What is lisinopril

Lisinopril is an angiotensin converting enzyme (ACE) inhibitor. Lisinopril is used alone or in combination with other medications to treat high blood pressure (hypertension) in adults and children who are at least 6 years old. Lisinopril is also used in combination with other medications to treat congestive heart failure in adults. Lisinopril is also used to improve survival after a heart attack.

Lisinopril is in a class of medications called ACE (angiotensin-converting enzyme) inhibitors. Lisinopril works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently. Lisinopril competitively binds to and inhibits angiotensin converting enzyme (ACE), thereby blocking the conversion of angiotensin I to angiotensin II. This prevents the potent vasoconstrictive actions of angiotensin II and results in vasodilation. Lisinopril also decreases angiotensin II-induced aldosterone secretion by the adrenal cortex, which leads to an increase in sodium excretion and subsequently increases water outflow.

Lisinopril is only available on prescription. It comes as tablets. It also comes as a liquid for people who find it hard to swallow tablets, but this has to be ordered specially by your doctor.

Lisinopril is also available combined with another blood pressure medicine called hydrochlorothiazide.

High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys, and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

Key facts

• Lisinopril lowers your blood pressure and makes it easier for your heart to pump blood around your body.
• Your very first dose of lisinopril may make you feel dizzy, so it’s best to take it at bedtime. After that you can take lisinopril at any time of day.
• Some people get a dry, irritating cough with lisinopril.
• Drinking alcohol with lisinopril can make you feel dizzy or lightheaded.
• Take lisinopril even if you feel well, as you will still be getting the benefits of the medicine.
• Lisinopril is also called by the brand name Zestril. When it’s mixed with hydrochlorothiazide it can be called Carace Plus, Lisoretic and Zestoretic.

What does lisinopril do?

Lisinopril is an angiotensin converting enzyme (ACE) inhibitor. Lisinopril competitively binds to and inhibits angiotensin converting enzyme (ACE), thereby blocking the conversion of angiotensin I to angiotensin II. This prevents the potent vasoconstrictive actions of angiotensin II and results in vasodilation. Lisinopril also decreases angiotensin II-induced aldosterone secretion by the adrenal cortex, which leads to an increase in sodium excretion and subsequently increases water outflow.

Like other ACE inhibitors, lisinopril relaxes and widens the blood vessels. This lowers your blood pressure and makes it easier for your heart to pump blood around your body. This can improve the symptoms of heart failure.

In diabetic kidney disease, lisinopril helps to protect your kidneys and slows down the disease. Lisinopril does this by reducing the amount of protein you lose through your kidneys and by reducing high blood pressure.

What is an ACE Inhibitor?

Angiotensin-converting-enzyme inhibitor (ACE Inhibitor) is the name used to describe a group of medications used to treat high blood pressure. They have also been used for treating problems with the heart and kidneys.

ACE Inhibitors are sold under many names, such as: benazepril (Lotensin®), captopril (Capoten®), cilazapril (Inhibace®), enalapril (Vasotec ®, Renitec®), fosinopril, imidapril (Tanatril®), lisinopril (Listril®, Lopril®, Novatec®, Prinivil®, Zestril®), moexipril (Univasc®), perindopril (Aceon®), quinapril (Accupril®), ramipril (Altace®, Prilace®, Ramace®, Ramiwin®, Triatec®, Tritace®), trandolapril (Gopten®, Mavik®, Odrik®) and zofenopril.

What are the differences between lisinopril and other ACE inhibitors?

Lisinopril works as well as other ACE inhibitors when you take it to lower blood pressure and for heart failure.

The side effects are also similar to those of other ACE inhibitors. You only need to take lisinopril once a day. Some other ACE inhibitors need to be taken 3 times a day.

Are there similar medicines to lisinopril?

There are lots of other ACE inhibitor medicines which work in the same way as lisinopril. They include enalapril, captopril, ramipril and perindopril.

There are also lots of other types of blood pressure-lowering medicines:

• calcium-channel blockers – for example amlodipine
• angiotensin receptor blockers – for example candesartan
• beta-blockers – for example bisoprolol diuretics (water tablets) – for example bendroflumethiazide

If you can’t take lisinopril or other ACE inhibitor medicines because of side effects such as a dry cough, you may be able to switch to another type of blood pressure-lowering medicine. This will usually be a medicine called an angiotensin receptor blocker such as candesartan, irbesartan, losartan or valsartan.

