Why it's used

Lisinopril is a prescription medicine that is used to treat high blood pressure, heart attack and kidney complications of diabetes mellitus. Lisinopril works by blocking certain chemicals that are responsible for the narrowing of the blood vessels. Lisinopril helps by making the blood to flow smoothly in the body. Lisinopril is also used to treat heart failure along with primary treatment.
Lisinopril may also be used along with other medicines in the treatment of certain conditions as recommended by the doctor. It is used with diuretics (for example, Hydrochlorthiazide) to treat high blood pressure and heart failure. It is also used together with Anti-Hypertensive to treat high blood pressure. It is also used together with Digitalis Glycosides to treat heart failure.
Angiotensin Converting Enzyme Inhibitor
Lisinopril belongs to the Angiotensin Converting Enzyme Inhibitor class of medicines. Angiotensin-converting enzyme (ACE) inhibitors treat a variety of conditions, such as high blood pressure, migraines, and scleroderma. It helps in relaxing the blood vessels.

How to use

Follow directions on the product label, information guide, and provided by your doctor before using Lisinopril. Consume this medicine as per your doctor's instructions.
You should track your blood pressure levels regularly. Discuss your results with the doctor, especially if your blood pressure measurements are too high or too low. Your treatment may need changes.
Lisinopril is consumed with or without food.
The typical adult dose of Lisinopril is 20-40 mg per day (not more than 80 mg a day). The typical dose for children is 0.07 mg/kg or 0.03 mg/lb once daily up to 5 mg (not more than 0.61 mg/kg or 0.3 mg/lb once daily up to 40 mg). Lisinopril is typically used at the same time every day. It takes 1 hour for this medicine to start its action. There are no known habit-forming tendencies with this medicine.
Lisinopril is to be used for longer periods of time. Lisinopril may be given for the long-term treatment of high blood pressure. You should continue to use this medicine as directed by the doctor even if you feel well.
Tell your doctor if you develop new symptoms. Talk to your doctor if a dry cough for a long time, swelling under the lower layer of skin, swelling of larynx, swelling of face, swelling of limbs, swelling of eyes, swelling of lips, swelling of tongue, difficulty in swallowing, difficulty in breathing, lowering of blood pressure while standing up from lying position, light-headedness, fainting, signs of infection, sore throat, and fever. If you have any kidney disease, the starting dose of Lisinopril should be decreased up to 5 mg for high blood pressure, 2.5 mg for heart failure and 2.5 mg for heart attack in patients with creatinine clearance more than or equal to 10 ml/min and less than or equal to 30 ml/min.
To see the impact of Lisinopril on the body, your doctor may recommend a lower initial dose. Please follow your doctor's instructions carefully.
When stopping this medicine, it is possible that you may experience withdrawal symptoms such as high blood pressure.
If you are giving Lisinopril to a child, be sure to use a product that is meant for use in children. Before giving this medicine, use the child's weight or age to find the right dose from the leaflet or product package. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.
Medicines may be given for uses other than those listed in the medicine guide. Do not use Lisinopril for symptoms for which it was not prescribed. Do not give Lisinopril to others who may have similar symptoms as you. Self-medication can cause harm.
Store Lisinopril at 20-25°C (68-77°F), away from moisture, and away from light. Keep this medicine away from children and pets.

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How to take Lisinopril

Your dose may depend on several personal factors. You should consult with your doctor to find out the dose that is best for you. The dose of Lisinopril depends on the following factors:
  • patient's age
  • patient's weight
  • patient's health
  • the health of the patient's liver
  • response to treatment

Lisinopril Dosage

Dosage for high blood pressure

Adult
  • Recommended: 20 to 40 mg per day in a single dose
  • Initial: 10 mg once daily or a starting dose of 2.5-5 mg is advised in patients with elevated blood pressure caused by kidney disease, decreased salt and body fluid, difficulty breathing, fatigue, and swelling of feet or leg, or severely low blood pressure.
  • Maximum: 80 mg
Children (aged 6 years and older with filtration rate by kidney more than 30 ml/min/1.73 m^2 and high blood pressure)
  • Initial: 0.07 mg/kg (0.03 mg/lb) once daily up to 5 mg
  • Maximum: 0.61 mg/kg (0.3 mg/lb) once daily up to 40 mg
Children (weighing 20 kg to less than 50 kg or 44 lb to less than 110 lb)
  • Initial: 2.5 mg once daily
  • Maximum: 20 mg daily
Children (weighing more than or equal to 50 kg or more than or equal to 110 lb)
  • Initial: 5 mg once daily
  • Maximum: 40 mg daily

