Heart Health High Blood Pressure Treatment What To Know About Lisinopril (Prinivil and Zestril) An ACE inhibitor used to treat hypertension, heart failure, and heart attack By Sherry Christiansen Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer's research. Learn about our editorial process Sherry Christiansen Published on January 25, 2021 Print Table of Contents View All Table of Contents Uses Before Taking Dosage Side Effects Warnings and Interactions Lisinopril (brand names Prinivil and Zestril) is considered a drug in the class of angiotensin-converting enzyme (ACE) inhibitors. It used to treat hypertension and heart failure. Lisinopril is also given after a recent heart attack or stroke because it’s been found to improve the survival rate when a person suffers from either of these maladies. ACE inhibitors work by creating a chemical called angiotensin II, which causes the blood vessels to constrict and then rise. By blocking the activity of ACE, less angiotensin II is produced by the body; this results in relaxing the blood vessels which lowers the blood pressure. Lisinopril is available as an oral (by mouth) tablet as well as a liquid solution. The oral tablets are available in 2.5, 5, 10, 20, and 40 mg tablets. The liquid form of lisinopril must be special ordered by your health care provider. Sometimes lisinopril is combined with other blood pressure medications (such as hydrochlorothiazide) to help potentiate its effectiveness. Anxiety is a possible side effect of lisinopril. Hailshadow / Getty Images Uses The Food and Drug Administration (FDA) has approved lisinopril for the treatment of: Heart failureHypertensionAcute (sudden and severe) myocardial Infarction (heart attack)High blood pressure in children aged 6 and older Off-Label Uses There are several off-label uses for lisinopril. This means the drug is sometimes prescribed but has not been approved by the FDA for use for a specific condition (due to lack of sufficient evidence from clinical research studies). Lisinopril is sometimes given for kidney disease. Although there has been some clinical research studies to back the effectiveness of lisinopril for some types of kidney disease, such as proteinuric (high amounts of protein in the urine) kidney disease. More studies are needed before the drug will be considered a mainstream medication for the treatment of this condition. Other off-label uses for lisinopril include: Migraine headachePrevention of diabetesMitral valve regurgitationMyocardial fibrosisCardiomyopathyInfertilityDiabetic retinopathy Before Taking Lisinopril Before giving you a prescription for lisinopril, your health care provider will evaluate your blood pressure readings and may do some blood tests to check your kidney function. A potassium level may be taken as well because lisinopril can raise serum (blood) potassium levels. Before taking lisinopril be sure to tell your health care provider if: You are taking any other prescription medications, over-the-counter (OTC) medications, vitamins, supplements, or any other type of drugsYou are pregnant or plan to become pregnant or are breastfeedingYou have kidney diseaseYou have heart problemsYou have been diagnosed with low blood pressureYou have diabetes You are scheduled for any type of major surgeryYou have had a recent bout of diarrhea or vomitingYou are on a special diet, such as a low sodium dietYou have had an allergic reaction to lisinoprilYou plan to have a desensitization treatment for allergies Lisinopril and Diabetes Lisinopril may impact your blood sugar, so you may need to check your level more frequently if taking this medication. If you have diabetes, make sure to speak with your health care provider. ACE Inhibitors: Blood Pressure Control in Diabetes Other ACE Inhibitors There are several other drugs that are considered ACE inhibitors, including Benazepril (Lotensin) Captopril (Capoten)Enalapril (Vasotec) Fosinopril (Monopril) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik) Ace Inhibitors and Beta-Blockers Beta-blockers are another medication used to lower blood pressure. One major difference between lisinopril and beta-blockers is that beta-blockers are effective in treating angina (chest pain). One of the major differences between lisinopril and beta-blocker is that beta-blockers are effective in treating angina (chest pain).A 2010 study found that drugs like lisinopril, along with other ACE inhibitors, and beta-blockers were equally effective in lowering blood pressure, for those who needed to take more than one type of blood pressure medication. Your Complete Guide to Hypertension Drugs Dosage Your health care provider will prescribe the dosage of lisinopril that is right for you depending on many factors, including the type of medical condition you have—such as high blood pressure or heart failure—and other factors. Always take lisinopril exactly as instructed by the prescribing health care provider. Average Dosage The average starting dosage of lisinopril is between 2.5 mg and 10 mg. It is usually to be taken only once per day. According to the FDA, lisinopril should be started at a lower dosage and increased gradually over a time span of several weeks. The starting dosage is different, depending on the type of medical treatment you are taking lisinopril for, such as: High blood pressure: 10 mg one time per dayRecent heart attack: 5 mg one time per dayHeart failure: 5 mg one time per day The maximum dosage of lisinopril is 80 mg one time per day. Dosages are lower for children and depend on many factors such as condition, the child’s age, weight, and more. Every prescription medication should be taken according to the drug manufacturer; there is usually a range of dosages that are considered therapeutic. Your health care provider will instruct you on what the correct dosage is for you. How To Take and Store How To Take Lisinopril The best time of day to start taking your initial dosage of