How long does it take for lisinopril to work?

Lisinopril starts to work within a few hours to reduce high blood pressure but it may take a few weeks for full effect.

If you’re taking lisinopril for heart failure, it may take weeks, even months, before you feel better.

If you’re taking lisinopril for high blood pressure or after a heart attack, you may not have any symptoms. In these cases, you may not feel any different when you take lisinopril. This doesn’t mean that the medicine isn’t working and it’s important to keep taking it.

Can I drink alcohol with lisinopril?

Drinking alcohol can increase the blood pressure-lowering effect of lisinopril, which can make you feel dizzy or light headed.

During the first few days of taking lisinopril or after increasing the dose, stop drinking alcohol until you see how the medicine affects you.

If lisinopril makes you feel dizzy, it’s best to stop drinking alcohol while you’re taking it.

Is there any food or drink I need to avoid?

Don’t use salt substitutes such as Lo-Salt. This is because they are high in potassium. When mixed with lisinopril they may make the level of potassium in your blood too high.

There’s nothing else you need to avoid while taking lisinopril. Eating a healthy, balanced diet can help if you have high blood pressure or heart failure.

How long will I take lisinopril for?

After a heart attack, you usually take lisinopril for 6 weeks. Your doctor will then decide if you need to keep taking it for longer.

For high blood pressure, heart failure and diabetic kidney disease, treatment with lisinopril is usually long term, even for the rest of your life.

Is lisinopril safe to take for a long time?

Lisinopril is generally safe to take for a long time. In fact, it works best when you take it for a long time.

Taking lisinopril for a long time can sometimes cause your kidneys to not work as well as they should. Your doctor will check how well your kidneys are working with regular blood tests.

Is lisinopril addictive?

No, there’s no evidence that lisinopril is addictive.

What will happen if I stop taking it?

Talk to your doctor if you want to stop taking lisinopril.

Stopping lisinopril may cause your blood pressure to rise – and this can increase your chances of having a heart attack or stroke.

If you’re bothered by side effects, your doctor may be able to prescribe you a different medicine.

Can I come off lisinopril now my blood pressure is lower?

Even if your blood pressure is successfully lowered by lisinopril, it’s best to carry on taking it. If you stop taking lisinopril, your blood pressure could rise back up again.

If you need blood pressure-lowering medicines, you’ll probably need to take them for the rest of your life.

Remember, by keeping your blood pressure low, you’re protecting yourself against having a heart attack or stroke in the future.

Can I take lisinopril before surgery?

Tell your doctor that you’re taking lisinopril if you’re going to be put to sleep for an operation or are going to have a major operation, such as a caesarean section, without a general anaesthetic.

Lisinopril can reduce your blood pressure when it’s used with a general anaesthetic.

Your doctor may advise you to stop taking it 24 hours before surgery.

Can I drive or ride a bike?

Lisinopril can cause blurred vision and make some people feel dizzy or tired – especially when you first start taking it or after an increase in dose. If this happens to you, don’t drive a car, ride a bike, or use tools or machines.

Can lifestyle changes help?

You can boost the health of your heart by making some key lifestyle changes. These will also help if you have high blood pressure or heart failure.

• Stop smoking – smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure and relieves heart failure symptoms. Try and avoid secondhand smoke.
• Drink alcohol sensibly – drinking too much alcohol raises blood pressure over time. It makes heart failure worse too. Men and women shouldn’t drink more than 14 units of alcohol a week.
• Be more active – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It doesn’t need to be too energetic – walking every day is enough.
• Eat healthily – aim to eat a diet that includes plenty of fruit and veg, wholegrains, fat-free or low-fat dairy products and lean proteins. It’s a good idea to cut down on salt too. Eating too much salt is the biggest cause of high blood pressure – the more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
• Manage stress – when you’re anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. This can make heart failure worse too. Find ways to reduce stress in your life. To give your heart a rest, try napping or putting your feet up when possible. Spend time with friends and family to be social and help avoid stress.
• Vaccinations – if you have heart failure, it’s recommended that you have a flu jab every year and a pneumonia vaccination every 5 years. Ask your doctor about these vaccinations.

Will lisinopril affect my contraception?

Lisinopril won’t affect any type of contraception.

However, some types of hormonal methods of contraception, like the combined contraceptive pill and contraceptive patch, aren’t usually recommended for women taking lisinopril and other medicines for high blood pressure. This is because some hormonal contraceptives can raise your blood pressure and stop lisinopril working properly.