Dosage for heart failure (used with diuretics or digitalis)

Adult
  • Initial: 5 mg once daily or 2.5 mg once daily for patients with low blood sodium levels (less than 130 mEq/L)
  • Maximum: 40 mg once daily

Dosage for heart attack

Adult (patients with normal blood pressure within 24 hours of heart attack)
  • Recommended: 5 mg orally, then 5 mg after 24 hours, followed by 10 mg after 48 hours and then continue a single daily dose of 10 mg for 6 weeks

Dosage for heart attack

Adult (patients having low blood pressure (less than or equal to 120 mmHg and more than 100 mmHg))
  • Recommended: 5 mg daily as the maintenance dose should be given but if low blood pressure occurs (less than or equal to 100 mmHg) it can be reduced up to 2.5 mg temporarily if needed
  • Initial: a starting dose of 2.5 mg should be given for the first 3 days after the heart attack

Dosage for high blood pressure (used with diuretics)

Adult
  • Recommended: 5 mg once a day with 12.5 mg of hydrochlorothiazide
  • Initial: 5 mg once a day

Dosage for kidney complications of diabetes mellitus

Adult (low blood pressure patients with type 2 diabetes and kidney dysfunction due to diabetes)
  • Recommended: 10 mg once daily can be increased to 20 mg single dose per day

Minimum Age

6 years

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Tablet
Strength: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, and 40 mg
Film-Coated Tablet
Strength: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, and 40 mg
Solution
Strength: 1 mg/ml

Special Instructions

Patients on hemodialysis or creatinine clearance (less than 10 ml/min)
The starting dose of Lisinopril should be 2.5 mg once daily in such patients.
Patients with creatinine clearance (more than or equal to 10 ml/min and less than or equal to 30 ml/min)
The starting dose of Lisinopril should be decreased up to 5 mg for high blood pressure, 2.5 mg for heart failure and 2.5 mg for heart attack in such patients.
Patients with creatinine clearance (31-80 ml/min)
The starting dose of Lisinopril should be 5-10 mg once daily in such patients.

Missed Dose

Take a dose as soon as remember. Skip the missed one if it's time for the next dose. Avoid taking a double dose to make up for the missed dose.

Overdose

What to do if you overdose on Lisinopril?
In case of overdose, stomach emptying should be performed by cleaning out the contents of the stomach by vomiting or by using adsorbents, a substance that absorbs poisons from the stomach and sodium sulphate. Also, provide treatment with an infusion of normal saline solution, angiotensin II into the vein, or catecholamines into the vein to such patients. If low blood pressure occurs, the patient should be laid flat on back with the raised legs position. Lisinopril should be removed from the body by blood purifying technique (called hemodialysis). Close supervision of blood electrolytes, vital signs, and creatinine level should be provided. Pacemaker therapy, a small device placed in the chest to control abnormal heart rhythms may be provided for patients in which decreased heartbeat is not being controlled by the medicines.
Symptoms of an overdose of Lisinopril
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Lisinopril, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Lisinopril

