Zestril (Lisinopril)

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What is lisinopril?

Lisinopril is a medication that may be prescribed to people with high blood pressure (hypertension). Doctors also prescribe it for people with heart failure to increase their chances of survival after a heart attack.

It belongs to the class of angiotensin-converting enzyme inhibitors, also known as ACE inhibitors. ACE inhibitors act on certain chemicals in the body, lowering the levels of chemicals known to tighten blood vessels. This aids blood circulation.

Lisinopril is the generic name of a particular ACE inhibitor for which the most common brand names are Zestril and Prinivil.

What is lisinopril used to treat?

Doctors prescribe this drug to people with high blood pressure or heart failure, or those recovering from these conditions. It can also help improve the symptoms of chronic kidney disease caused by diabetes.

How do you take lisinopril?

A typical dosage¹ of lisinopril to treat hypertension would be:

Adults

  • Initial dose: 5–10mg, taken orally once daily. (Doctors may administer 5mg if you are also taking a diuretic.)

  • Maintenance dose: 20–40mg, taken orally once daily.

  • Maximum dose: 80mg, taken orally once daily.

Children over the age of six

  • Initial dose: 0.07mg per kilogram of weight, daily.

  • Maintenance dose: the dose may be adjusted depending on blood pressure response at one or two-week intervals.

 Older patients

  • Initial dose: 2.5–5mg taken orally, once daily.

  • Maintenance dose: can be increased by another 2.5–5mg at one or two-week intervals.

  • Maximum dose: 40mg, taken orally, once daily.

Seeing results

When taken to treat high blood pressure, lisinopril should take effect within a few hours.² However, high blood pressure rarely causes noticeable symptoms, so you might not know if the medication is working until you have a blood pressure reading taken.

Potential side effects of lisinopril

Common side effects of lisinopril include:

  • Dry cough

  • Headache

  • Nausea

  • Fatigue

  • Runny nose

  • Diarrhea

  • Allergies

  • Low blood pressure

  • Chest pain

  • Anxiety

Lisinopril may cause more serious side effects. Contact your doctor right away if you develop symptoms of any of the following conditions:

  • Low blood pressure (hypotension): symptoms may include dizziness, extreme lack of concentration, loss of consciousness, and dehydration.

  • Liver problems: symptoms may include weight loss, stomach pain, or jaundice (yellowing of the skin and eyes).

  • Kidney problems: symptoms may include tiredness or fatigue, nausea, swollen extremities, and shortness of breath.

 Other serious side effects include:

  • Extreme allergic reaction

  • Fever

  • Lightheadedness

  • Arrhythmia caused by high potassium levels

Long-term use of lisinopril

Lisinopril is designed to be a long-term maintenance drug for health conditions like high blood pressure. However, long-term lisinopril use may cause reduced kidney function.³

Missed doses

Take a missed dose as soon as you remember. If it’s nearly time for your next dose, skip the missed dose and resume your normal schedule. Don’t take two doses at once to make up for a missed dose.

Overdoses

Lisinopril overdose may cause symptoms, such as low blood pressure, lightheadedness, or loss of consciousness. 

Seek emergency medical help if you think you or someone else has taken too much lisinopril or are displaying these symptoms.

What to discuss with your doctor before taking lisinopril

Before taking lisinopril, you must tell your doctor about any other prescription or over-the-counter medications, herbal medicines, or nutritional supplements you are currently taking (or plan to start taking). They may interact with lisinopril and cause harmful complications.

Tell your doctor about any other diagnosed health conditions, including diabetes or kidney disease. They should also be aware if you are at risk of angioedema, a condition that causes difficulty swallowing and could result in swelling of the face, tongue, throat, lips, and limbs.

Provide information about other medical or non-medical treatments you are undergoing for your health conditions.

If you previously had an allergic reaction to lisinopril or any other medication, tell your doctor.

Let your doctor know if you are pregnant, breastfeeding, or planning a pregnancy.

Before taking lisinopril, ask your doctor about the possible side effects and weigh up the risks and benefits of taking the drug.

Ask your doctor if there are certain foods or substances you need to avoid when taking lisinopril, like alcohol.

Stopping lisinopril

Don’t stop taking lisinopril unless your doctor tells you to.

Stopping lisinopril treatment suddenly can cause withdrawal effects,⁴ such as tachycardia, a condition where the heart beats abnormally fast.

Lisinopril and pregnancy

As an ACE inhibitor, lisinopril is considered a pregnancy category C⁵ medication during the first trimester and a pregnancy category D medication during the second and third trimesters. This means the drug can seriously harm a developing fetus at this stage.

Tell your doctor immediately if you become pregnant, or if you are planning a pregnancy.

Taking lisinopril while breastfeeding is not advised, as the drug passes into breast milk and may harm a nursing baby.

Interactions with other drugs

Here are some of the drugs that interact with lisinopril that could cause adverse effects:

  • Blood pressure medications: this could result in hypotension or low blood pressure.

  • Bactrim: could significantly increase potassium levels in the body, resulting in hyperkalemia.

  • Non-steroidal anti-inflammatory drugs (NSAIDs): could reduce the effectiveness of lisinopril and harm the kidneys.

  • Insulin: could significantly lower your blood pressure.

  • Diuretics (water pills): may lower your blood pressure.

  • Neprilysin inhibitors: could increase the risk of angioedema.

  • Immunosuppressants (used to prevent rejection after organ transplant): may increase the risk of angioedema.

  • Injectable gold (sodium aurothiomalate): may increase the risk of nitritoid reaction.

Lisinopril may also interact with other medicines such as aspirin, duloxetine, atorvastatin, and vitamins, including vitamin B12 and ascorbic acid.

Allergy information

Some people develop a mild allergic reaction when taking lisinopril. Symptoms may include rashes, itchiness, flushing, or reddening of the skin.

Severe allergic reactions with symptoms like trouble breathing and swollen eyelids, lips, and limbs could occur.

Seek urgent medical care if you develop symptoms of an allergic reaction.

Tips and advice for taking lisinopril

Here are some tips and advice for taking lisinopril safely and effectively:

  • Avoid drinking alcohol when you are taking this medication.

  • Avoid being dehydrated when taking this medication, especially when doing exercise.

  • Move from a seated or lying down position slowly to avoid dizziness.

  • Check your blood pressure regularly and schedule regular visits to your doctor.

  • Store lisinopril in a tightly sealed container away from light, at room temperature of 15 to 30 degrees Celsius. Keep the medication away from damp places.

  • Ask your doctor about taking supplements such as potassium supplements and salt substitutes.

  1. Lisinopril | Drugs.com

  2. Lisinopril (Zestril) | Everyday Health

  3. Side effects of lisinopril | NHS

  4. What to know about lisinopril (Prinivil and Zestril) | Verywell Health

  5. Zestril | Food and Drug Administration

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Disclaimer

Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.

However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.

It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.

Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.

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