Talk to your doctor if you’re taking combined hormonal contraceptives.

Will lisinopril affect my fertility?

There’s no evidence that lisinopril reduces fertility in men or women.

However, if you’re a woman and you’re trying to get pregnant, talk to your doctor first. This medicine is usually not recommended in pregnancy.

How should lisinopril medication be used?

Lisinopril comes as a tablet to take by mouth. It is usually taken once a day. To help you remember to take lisinopril, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take lisinopril exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor will probably start you on a low dose of lisinopril and gradually increase your dose.

You can take lisinopril with or without food. Swallow lisinopril tablets whole with a drink.

If you’re taking lisinopril as a liquid, it will come with a plastic syringe or spoon to help you measure out the right dose. If you don’t have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not give the right amount of medicine.

Lisinopril controls high blood pressure and heart failure but does not cure them. Continue to take lisinopril even if you feel well. Do not stop taking lisinopril without talking to your doctor.

Lisinopril Contraindications

Lisinopril tablets are contraindicated in combination with a neprilysin inhibitor (e.g., sacubitril). Do not administer lisinopril tablets within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor.

Lisinopril tablets are contraindicated in patients with:

• a history of angioedema or hypersensitivity related to previous treatment with an angiotensin converting enzyme inhibitor
• hereditary or idiopathic angioedema

Do not co-administer aliskiren with lisinopril tablets in patients with diabetes

Who can and can’t take lisinopril

Lisinopril can be taken by adults and children aged 6 years and over.

If you have diabetes, check your blood sugar (glucose) more often, particularly in the first few weeks. This is because lisinopril can lower the sugar level in your blood.

Lisinopril isn’t suitable for everyone.

To make sure lisinopril is safe for you, tell your doctor if you:

• have had an allergic reaction to lisinopril or any other medicine in the past
• are trying to get pregnant, are already pregnant or you are breastfeeding
• are having dialysis or any other type of blood filtration
• have heart, liver or kidney problems
• have unstable or low blood pressure
• have diabetes
• have recently had diarrhea or vomiting
• are on a low-salt diet
• are going to have desensitization treatment to reduce your allergy to insect stings
• are going to have a major operation or a general anaesthetic (to put you to sleep)
• have a blood problem such as too few white blood cells (neutropenia or agranulocytosis)

Lisinopril special precautions

Before taking lisinopril:

• tell your doctor and pharmacist if you are allergic to lisinopril; other ACE inhibitors such as enalapril (Vasotec, in Vaseretic), benazepril (Lotensin, in Lotrel), captopril (Capoten), fosinopril (Monopril), moexipril (Univasc, in Uniretic), perindopril (Aceon), quinapril (Accupril, in Accuretic, in Quinaretic), ramipril (Altace), and trandolapril (Mavik, in Tarka); any other medications; or any ingredients in lisinopril tablets. Ask your pharmacist for a list of the ingredients.

• tell your doctor or pharmacist if you are taking valsartan and sacubitril (Entresto) or if you have stopped taking it within the last 36 hours. Your doctor will probably tell you not to take lisinopril, if you are also taking valsartan and sacubitril. Also, tell your doctor if you have diabetes and you are taking aliskiren (Tekturna, in Amturnide, Tekamlo, Tekturna HCT). Your doctor will probably tell you not to take lisinopril if you have diabetes and you are also taking aliskiren.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin (Indocin, Tivorbex); diuretics (‘water pills’); lithium (Lithobid); and potassium supplements. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor if you have or have ever had heart or kidney disease; diabetes; lupus; scleroderma (a condition in which extra tissue grows on the skin and some organs); or angioedema (a condition that causes difficulty swallowing or breathing and painful swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs).

• tell your doctor if you are breastfeeding.

• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking lisinopril.

• you should know that diarrhea, vomiting, not drinking enough fluids, and sweating a lot can cause a drop in blood pressure, which may cause lightheadedness and fainting.

• talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

Cautions with other medicines

There are some medicines that may interfere with the way lisinopril works.