Before you use Lisinopril, discuss with your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic any of the following substances: angiotensin-converting enzyme inhibitor.
Before you use Lisinopril, tell your doctor of your medical and health history including the following: fluid accumulation under the skin, surgery of airways, heart or brain disease, history of in utero exposure to Lisinopril, narrowing of the aorta (an artery in the heart), narrowing of the heart valves (mitral valves), narrowing of the kidney artery, an increase in the thickness of the heart muscle (hypertrophic cardiomyopathy), blood vessels (collagen vascular disease), low blood pressure, kidney problems, undergoing kidney dialysis, liver problems, diabetes, diarrhea, vomiting, if you are on a controlled salt diet, high cholesterol level, undergoing a treatment for removal of cholesterol from blood (LDL apheresis), or people of black origin. The patients with a history of airway surgery are more likely to experience an airway obstruction during an allergic reaction. If symptoms such as less urine production or low blood pressure occur in babies with a history of in utero exposure, appropriate treatment such as blood transfusion or dialysis should be provided for the maintenance of blood pressure and functioning of the kidneys. Lisinopril may be less effective in patients who are of black origin. They are also more likely to suffer from fluid accumulation under the skin. Before having surgery during the use of Lisinopril, discuss with your doctor and dentist about the medicinal products you use including prescription/non-prescription/herbal medicines.
The use of this medicine may change liver enzyme. An increase in the level of liver enzymes may occur while using Lisinopril.
The use of this medicine may change blood urea nitrogen. A small increase in the blood urea nitrogen level may occur while using Lisinopril. This is reversible upon discontinuing the use of Lisinopril. Such changes are more commonly seen in patients suffering from narrowing of kidney arteries or heart failure and undergoing treatment with diuretics.
The use of Lisinopril may change creatinine level. A small increase in the creatinine level may occur while using Lisinopril. This is reversible upon stopping the use of the medicine. This is more commonly seen in patients suffering from narrowing of kidney arteries or heart failure and undergoing treatment with diuretics.
The use of this medicine may change potassium levels. The use of Lisinopril in patients with high blood pressure and heart failure may cause an increase in the potassium levels (greater than 5.7 mEq/L).
The use of Lisinopril may change hemoglobin and ratio of the volume of red blood cells to total blood volume (hematocrit). A small decrease in the hemoglobin and ratio of the volume of red blood cells to total blood volume (hematocrit) level may occur while using Lisinopril.
Lisinopril can make you feel sleepy. Be careful when using any machinery, driving a vehicle, or doing any other activity that needs you to be fully alert. The consumption of alcohol with Lisinopril can worsen the sleepiness.
The use of Lisinopril is known to be not safe for use in pregnant women. If you are planning to become pregnant or are currently pregnant, you should discuss with your doctor the potential impact of this medicine on the baby before you start to using it. The use of Lisinopril in the second and third trimesters of pregnancy causes a decrease in the functioning of kidneys and increases the chances of fatality in the unborn baby. It can also result in a deficiency of amniotic fluid in womb associated with incomplete development of lungs and bone deformations. Other side effects caused by Lisinopril include skull abnormalities, less production of urine, low blood pressure, kidney failure, and other defects in the baby. When pregnancy is detected, stop using Lisinopril. Appropriate management of high blood pressure in the mother during pregnancy should be done. If no alternative therapy is available, tell the mother about the risk of deficiency of amniotic fluid and perform ultrasound regularly. Closely observe babies with a history of in utero exposure to Lisinopril for symptoms of low blood pressure, less urine production, and increased potassium levels. The use of Lisinopril is not safe for use in women who are breastfeeding. If you are breastfeeding a baby, discuss with your doctor if you should either discontinue breastfeeding or stop using this medicine while breastfeeding. It is unknown whether Lisinopril passes into human milk or not. Due to the possibility of severe side effects in infants from ACE inhibitors, a decision should be made whether to discontinue breastfeeding or stop using this medicine based on the importance of this drug to the mother. Consult with your doctor on the use of Lisinopril, if you are trying to conceive.
This medicine may increase your sensitivity to sunlight. If this happens, use a sunscreen and cover your skin when you are outdoors. Limit your time in the sun. If you get a sunburn on your skin, consult with your doctor.
Lisinopril may cause increased incidence of side-effects in older patients. Elderly patients may see an increased risk of kidney dysfunction.

What precautions should be taken during Pregnancy and Nursing, and administering Lisinopril to Children or the Older Adults?

Pregnant Women

Contraindicated or Not Recommended
Warning: The use of Lisinopril in the second and third trimesters of pregnancy causes a decrease in the functioning of kidneys and increases the chances of fatality in the unborn baby. It can also result in a deficiency of amniotic fluid in womb associated with incomplete development of lungs and bone deformations. Other side effects caused by Lisinopril include skull abnormalities, less production of urine, low blood pressure, kidney failure, and other defects in the baby. When pregnancy is detected, stop using Lisinopril. Appropriate management of high blood pressure in the mother during pregnancy should be done. If no alternative therapy is available, tell the mother about the risk of deficiency of amniotic fluid and perform ultrasound regularly. Closely observe babies with a history of in utero exposure to Lisinopril for symptoms of low blood pressure, less urine production, and increased potassium levels.

Breastfeeding

Contraindicated or Not Recommended
Warning: It is unknown whether Lisinopril passes into human milk or not. Due to the possibility of severe side effects in infants from ACE inhibitors, a decision should be made whether to discontinue breastfeeding or stop using this medicine based on the importance of this drug to the mother.

