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Blood Pressure/Cholesterol

Lisinopril
Lisinopril
Lisinopril is used to treat elevated blood pressure and heart failure.
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Drug Name

Lisinopril


Drug Uses

Lisinopril is used to treat elevated blood pressure and heart failure.


How to use

Lisinopril should be taken at doses specifically directed by the physician. Lisinopril can be taken with or without food. Lisinopril should be taken at the same time each day to maintain consistent blood levels. Lisinopril should not be taken within two hours of taking an antacid since the antacid binds lisinopril and prevents its absorption. Lisinopril is often tapered when discontinuing.


Drug Class and Mechanism

Lisinopril is an angiotensin converting enzyme (ACE) inhibitor. Angiotensin is a chemical that is made by the body continuously. It narrows blood vessels and thereby maintains (elevates) blood pressure. When the enzyme is blocked by lisinopril, angiotensin cannot be converted into its active form. As a result, blood pressure falls.

Interestingly, lisinopril and other ACE inhibitors were developed from the venom of a poisonous Brazilian snake.


Missed Dose

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.


Storage

Lisinopril should be stored in a dry place at 15-30 degrees C (59-86 degrees F).


Possible Side Effects

First doses of lisinopril can cause dizziness due to a drop in blood pressure. Lisinopril should be stopped if there are symptoms or signs of an allergic reaction including feelings of swelling of the face, lips, tongue or throat. Severe allergic reactions (anaphylaxis) and hives occasionally occur.

An uncommon but dangerous side effect is a drop in the white blood cells which fight infection. Cough is a known side effect of this drug.

Lisinopril can impair the function of the kidneys, and every person taking this medication should have their kidney function checked. Lisinopril rarely can cause nausea, headaches, anxiety, insomnia, drowsiness, nasal congestion and sexual dysfunction.



More Information

  • If you experience any of the following serious side effects, stop taking lisinopril and call your doctor immediately or seek emergency medical treatment:
    • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
    • difficulty breathing;
    • little or no urine;
    • an irregular heartbeat or changes in your heartbeat;
    • chest pain;
    • severe dizziness or fainting; or
    • signs of an infection including a sore throat or a fever.
  • Other, less serious side effects may be more likely to occur. Continue to take lisinopril and talk to your doctor if you experience
    • mild dizziness or lightheadedness;
    • headache;
    • unusual fatigue or weakness;
    • dry, tickling cough;
    • muscle cramps;
    • numbness or tingling in the hands, feet, arms, or legs;
    • nausea, vomiting, or diarrhea;
    • a rash; or
    • impotence.
  • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.


Warnings/Precautions

Use caution when driving, operating machinery, or performing other hazardous activities. Lisinopril may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities and notify your doctor. Also use caution when rising from a sitting or lying position. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking lisinopril. Alcohol may further lower blood pressure and increase drowsiness and dizziness when you are taking lisinopril. Do not use salt substitutes or potassium supplements while taking lisinopril except under the supervision of your doctor. Heavy sweating, vomiting, diarrhea, or other causes of fluid loss may lead to very low blood pressure, dizziness, and fainting during therapy with lisinopril. Maintain proper fluid intake to prevent dehydration and related side effects. First doses of lisinopril or any ACE inhibitor should be taken under observation if the patient also is taking diuretics (water pills). In such patients, blood pressure can drop quickly (though this is unusual). In general, lisinopril should not be taken with potassium supplements or diuretics that conserve potassium, e.g., Dyazide, since blood potassium levels may rise to dangerous levels. Lisinopril should not be taken during pregnancy.


What is lisinopril?

Lisinopril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme.

Lisinopril is used to treat high blood pressure (hypertension), congestive heart failure, and to improve survival after a heart attack.

Lisinopril may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about lisinopril?

Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Lisinopril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of lisinopril. Do not use salt substitutes or potassium supplements while taking lisinopril, unless your doctor has told you to.

Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking lisinopril. Drink plenty of water each day while you are taking this medication.

What should I discuss with my healthcare provider before taking lisinopril?

Do not use this medication if you are allergic to lisinopril or to any other ACE inhibitor, such as benazopril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

Before using lisinopril, tell your doctor if you are allergic to any drugs, or if you have:

  • kidney disease (or if you are on dialysis);

  • liver disease;

  • heart disease or congestive heart failure;

  • diabetes; or

  • a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis.

If you have any of these conditions, you may not be able to use lisinopril, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category D. Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Lisinopril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. It is not known whether lisinopril passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take lisinopril?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take each dose with a full glass of water.

Lisinopril can be taken with or without food.

Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking lisinopril. Drink plenty of water each day while you are taking this medication.

To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking lisinopril. You may need to stop using the medicine for a short time.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Store lisinopril at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a lisinopril overdose may include feeling extremely dizzy or light-headed, or fainting.

What should I avoid while taking lisinopril?

Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of lisinopril. Do not use salt substitutes or potassium supplements while taking lisinopril, unless your doctor has told you to.

Lisinopril side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
  • feeling light-headed, fainting;

  • urinating more or less than usual, or not at all;

  • fever, chills, body aches, flu symptoms;

  • tired feeling, muscle weakness, and pounding or uneven heartbeats;

  • chest pain; or

  • swelling, rapid weight gain.

Less serious side effects may be more likely to occur, such as:

  • cough;

  • dizziness, drowsiness, headache;

  • nausea, vomiting, diarrhea, upset stomach; or

  • mild skin itching or rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Lisinopril Dosing Information

Usual Adult Dose for Hypertension:

Initial dose: 10 mg orally once a day, in patients not receiving a diuretic.
Maintenance dose: 20 to 40 mg orally once a day.
Some patients appear to have a further response to 80 mg, but experience with this dose is limited.

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 5 mg orally once a day (If on diuretic, the diuretic dose should be reduced).
Maintenance dose: 5 to 20 mg orally once a day.

Usual Adult Dose for Myocardial Infarction:

Initial dose: 5 mg orally (within 24 hours of the onset of acute myocardial infarction).
Subsequent doses: 5 mg orally after 24 hours.
10 mg orally after 48 hours.
Maintenance dose: 10 mg orally once a day. Dosing should continue for six weeks.
Patients with a low systolic blood pressure (<=120 mm Hg) when treatment is started or during the first 3 days after the infarct should be given a lower 2.5 mg oral dose of lisinopril. If hypotension occurs (systolic blood pressure <=100 mm Hg) a daily maintenance dose of 5 mg may be given with temporary reductions to 2.5 mg if needed. If prolonged hypotension occurs (systolic blood pressure <90 mm Hg for more than 1 hour), lisinopril should be withdrawn.

Usual Adult Dose for Diabetic Nephropathy:

Initial dose: 10 to 20 mg orally once a day.
Maintenance dose: 20 to 40 mg orally once a day.
Dosage may be titrated upward every 3 days.

Usual Geriatric Dose for Hypertension:

Initial dose: 2.5 to 5 mg orally once a day.
Maintenance dose: Dosages should be increased at 2.5 to 5 mg/day increments at 1 to 2 week intervals.
Maximum dose: 40 mg/day.

What other drugs will affect lisinopril?

Before taking lisinopril, tell your doctor if you are taking any of the following drugs:

  • lithium (Lithobid, Eskalith);

  • gold injections, or aurothioglucose (Solganal);

  • a potassium supplement such as K-Dur, Klor-Con;

  • salt substitutes that contain potassium;

  • insulin or diabetes medication you take by mouth;

  • aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), naproxen (Aleve, Naprosyn), and others; or

  • a diuretic (water pill).

If you are using any of these drugs, you may not be able to use lisinopril or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect lisinopril. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has information about lisinopril written for health professionals that you may read.
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