Tell your doctor if you’re taking:

• anti-inflammatory medicines such as ibuprofen, indomethacin or aspirin for pain relief. (A low-dose aspirin – 75mg a day – is safe to take with lisinopril.)
• medicines to treat low blood pressure, heart failure, asthma or allergies, such as ephedrine, noradrenaline or adrenaline
• medicines to treat high blood pressure, such as aliskeren
• other medicines which can lower your blood pressure such as some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), anaesthetics or medicines for an enlarged prostate gland
• medicines that damp down your immune system, such as ciclosporin or tacrolimus
• water tablets such as furosemide
• medicines which can increase the amount of potassium in your blood such as spironolactone, triamterene, amiloride, potassium supplements, trimethoprim (for infections) and heparin (for thinning blood)
• steroid medicines such as prednisone
• allopurinol (for gout)
• procainamide (for heart rhythm problems)
• medicines for diabetes
• racecadotril (for diarrhoea)
• lithium (for mental health problems)

Mixing lisinopril with herbal remedies or supplements

There’s very little information about taking herbal remedies and supplements with lisinopril.

For safety, speak to your pharmacist or doctor before taking any herbal or alternative remedies with lisinopril.

Pregnancy and breastfeeding

Lisinopril is not normally recommended in pregnancy or when breastfeeding. However, it may be prescribed if your doctor thinks the benefits of the medicine outweigh the risks (see Important Warning above).

If you’re trying to get pregnant or you’re already pregnant, talk to your doctor about the benefits and possible harms of taking lisinopril. These will depend on how many weeks pregnant you are and the reason why you’re taking it. There may be other treatments that are safer for you.

Lisinopril and breastfeeding

Small amounts of lisinopril may get into breast milk. This can cause low blood pressure in the baby.

Talk to your doctor, as other medicines might be better while you’re breastfeeding.

Can taking lisinopril or ACE Inhibitors during my pregnancy cause birth defects?

Currently, there is no proven risk of birth defects with first trimester use of ACE Inhibitors. The majority of studies have not found birth defects to occur more often in women who took or were prescribed an ACE Inhibitor in the first trimester of their pregnancy. It is difficult to study medications as a group because even though the ACE Inhibitors work in similar ways there are some differences among the individual medications. When drugs are studied as a group, differences for individual drugs could be missed. Also, problems reported in studies may be related to high blood pressure itself, and might not be due to the medication.

Can taking lisinopril or ACE Inhibitors after the first trimester cause pregnancy complications?

Yes. ACE Inhibitors should be avoided during the second and third trimester of pregnancy. When used AFTER the first trimester, ACE Inhibitors can cause low levels of amniotic fluid. Amniotic fluid surrounds the baby. Low levels of amniotic fluid can lead to health problems for the developing baby. Some of these problems include poor lung development, poor growth, poor development of the skull bones, birth defects, problems with the development of the kidneys and even death of the developing baby

I take a lisinopril for high blood pressure and just found out that I am pregnant. What tests can be done to check the baby?

If you took an ACE Inhibitor during the first trimester, a detailed ultrasound to look at the unborn baby can be done in the second trimester. If you took an ACE Inhibitor after the first trimester, repeated ultrasound scans to look for low fluid around the pregnancy and to monitor the growth of the baby may be offered. Your health care provider can help to arrange any monitoring appropriate for you.

How long do ACE Inhibitors stay in the body? Should I stop taking it before I try to get pregnant?

Some of the ACE inhibitor medications are cleared from the body faster than others. The amount of time it takes will vary with each particular medication and might also vary from person to person. Kidney disease can affect the amount of time it takes for your body to clear medication. Your health care provider or pharmacist may be able to help answer how long it takes for your particular ACE inhibitor medication to be cleared from your body.

You should not stop taking any medication without first talking with your health care provider. It is important to maintain a healthy blood pressure. ACE inhibitors are generally avoided during pregnancy unless no other medication would be effective for a severe condition. Your health care provider will work with you to determine the most appropriate way to treat your blood pressure during pregnancy.

Can high blood pressure during my pregnancy cause problems?

Yes. High blood pressure that started before pregnancy or before the 20th week of pregnancy can cause slow growth, low birth weight, or premature delivery (birth before 37 weeks). Some women develop elevated blood pressure after the 20th week of pregnancy (known as preeclampsia). Treatment depends on how high the blood pressure is and should be discussed further with your health care provider.

Can I take ACE Inhibitors while breastfeeding?

There is not a lot of information available about breastfeeding while taking ACE Inhibitors. You can contact MotherToBaby to learn more about your specific mediation(s). Be sure to talk to your health care provider about your medications and all of your breastfeeding questions.

What if the father of the baby takes ACE Inhibitors?