Younger Adults Population

Possibly safe
Warning: The safety and effectiveness of Lisinopril have not been established in children of age less than six years or having a filtration rate of less than 30 mL/min/1.73m^2 by kidneys.

Older Adults Population

Possibly safe
Warning: Elderly patients are at higher risk of developing kidney dysfunction and are usually more sensitive to this medicine.

Lisinopril Side-effects

The following side-effects may commonly occur when using Lisinopril. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in older patients on the use of Lisinopril. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • kidney dysfunction
Rarely, the use of Lisinopril may cause the following side-effects:
  • abnormality of lymph nodes
  • benign enlargement of the male breast
  • benign skin disorders (cutaneous pseudolymphoma)
  • blistering of the skin
  • changes in the sense of smell (olfactory disturbance)
  • dark coloured urine
  • difficult to swallow
  • difficulty in erection (impotence)
  • double vision (diplopia)
  • dry mouth
  • elevated red blood cell sedimentation rate (ESR)
  • fainting
  • fast heartbeat (palpitations)
  • fatigue
  • feeling hungry, sleepy, tired and weak
  • flushing
  • hair loss
  • high buildup of uric acid (gout)
  • hives
  • increase in the number of white blood cells (eosinophilia)
  • indigestion
  • inflamed gut
  • joint and muscle pain
  • kidneys stop producing urine (anuria)
  • lack of energy
  • loss of appetite
  • low output of urine
  • lumps
  • mood alterations
  • narrowing of blood vessels that supply blood to the skin in response to cold (Raynaud's phenomenon)
  • nausea
  • pain and inflammation of the joint (arthritis)
  • pain in joints
  • pale skin
  • photophobia
  • positive antinuclear antibodies (ANA)
  • raised level of urea in the blood (uraemia)
  • red and itchy patches on the skin (psoriasis)
  • ringing in the ears (tinnitus)
  • runny nose
  • severe itching
  • sleep disturbances
  • sore throat
  • stomach pain (abdominal pain)
  • stuffy nose (rhinitis)
  • sweating
  • swelling of the joints or glands
  • swelling of the lips, extremities, face, tongue, glottis, and larynx
  • syndrome of inappropriate antidiuretic hormone secretion (SIADH)
  • taste disturbance
  • tingling or pricking sensation skin
  • vertigo
  • visual loss
The following severe side-effects may also occur when using Lisinopril:
Your doctor has prescribed this Lisinopril because they have judged that the benefits outweigh the risks posed by side-effects. Many people using this medicine do not have serious side-effects. This is not a complete list of possible side-effects for Lisinopril.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Lisinopril by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Older Adults

Following are the side-effects of this medicine in elderly patients:
  • kidney dysfunction

Mild Allergic Reactions

Following are the symptoms of mild allergic reactions to this medicine:
  • burning, red or peeling skin
  • difficult to swallow
  • hives
  • itchy or red patches (psoriasis)
  • severe itching of the skin
  • swelling of the face, tongue, lips, or throat
  • watery blisters form on the skin (pemphigus)

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
If this happens, stop using this medicine and contact your doctor immediately.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Abnormalities in unborn babies

Women using Lisinopril during the first, second and third trimesters of pregnancy are at an increased risk. The use of Lisinopril in the second and third trimesters of pregnancy causes a decrease in the functioning of kidneys and increases the chances of fatality in the unborn baby. It can also result in a deficiency of amniotic fluid in womb associated with incomplete development of lungs and bone deformations. Other side effects caused by Lisinopril include skull abnormalities, less production of urine, low blood pressure, kidney failure, and other defects in the baby. When pregnancy is detected, stop using Lisinopril. Appropriate management of high blood pressure in the mother during pregnancy should be done. If no alternative therapy is available, tell the mother about the risk of deficiency of amniotic fluid and perform ultrasound regularly. Closely observe babies with a history of in utero exposure to Lisinopril for symptoms of low blood pressure, less urine production, and increased potassium levels.

