. Swelling can happen at any time while you’re taking this drug. Your risk may be higher if you have a history of angioedema.
  • Hypotension (low blood pressure): This drug can cause low blood pressure, especially during the first few days of taking it. Tell your doctor if you feel lightheaded, dizzy, or like you’re going to faint. You may be more likely to have low blood pressure if you:
    • aren’t drinking enough fluids
    • are sweating heavily
    • have diarrhea or are vomiting
    • have heart failure
    • are on dialysis
    • take diuretics

    What is lisinopril?

    Lisinopril oral tablet is a prescription drug that’s available as the brand-name drugs Prinivil and Zestril. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

    Why it’s used

    This drug is used to treat high blood pressure and heart failure. It’s also used to improve your chance of survival after a heart attack.

    This drug may be used as part of a combination therapy. That means you may need to take it with other drugs.

    How it works

    This drug belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors.

    A class of drugs is a group of medications that work in a similar way. They have a similar chemical structure and are often used to treat similar conditions.

    This drug relaxes the blood vessels in your body. This reduces stress on your heart and lowers your blood pressure.

    Lisinopril side effects

    Lisinopril oral tablet does not cause drowsiness. However, it may cause low blood pressure. This can make you feel faint or dizzy. You shouldn’t drive, use machinery, or do other activities that require alertness until you know how this drug affects you. Lisinopril can also have other side effects.

    More common side effects

    The most common side effects that occur with lisinopril include:

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

    If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

    Serious side effects

    Call your doctor right away if you have any of these serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

    • hypersensitivity (allergic) reaction. Symptoms include:
      • swelling of your face, lips, tongue, or throat
      • trouble breathing
      • trouble swallowing
      • stomach (abdomen) pain with or without nausea or vomiting
      • tiredness
      • swelling, especially of your hands, feet, or ankles
      • shortness of breath
      • weight gain
      • yellowing of your skin and the whites of your eyes
      • elevated liver enzymes
      • stomach pain
      • nausea and vomiting

      Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

      Lisinopril may interact with other medications

      Lisinopril oral tablet can interact with other medications, herbs, or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or cause the drugs that you take to not work as well.

      To help prevent interactions, your doctor should manage all of your medications carefully. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

      Examples of drugs that can cause interactions with lisinopril are listed below.

      Blood pressure drugs

      Taking certain blood pressure drugs with lisinopril increases your risk for low blood pressure, high blood potassium, and kidney problems including kidney failure. These drugs include:

      • angiotensin receptor blockers (ARB). Examples include:
        • candesartan (Atacand, Atacand HCT)
        • eprosartan (Teveten)
        • irbesartan (Avapro, Avalide)
        • losartan (Cozaar, Hyzaar)
        • olmesartan (Benicar, Benicar HCT, Tribenzor, Azor)
        • telmisartan (Micardis, Micardis HCT, Twynsta)
        • valsartan (Diovan, Diovan HCT, Exforge, Exforge HCT)
        • azilsartan (Edarbi, Edarbyclor)
        • benazepril (Lotensin, Lotrel, Lotensin HCT)
        • captopril
        • enalapril (Vasotec, Epaned)
        • fosinopril (Monopril)
        • lisinopril (Prinivil, Zestril, Prinzide, Zestoretic)
        • moexipril (Uniretic)
        • perindopril (Aceon)
        • quinapril (Accupril, Accuretic)
        • ramipril (Altace)
        • trandolapril (Mavik, Tarka)
        • aliskiren (Tekturna, Tekturna HCT)

        Diabetes drugs

        Taking diabetes drugs with lisinopril can lower your blood sugar level too much. These drugs include:

        • insulins
        • oral diabetes drugs

        Water pills (diuretics)

        Taking water pills with lisinopril can make your blood pressure too low. These drugs include:

        • hydrochlorothiazide
        • chlorthalidone
        • furosemide
        • bumetanide

        Potassium supplements and potassium-sparing diuretics

        Taking potassium supplements or potassium-sparing diuretics with lisinopril can increase potassium in your body. These drugs include:

        • spironolactone
        • amiloride
        • triamterene

        Mood stabilizer drugs

        Lisinopril can increase the effects of lithium. This means that you may have more side effects.

        Pain drugs

        Taking certain pain drugs with lisinopril can decrease your kidney function. These drugs include:

        • non-steroidal anti-inflammatory drugs, such as:
          • ibuprofen
          • naproxen
          • aspirin
          • diclofenac
          • indomethacin
          • ketoprofen
          • ketorolac
          • sulindac
          • flurbiprofen

          Neprilysin inhibitors

          These drugs are used to treat heart failure. They should not be used with enalapril. Do not use enalapril within 36 hours of switching to or from a neprilysin inhibitor. Using these drugs together raises your risk of sudden swelling of your face, arms, legs, lips, tongue, throat, and intestines (angioedema).

          An example of this drug class includes:

          • sacubitril

          Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

          Lisinopril warnings

          Allergy warning

          This drug can cause a severe allergic reaction. Symptoms include:

          • trouble breathing
          • swelling of your throat or tongue
          • hives

          Call 911 or go to the nearest emergency room if you develop these symptoms.

          Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

          Alcohol interaction

          The use of drinks that contain alcohol can increase the blood pressure-lowering effects of lisinopril. This may cause you to feel dizzy or faint. If you drink alcohol, talk to your doctor.