There are no reports of male infertility while using ACE Inhibitors. There is no evidence to suggest that a father’s use of an ACE Inhibitor causes any birth defects. In general, exposures that fathers have are unlikely to increase risks to a pregnancy.

What is lisinopril used for?

Lisinopril is a medicine to treat high blood pressure (hypertension) and heart failure. It’s also prescribed after a heart attack and in diabetic kidney disease.

Lisinopril helps to prevent future strokes and heart attacks. It also improves your survival if you’re taking it after a recent heart attack (myocardial infarction) or for heart failure. Lisinoprilt also slows down diabetic kidney disease.

Lisinopril dosage

It’s usual to take lisinopril once a day. You will probably be prescribed a low dose of lisinopril at first so it doesn’t make you feel dizzy. This will usually be increased gradually until you reach the right dose for you. If you have side effects with lisinopril you may stay on a lower dose.

Your doctor may suggest that you take your first dose before bedtime, because it can make you dizzy. After the very first dose, you can take lisinopril at any time every day. Try to take it at the same time every day.

The dose of lisinopril you take depends on why you need the medicine. Take it as instructed by your doctor.

To decide your dose, your doctor will check your blood pressure and ask you if you are getting any side effects. You may also have blood tests to check how well your kidneys are working and the amount of potassium in your blood.

Depending on why you’re taking lisinopril, the usual starting dose is between 2.5mg and 10mg once a day. This will be increased gradually over a few weeks to a usual dose of:

• 20mg once a day for high blood pressure (the maximum dose is 80mg once a day)
• 10mg once a day after a recent heart attack
• 20mg to 35mg once a day for heart failure
• 10mg to 20mg once a day for diabetic kidney disease

Doses are usually lower for children.

Adult Dose for Hypertension

• Initial dose: 10 mg orally once a day; 5 mg orally once a day
• Maintenance dose: 20 to 40 mg orally once a day
• Maximum dose: 80 mg orally once a day

Comments:

• The initial dose is 5 mg orally once a day in patients receiving a diuretic.
• The 80 mg dose is used but does not appear to give greater effect.
• If blood pressure is not controlled with lisinopril alone, a low dose of a diuretic may be added (e.g., hydrochlorothiazide, 12.5 mg). After the addition of a diuretic, it may be possible to reduce the dose of lisinopril.

Adult Dose for Congestive Heart Failure

• Initial dose: 2.5 to 5 mg orally once a day
• Maintenance dose: Dosage should be increased as tolerated
• Maximum dose: 40 mg orally once a day

Comments:

• The diuretic dose may need to be adjusted to help minimize hypovolemia, which may contribute to hypotension. The appearance of hypotension after the initial dose of lisinopril does not preclude subsequent careful dose titration with the drug.

Adult Dose for Heart Attack (myocardial infarction)

Uses: Reduction of mortality in acute 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, then 10 mg orally after 48 hours.
• Maintenance dose: 10 mg orally once a day. Dosing should continue for at least 6 weeks.

Comments:

• Therapy should be initiated at 2.5 mg in patients with a low systolic blood pressure (less than or equal to 120 mm Hg and greater than 100 mmHg) during the first 3 days after the infarct. If prolonged hypotension occurs (systolic blood pressure less than 90 mmHg for more than 1 hour) therapy should be withdrawn.

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

Comments:

• Not an approved indication.

Geriatric Dose for Hypertension

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

Pediatric Dose for Hypertension

Pediatric patients greater than or equal to 6 years of age:

• Initial dose: 0.07 mg/kg orally once a day (Maximum initial dose is 5 mg once a day)
• Maintenance dose: Dosage should be adjusted according to blood pressure response at 1 to 2 week intervals.
• Maximum dose: Doses above 0.61 mg/kg or greater than 40 mg have not been studied in pediatric patients

Comments:

• This drug is not recommended in pediatric patients less than 6 years old or in pediatric patients with glomerular filtration rate less than 30 mL/min.

Renal Dose Adjustments

• Creatinine clearance greater than 30 mL/min: No adjustment recommended
• Creatinine clearance 10 mL/min to less than or equal to 30 mL/min: Recommended initial dose is half of the usual recommended dose (i.e., hypertension, 5 mg; systolic heart failure, 2.5 mg, and acute MI, 2.5 mg. Up titrate as tolerated to a maximum of 40 mg daily)
• Creatinine clearance less than 10 mL/min or on hemodialysis: Recommended initial dose is 2.5 mg orally once a day

Liver Dose Adjustments

Patients who develop jaundice or marked elevations of hepatic enzymes should discontinue therapy and receive appropriate medical treatment.