Swelling of the lower layer of the skin

Patients with the history of swelling of the lower layer of the skin by using angiotensin-converting enzyme inhibitor drugs are at an increased risk when using this medicine. Also, black patients are at an increased risk as compared to non-black patients. These patients may suffer from swelling of the extremities, face, lips, tongue, glottis and larynx. Patients with a history of airway surgery are at an increased risk of airway obstruction due to the involvement of tongue, glottis or larynx. In black patients, the effectiveness of Lisinopril may be reduced because of low level of an enzyme (known as renin). If this happens, stop using this medicine, and give proper treatment or monitoring to the patient. The treatment may involve the use of adrenaline, which is used to reduce the allergy. Also, airway management is advised in the patient.

Severe allergy (anaphylactoid reactions) during desensitization

Patients treated with hymenoptera venom for desensitization while taking ACE inhibitors are at an increased risk. These patients may sustain life-threatening allergic reactions. The treatment with ACE inhibitors is temporarily stopped in such patients to avoid these reactions.

Severe allergy (anaphylactoid reactions) during dialysis

Patients undergoing dialysis with high flux membranes while using ACE inhibitors are at an increased risk. Such patients may suffer from life-threatening allergic reactions. Severe allergic reactions also occur when taking dextran sulfate for removing low-density lipoprotein (LDL) cholesterol from the blood while using ACE inhibitors. The dialysis should be stopped immediately and provide appropriate treatment to the patient for these allergic reactions. The use of a different type of dialysis membrane and medicine for high blood pressure is advised.

Kidney dysfunction

Patients suffering from narrowing of kidney arteries (renal artery stenosis), kidney insufficiency, high blood pressure, severe congestive heart failure, severe kidney disease, syndrome occurring after heart failure or volume depletion are at an increased risk while using this medicine. Patients are at risk of an increase in the level of urea and creatinine in the blood. The patients with heart failure may suffer from kidney failure. In such patients, the treatment should be done only under medical supervision. Also, a low dosage of Lisinopril in carefully divided doses is recommended. The combined treatment with diuretics should be discontinued and the functioning of the kidneys should be monitored during the first few weeks of Lisinopril therapy. The use of Lisinopril should be stopped if the patient suffers from kidney dysfunction during the treatment. In patients with kidney dysfunction, an initial dose of Lisinopril should be adjusted according to creatinine clearance and based on patient's response. The regular monitoring of potassium and creatinine level is recommended in such patients. The kidney disease patients suffering from a heart attack should not use this medicine.

Low blood pressure

The patients with heart failure having low blood pressure (below 100 mmHg), reduced oxygen supply to heart (ischemic heart disease), brain damage from the obstruction of blood supply (cerebrovascular disease), low sodium level, high dose of diuretics, having limitation on dietary salt, diarrhea, vomiting, high blood pressure, kidney disease, undergoing kidney dialysis, excess salt and water excretion in the urine (volume-depletion), narrowed opening of heart valve (severe aortic stenosis) or thickening of heart muscle (hypertrophic cardiomyopathy) are at an increased risk. Such patients are at the risk of developing excessive low blood pressure. This may occur together with reduced urine production, kidney failure or abnormally high levels of nitrogen in the blood and it can be possibly fatal. The patient should be placed in lying position and if necessary an intravenous infusion of normal saline may be given. The use of this medicine should be done only under close supervision in such patients. Such patients should be observed closely for the first two weeks of treatment or whenever the dose of Lisinopril or diuretic is increased. The use of Lisinopril should be avoided or a low dose of Lisinopril should be used in patients with unstable blood pressure after a heart attack.

High blood potassium level (hyperkalemia)

The patients with kidney insufficiency and diabetes mellitus are at an increased risk when using this medicine. Also, the combined use of potassium-sparing diuretics, potassium-containing salt substitutes, and potassium supplements with this medicine are at an increased risk. These patients may suffer from increased blood potassium level. If using these combinations, the regular monitoring of blood potassium is recommended.

Patients undergoing surgery or using anesthesia

The patients undergoing surgery or using anesthesia that reduces the blood pressure are at an increased risk while using this medicine. Lisinopril may block the release of an enzyme causing low blood pressure in such patients. If this occurs, a rapid expansion of the blood volume is advised.

Liver failure

Patients who use angiotensin-converting enzyme inhibitor drugs are at an increased risk. These patients may have hepatitis or jaundice including decreased bile flow from the liver (cholestatic jaundice) and leads to liver tissue death (necrosis) and sometimes fatality. If the patient develops jaundice or increase in the liver enzymes, this medicine should be discontinued and receive appropriate treatment.