          Warnings for people with certain health conditions

          For people with kidney disease: If you have kidney disease or are on dialysis, you have a higher risk of getting certain serious side effects from this drug. Your doctor will monitor your kidney function and adjust your medication as needed. Your doctor should start you on a lower dose of this drug.

          For people with diabetes: This drug can affect your blood sugar levels. Your doctor may need to change your dose of your diabetes medicines. Your doctor will tell you how often to test your blood sugar levels.

          Warnings for other groups

          For pregnant women: This drug is a category D pregnancy drug. That means two things:

          Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

          For women who are breastfeeding: It isn’t known if this drug passes into breast milk. If it does, it may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your baby. You may need to decide whether to stop breastfeeding or stop taking this medication.

          For seniors: Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

          For children: This medicine hasn’t been studied and shouldn’t be used in children younger than 6 years.

          How to take lisinopril

          This dosage information is for lisinopril oral tablet. All possible dosages and forms may not be included here. Your doctor will tell you what dosage is right for you. Your dose, form, and how often you take it will depend on:

          • your age
          • the condition being treated
          • how severe your condition is
          • other medical conditions you have
          • how you react to the first dose

          Forms and strengths

          Generic: lisinopril

          • Form: Oral tablet
          • Strengths: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, 40 mg

          Brand: Prinivil

          • Form: Oral tablet
          • Strengths: 5 mg, 10 mg, 20 mg

          Brand: Zestril

          • Form: Oral tablet
          • Strengths: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, 40 mg

          Dosage for hypertension

          Adult dosage (ages 18–64 years)

          • starting dose: 10 mg taken by mouth once per day
          • usual dose: 20–40 mg taken once per day
          • maximum dose: 80 mg taken once per day

          Child dosage (ages 6–17 years)

          • starting dose: 0.07 mg/kg of body weight taken by mouth once per day
          • dose adjustments will be based on your blood pressure response.
          • maximum dose: 0.61 mg/kg, up to 40 mg, once per day

          Child dosage (ages 0–5 years)

          This medicine hasn’t been studied and shouldn’t be used in children younger than 6 years.

          Senior dosage (ages 65 years and older)

          There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

          Dosage for heart failure

          Adult dosage (ages 18–64 years)

          • starting dose: 5 mg taken by mouth once per day
          • maximum dose: 40 mg taken once per day

          Child dosage (ages 0–17 years)

          This medicine hasn’t been studied and shouldn’t be used in children younger than 18 years for heart failure.

          Senior dosage (ages 65 years and older)

          There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

          Dosage for acute myocardial infarction (heart attack)

          Adult dosage (ages 18–64 years)

          • starting dose: 5 mg taken by mouth within the first 24 hours of when symptoms of heart attack start. Your doctor will give you another 5 mg after another 24 hours.
          • usual dose: 10 mg given 48 hours after heart attack. Then 10 mg taken once per day for at least 6 weeks.

          Child dosage (ages 6–17 years)

          This medicine hasn’t been studied and shouldn’t be used in children younger than 18 years for improving survival after a heart attack.

          Child dosage (ages 0–5 years)

          This medicine hasn’t been studied and shouldn’t be used in children younger than 6 years.

          Senior dosage (ages 65 years and older)

          There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

          Special considerations

          • Heart failure: If you have low blood sodium levels, your starting dose may be 2.5 mg taken once per day.
          • Improving survival after a heart attack: If you have low blood pressure, your starting dose may be 2.5 mg for the first 3 days after having a heart attack.

          Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.

          Take as directed

          Lisinopril oral tablet is used for long-term treatment. This drug comes with serious risks if you don’t take it as prescribed.

          If you don’t take it at all: If you don’t take it at all, your blood pressure will stay high. This will raise your risk for a heart attack and stroke.

          If you stop taking it suddenly: If you stop taking this drug suddenly, your blood pressure may spike. This can cause anxiety, sweating, and a fast heart rate.

          If you don’t take it on schedule: You may not feel any different, but your blood pressure may not be controlled. This can put you at higher risk for heart attack and stroke.

          What to do if you miss a dose: If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time. Never try to catch up by taking two doses at once. This could result in toxic side effects.

          If you take too much: If you take too much of this drug, you may have a drop in blood pressure. This may cause you to faint. If you think you’ve taken too much of the drug, act right away. Call your doctor or local Poison Control Center, or go to the nearest emergency room.

          How to tell this drug is working: Your doctor will monitor your blood pressure and other symptoms of your condition to tell if this drug is working for you. You also may be able to tell this drug is working if you check your blood pressure and it’s lower.

          Important considerations for taking this drug

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

          General

          This drug should be taken around the same time every day.You can crush or cut the tablet.

          Storage

          • Keep it from 59°F (20°C) to 86°F (25°C).
          • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

          Refills

          A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

          Travel

          When traveling with your medication:

          • Always carry it with you or in your carry-on bag.
          • Don’t worry about airport x-ray machines. They can’t hurt your medication.
          • You may need to show airport security staff the pharmacy prescription label for your medication. Always carry the original prescription-labeled box with you.
          • Don’t leave this medicine in the car, especially when the temperature is hot or freezing.

          Self-management

          Your doctor may ask you to check your blood pressure at home. To do this, you’ll need to purchase a home blood pressure monitor. These are available at most pharmacies. You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

          Clinical monitoring

          Before starting and during your treatment with this drug, your doctor may check the following to tell if this drug is working or is safe for you:

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

          Hidden costs

          You may need to buy a blood pressure monitor to check your blood pressure at home.

          Are there any alternatives?

          There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other options that may work for you.

          Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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