What should I do if I forget a dose?

If you miss a dose of lisinopril, take it as soon as you remember. If you don’t remember until the following day, skip the missed dose. Do not take a double dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

If you take too many lisinopril tablets, contact your doctor or nearest hospital straight away.

An overdose of lisinopril can cause dizziness, sleepiness and a pounding heartbeat.

The amount of lisinopril that can lead to an overdose varies from person to person. Call your doctor or go to emergency department straight away if you take too much lisinopril by accident

If you need to go to a hospital accident and emergency department, do not drive yourself – get someone else to drive you or call for an ambulance.

Take the lisinopril packet or leaflet inside it plus any remaining medicine with you.

Lisinopril side effects

Like all medicines, lisinopril can cause side effects in some people but many people have no side effects or only minor ones.

Common side effects

These common side effects happen in more than 1 in 100 people. Talk to your doctor or pharmacist if these side effects bother you or don’t go away:

• dry, tickly cough that does not go away
• feeling dizzy or light headed, especially when you stand up or sit up quickly. This is more likely to happen when you start taking lisinopril or move onto a higher dose
• headache
• diarrhea and vomiting
• a mild skin rash
• blurred vision

Tell your doctor if any of these symptoms are severe or do not go away:

• cough
• dizziness
• headache
• excessive tiredness
• nausea
• diarrhea
• weakness
• sneezing
• runny nose
• decrease in sexual ability
• rash

Serious side effects

It happens rarely, but some people may have serious side effects when taking lisinopril.

Tell a doctor straight away if you get:

• weak arms and legs or problems speaking – these can be signs of a stroke
• yellow skin or eyes – this can be a sign of liver problems
• paleness, feeling tired, faint or dizzy, any sign of bleeding (for example bleeding from the gums or bruising more easily than usual), sore throat and fever and getting infections more easily – these can be signs of blood or bone marrow disorder
• a faster heart rate, chest pain and tightness in your chest – these can be signs of heart problems
• shortness of breath, wheezing and tightening of the chest – these can be signs of lung problems
• severe tummy pain – this can be a sign of an inflamed pancreas
• swollen ankles, blood in your pee or not peeing at all – these can be signs of kidney problems

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction to lisinopril.

Contact a doctor straight away if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you’re wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

These are warning signs of a serious allergic reaction. A serious allergic reaction is an emergency.

These are not all the side effects of lisinopril. For a full list see the leaflet inside your medicines packet.

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• difficulty breathing or swallowing
• fever, sore throat, chills, and other signs of infection
• yellowing of the skin or eyes
• lightheadedness
• fainting
• chest pain

Lisinopril may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

How to cope with side effects

What to do about:

• dry irritating cough – cough medicines don’t usually help for coughs caused by lisinopril. Sometimes, the cough gets better on its own. Talk to your doctor if it bothers you or stops you from sleeping as another medicine may be better. Even if you stop taking lisinopril, the cough may take up to a month to go away.
• feeling dizzy – if lisinopril makes you feel dizzy when you stand up, try getting up very slowly or stay sitting down until you feel better. If you begin to feel dizzy, lie down so that you don’t faint, then sit until you feel better.
• headaches – make sure you rest and drink plenty of fluids. Don’t drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if they last longer than a week or are severe.
• diarrhea and vomiting – drink plenty of water in small, frequent sips. It may also help to take oral rehydration solutions. You can buy these from a pharmacy or supermarket to prevent dehydration. Don’t take any other medicines to treat diarrhoea or vomiting without speaking to a pharmacist or doctor. If you get diarrhoea or vomiting from a stomach bug, or illness, tell your doctor. You may need to temporarily stop taking lisinopril until you feel better.
• itching or a mild rash – it may help to take an antihistamine which you can buy from a pharmacy. Check with the pharmacist to see what type is suitable for you.
• blurred vision – avoid driving or using tools or machines while this is happening. If it lasts for more than a day or two speak to your doctor as they may need to change your treatment.

Lisinopril overdose

Following a single oral dose of 20 g/kg no lethality occurred in rats, and death occurred in one of 20 mice receiving the same dose. The most likely manifestation of overdosage would be hypotension, for which the usual treatment would be intravenous infusion of normal saline solution.

Lisinopril can be removed by hemodialysis.

Symptoms of overdose may include the following:

• lightheadedness
• fainting