Heart diseases

Patients with narrowing of the heart blood vessel, blockage of blood flow in the heart, and abnormally thick heart muscle are at an increased risk while using this medicine. Such patients should take caution while taking Lisinopril.

Patients taking mTOR inhibitors

Patients taking mTOR inhibitors such as everolimus, sirolimus, or temsirolimus are at an increased risk while using this medicine. These patients may suffer from swelling due to fluid accumulation under the skin.

Abnormally low count of white blood cells

Patients using Lisinopril are at an increased risk. There is a risk of the abnormally low count of white blood cells, red blood cells, and platelets while using this medicine. The stoppage of ACE inhibitors may reverse abnormally low count of white blood cells. Take Lisinopril with caution and monitor white blood cells counts in patients with inflammation of the tissues (collagen), suppression of the immune system, using procainamide or allopurinol, or having kidney dysfunction. These patients may develop serious infections that do not respond to antibiotic therapy. Patients are advised to report signs of infection while using Lisinopril.

Blood pressure lowering agents

Patients with diabetic kidney disease are at an increased risk when using Lisinopril in combination with blood pressure lowering agents such as aliskiren, ACE inhibitors, or angiotensin two receptor blockers. These patients may have low blood pressure, raised potassium level in the blood (hyperkalemia), and changes in the functioning of kidneys. In patients with diabetic kidney disease, Lisinopril should not be used with these drugs. This combination should only be used under the specialist supervision and the close monitoring of electrolytes, blood pressure and functioning of the kidney are required.

Continuous dry cough production

Patients using ACE inhibitors are at an increased risk. These patients may suffer from a continuous and dry cough. A cough may resolve after stopping the use of ACE inhibitors.

Pregnancy

Patients who are pregnant and planning to become pregnant are at an increased risk when using this medicine. The use of Lisinopril in the second and third trimesters of pregnancy causes a decrease in the functioning of kidneys and increases the chances of fatality in the unborn baby. It can also result in a deficiency of amniotic fluid in womb associated with incomplete development of lungs and bone deformations. Other side effects caused by Lisinopril include skull abnormalities, less production of urine, low blood pressure, kidney failure, and other defects in the baby. Angiotensin-converting enzyme inhibitors should not be used in pregnancy. In pregnant women use of an alternative therapy is recommended.