lisinopril is just before bedtime because it may cause dizziness. Once the dizziness subsides, it’s okay to take it any time of the day. Lisinopril can be taken with food or on its own. Do not crush the tablet; swallow it whole with a drink of water or other types of fluid. If you were prescribed the liquid form, you’ll receive an oral (by mouth) syringe to help you measure the precise dosage. If you are unsure about how to measure your dosage, be sure to talk to your nurse, the pharmacist, or other health care provider. Proper Measuring Devices Make sure you are using a proper measuring device for the liquid form of lisinopril. Do not measure it in a regular household measuring tool such as a teaspoon. How To Store Lisinopril Storage recommendations for lisinopril include: Keeping it at room temperatureKeeping it out of the reach of small childrenProtecting the bottle from getting wetKeeping the lid tightly closedThrowing away any unused tablets or liquid once it has reached its expiration date Side Effects Common Common side effects of lisinopril that do not usually require immediate medical attention (unless they do not go away or are causing discomfort) include: A change in the perception of tasteA cough (sometimes referred to as lisinopril cough)DizzinessLight sensitivityA headacheA feverAnxiety If anxiety is severe, or it does not subside after taking lisinopril for a short time, it should be reported to your health care provider. Be aware that if you stop taking lisinopril suddenly, this can cause or worsen lisinopril anxiety. Other signs of abruptly discontinuing lisinopril can include tachycardia (a fast heart rate) and sweating. What Is a Lisinopril Cough? Severe Severe side effects, those that should be reported to your health care provider right away, include: Dysuria: Problems passing urine, which could be a sign of kidney problems.Signs of increased potassium levels: Such as weakness in the muscles, chest pain, or irregular heart rate.Signs of liver problems: Such as flu-like symptoms, light-colored stools, dark urine, general malaise, upper right abdominal pain, nausea, yellowing of the skin or in the whites of the eyes.Dizziness, feeling faint, lightheadedness, or falling: These are signs of low blood pressure.Nausea and vomitingAn allergic reaction: Including symptoms such as a rash, swelling in the face, lips, throat, hand, feet, or tongueDifficulty breathing This list may not describe every possible side effect from lisinopril If you experience any other side effects, be sure to contact your health care provider. You can also report side effects to the FDA by calling 1-800-FDA-1088. Lisinopril Warnings and Interactions Do not use heavy machinery or perform any type of activity that requires mental alertness. Do not stand up, or sit up suddenly after taking lisinopril, particularly if you are a senior as this could increase your risk of falls. Lisinopril should be used with caution in some conditions, including: Hyperkalemia (high potassium levels) ACE inhibitors can raise blood potassium levels; lisinopril should be used with caution in those with hyperkalemia.Those with African ancestry-some studies have found that people of African ancestry do not respond well to ACE inhibitors, also, this population may be more at risk for a potentially fatal complication from lisinopril, called angioedema. Note, these do not represent all of the warnings for taking lisinopril; be sure to talk with your healthcare provider about any other precautions or warnings linked with ACE inhibitors. Lisinopril and Alcohol Do not drink alcohol while taking lisinopril; alcohol may increase drowsiness and dizziness as well as other side effects of lisinopril. What Is a Black Box Warning? A black box warning (also referred to as a “boxed warning”), is a drug that has been deemed by the FDA as having a serious safety risk. The black box warning for Lisinopril includes information about the use during pregnancy. ACE inhibitors (such as lisinopril) can cause injury or even death to the developing fetus during the second or third trimester of pregnancy. If pregnancy occurs, lisinopril should be discontinued as soon as possible. Precautions and Contraindications A contraindication is a medication, surgery, or procedure, which shouldn’t be used in a specific situation because it could cause harm. This could describe when two medications should not be given together, or in the instance of a certain condition (such as kidney disease). Another scenario that constitutes a contraindication is when a person (such as a child or a pregnant woman) should not be given a specific medication. Contraindications for lisinopril include medications such as: Hymenoptera venom (venom from insects used to treat immune-related or inflammatory disease)Aliskiren Angiotensin receptor blockers, like losartan, sucabitril or valsartanSome diabetic medicationsDiuretics Lithium NSAIDs Potassium supplementsSalt substitute This list of medications is not all-inclusive, so be sure to provide your health care provider with a list of every type of medication you are taking, including the dosage and when you take the drug/s. Don’t forget to including OTC medications, herbal and natural supplements (including vitamins), and any other type of mediation you take. Other Contraindications Other contraindications for lisinopril include: Pregnant or breastfeeding mothersHistory of angioedema Bilateral renal artery stenosis Kidney failure Diabetes mellitus Was this page helpful? Thanks for your feedback! Looking to start a diet to better manage your high blood pressure? Our nutrition guide can help. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Food and Drug Administration. Zestril (lisinopril). Updated 2008. U.S. National Library of Medicine. Safety study of lisinopril in children and adolescents with a kidney transplant (PTN_LISINO). Updated July 8, 2015. 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