Interactions with Lisinopril

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Lisinopril interacts with Non-steroidal anti-inflammatory agents, which are used to reduce fever and pain. While using Lisinopril with non-steroidal anti-inflammatory agents (acetylsalicylic acid, selective cyclooxygenase-2 inhibitors or non-selective NSAIDs) the effectiveness (blood pressure lowering effect) of Lisinopril may be reduced. The concurrent use of these medicines in elderly, volume-depleted or in patients with kidney dysfunction may cause a reversible deterioration of functioning of the kidneys or kidney failure. In elderly, use caution while using these medicines together. The patients should be adequately hydrated and monitored for the functioning of the kidneys.
There may be an interaction of Lisinopril with antidiabetics, which are used to treat high blood sugar level. The use of Lisinopril with antidiabetic medicines such as oral hypoglycemic agents and insulin may increase the risk of blood glucose lowering effect. This is more likely to occur in patients with kidney dysfunction or during the first few weeks of concurrent use of these medicines.
Lisinopril may interact with diuretics, which are used to increase urine production. The use of Lisinopril with diuretics may cause an excessive decrease in blood pressure. Such events can be minimized by reducing or stopping the use of the diuretic together with Lisinopril. Increasing the intake of salt prior to the treatment with Lisinopril is also recommended. If not possible, decrease the dose of Lisinopril.
Your doctor's guidelines may need to be followed while taking this medicine along with lithium, which is used to treat mental disorders. The use of Lisinopril with lithium may cause an enhancement in the levels of lithium in the blood. This condition is reversible upon stopping the use of this medicine. The use of Lisinopril with lithium is not recommended. If the concurrent use is necessary, the monitoring of lithium level in the blood is recommended.
Special instructions need to be followed while taking this medicine along with blood pressure lowering agents. The use of Lisinopril together with blood pressure lowering agents such as aliskiren, ACE inhibitors, or angiotensin receptor blockers, may cause an increased risk of low blood pressure, raised potassium level in the blood (hyperkalemia), and changes in the functioning of kidneys. A decrease in the blood pressure may occur while using Lisinopril with other blood pressure lowering agents (for example, vasodilators, glyceryl trinitrate or other nitrates). The use of Lisinopril with blood pressure lowering drugs which act on the renin-angiotensin system should be avoided. The patients using these medicines together should be monitored closely for blood pressure, electrolyte level and functioning of kidneys. The use of aliskiren is not recommended in patients suffering from diabetes or kidney dysfunction.
Your doctor's guidelines may need to be followed while taking this medicine along with drugs which mimic the stimulation of sympathetic nervous system (sympathomimetics), which are used to treat heart attack, low blood pressure and other conditions. The use of Lisinopril with sympathomimetics may decrease the blood pressure lowering effect of Lisinopril.
Special instructions need to be followed while taking this medicine along with tissue plasminogen activators, which are used to treat blood clots. The use of Lisinopril with tissue plasminogen activators may cause fluid accumulation under the skin in the patients.
Lisinopril interacts with inhibitors of mammalian target of rapamycin (mTOR), which are used to avoid rejection of organ transplantation. The use of Lisinopril with mammalian target of rapamycin (mTOR) inhibitors such as temsirolimus, everolimus or sirolimus may cause fluid accumulation under the skin in the patients.
There may be an interaction of Lisinopril with cotrimoxazole, which is used to treat bacterial infections. The use of Lisinopril while using cotrimoxazole (trimethoprim/sulfamethoxazole) may cause an increase in the potassium level in the blood.
Lisinopril may interact with gold, which is used to treat pain associated with swelling and stiffness of the joints (rheumatoid arthritis). The use of Lisinopril with injectable gold (sodium aurothiomalate) may cause nitritoid reactions (dizziness, low blood pressure, nausea, vomiting and redness of the face) in the patients.
There may be an interaction of Lisinopril with potassium containing medicines. The use of Lisinopril with potassium-sparing diuretics, potassium-containing salt substitutes, potassium supplements or other drugs that may increase potassium level especially in patients with kidney dysfunction may cause an increase in the potassium level in the blood. While the use of Lisinopril with a potassium-losing diuretic may cause a decrease in the potassium level. The potassium levels should be monitored in such patients.
Lisinopril may interact with antipsychotics, tricyclic antidepressants, or anesthetics which are used to treat mental disorders and to numb the body sensation respectively. The use of Lisinopril with antipsychotics, tricyclic antidepressants, or anesthetics may cause a further decrease in blood pressure.
This page does not contain all the possible interactions of Lisinopril. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Interactions of Lisinopril by Severity

Severe

The following medicines are usually not to be taken together without consulting with your doctor or pharmacist.

Serious

The following medicines may interact when taken together and can cause harmful effects in the body. Please consult with your doctor or pharmacist before taking these medicines together.

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Lisinopril be not used?

History of severe allergy to angiotensin-converting enzyme inhibitors

Lisinopril is not recommended in patients with the history of severe allergy to angiotensin-converting enzyme inhibitor medicines. These patients may have the following symptoms if they use this medicine:
  • swelling of the face, tongue, lips, or throat
  • difficult to swallow
  • severe itching of the skin
  • burning, red or peeling skin
  • hives
  • itchy or red patches (psoriasis)
  • watery blisters form on the skin (pemphigus)
  • severe or sudden swelling of the hands, feet and ankles
  • difficulty breathing
  • rash
  • severe skin allergic reactions (Stevens-Johnson Syndrome)
  • reddening of the skin (erythema multiforme)

Severe allergy due to an unknown cause or by birth

Lisinopril is not recommended in patients with swelling of the lower layer of skin from an unknown cause or by birth.

Diabetic or kidney disease patients using aliskiren

The use of aliskiren with Lisinopril is not recommended in diabetic or kidney disease (clearance rate by kidney less than 60 ml/min) patients. Such patients are at an increased risk of low blood pressure, change in the functioning of the kidney including kidney failure and high blood potassium levels.

Pregnancy

The use of Lisinopril during the first, second and third trimesters of pregnancy is not recommended. Such patients are at an increased risk of abnormalities in newborns such as decreased functioning of the kidney, low blood pressure, high blood potassium levels, deficiency of amniotic fluid in the uterus, and skull abnormalities.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Lisinopril is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Lisinopril .
High Blood Pressure
Heart Attack
Diabetic Kidney Disease
Heart Failure

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