Lisinopril, What Is It, And What Are Its Side Effects?
Blood pressure is a product of cardiac output as well as the resistance of the walls of the arteries and veins to blood. When the heart pumps with more “vigor,” or the vessels are “stiffer” than usual, this pressure can increase and cause high blood pressure (1-2). High blood pressure (hypertension) affects nearly half of the adults in the U.S., with almost a 90% lifetime risk. (3) A diagnosis of hypertension is made when the blood pressure is higher than normal (130/80 mmHg).
Hypertension is a health condition that is mostly without symptoms, and it should be continuously treated because it can increase the risk of heart disease and/or strokes. These are some of the leading causes of death in the U.S. Yet, only one-fourth of adults have their essential hypertension under control (4-5). Consequently, effective medication therapy can keep blood pressure under control (5).
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor and is a proven antihypertensive drug that lowers blood pressure. It blocks a substance in the body that tightens the blood vessels and increases water retention (6-7). In addition to hypertension, lisinopril is prescribed to treat heart failure and heart attacks (7). Although it mainly presents good tolerance, people using lisinopril should know and recognize possible side effects. Some can be serious and require immediate discontinuation.
Keep reading to find out what lisinopril is and its possible side effects. In this article, you will learn when to contact your doctor and stop taking the medication immediately.
What is Its Presentation?
Lisinopril, known under Zestril and Prinivil brand names but also generic names (Acebitor, Acemin, Acinopril, Fisopril, Tensopril, and others), is available in syrup 1mg/ml strength for pediatric use and tablets with the following strengths: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, and 40 mg, which makes dosage more convenient.
For hypertension, the initial dose in adults is 10 mg once daily. Then, according to the daily blood pressure measured values, the doctor may increase the dose to a maximal daily dose of 40 mg. In children older than 6, the doctor will define the dose based on the body weight calculating 0.07 mg/kg, but not more than 5 mg daily (8-9).
The initial dose for heart failure treatment and acute myocardial infarction (MI) is 5 mg. In MI, the next day follows another 5 mg dose, after 10 mg daily. For heart failure, the doctor can increase the dose to a maximum of 40 mg daily, depending on how the patient tolerates it (5, 8, 9).
What Side Effects May Lisinopril Cause?
Lisinopril is a medication that positively affects high blood pressure regulation and, therefore, risk reduction of life-threatening conditions mentioned before. However, lisinopril may cause side effects that can be mild to serious and affect different systems in the body.
Common Side Effects
The following side effects may happen to 1-10% of people taking lisinopril:
- A dry, hacking cough – When lisinopril causes this problem, cough medicines usually do not help. This cough typically begins within a week or two of starting the medication but can be delayed up to six months. The resolution is typically within 1-4 days but can take up to a month. Another medication for hypertension might be more appropriate for you. (10)
- Dizziness and lightheadedness– This effect may happen when you begin with the treatment or increase the dose. If it happens to you when you stand up, sit until you feel better and get up slowly. Lying down also helps; sit after and stay like that until you feel better. Dizziness can be unsafe, so don’t ride a bike, drive, or operate heavy machinery.
- Headaches – If you experience headaches more than before, drink more water and avoid alcohol. Painkillers can help, but before you take them, even out-of-the-counter (OTC) ones, consult your physician about which one. If headaches are bothering you longer than a week or are severe to stand, talk to your doctor.
- Skin rash or itching – When this mild allergy symptom occurs, an antihistamine, recommended by a pharmacist, may help.
- Blurred vision – Avoid driving or operating machinery while this happens to you. (8-11)
Serious Side Effects
If you experience some of the following symptoms, call your doctor immediately or emergency services at 911. Although rare (1 in 1,000 – 1 to 10,000 patients), these are serious:
- Yellowing of the skin or eyes – This can be a sign of a liver problem when the whites of the eyes become yellow or the skin.
- Feel tired, dizzy, easily bleeding, fever, sore throat, or signs of infection – These signs may be a result of a blood or bone marrow disorder.
- Severe stomach pain – ACE-I can rarely cause pancreatitis, which would present with severe stomach pain.
- Swelling in hands, feet, ankles, or lower legs – These might be the signals that occur when there are kidney problems. Long-term therapy with lisinopril may, in rare cases, damage the kidneys. (8-11)
- Hoarseness and difficulty breathing or swallowing, swelling of the face, throat, tongue, rash, and itching – These signs could be a result of an allergic reaction (7) and require immediate attention.
You can find the complete list of side effects in the Medication Guide (8-9). Read it carefully and ask your doctor about the side effects you want to know more about.
Tell your doctor if you experience any event that seems like the described side effects. You can also report side effects to the United States Food and Drug Administration (FDA) by phone (1-800-332-1088) or at the following link:
MedWatch: The FDA Safety Information and Adverse Event Reporting Program.
Symptoms of Overdose
Hypotension is the most likely manifestation of an overdose which requires a saline solution to be taken intravenously in the hospital. Overdose symptoms may include the following:
- Lightheadedness (6);
- Fainting (6).
In such cases, call the poison center helpline at 1-800-222-1222.
Fetal Toxicity: Important Warning
Women must know that lisinopril or any other drug that acts directly on the renin-angiotensin system (a physiological system that regulates blood pressure) can cause injury and death to the developing fetus. Therefore, if pregnancy is detected, stop taking lisinopril immediately, and call your doctor for recommendations on how to continue the high blood pressure treatment (8-9).
Additional Precautions and Measures
Follow the recommendations and preventive measures to be sure that your lisinopril treatment will be safe:
- Tell your doctor if you have any other medical problems such as angioedema caused by other ACE inhibitors, diabetes, kidney problems, low sodium in the blood (electrolyte imbalance), heart or blood vessel problems, liver disease, etc., or allergies to medications;
- Tell your doctor about any medication that you take, even OTC; some drugs may interact with lisinopril. Therefore, the treatment should not cause any harm to you;
- If you miss a dose, take it as soon as possible; if the time is close to the next dose, wait for the time to come. Do not take a double dose to make up for a missed one (6).
- Reduce salt intake if you eat salty food;
- Consult your doctor about diet changes and consuming alcohol (7).
Medications cannot do their job alone in hypertension regulation. Regular blood pressure measurement is one of the essential components to determine if high blood pressure is under control.
Lifestyle changes are necessary for a comprehensive approach to keeping blood pressure values in a healthy range, recommends the American Heart Association. Physical activity of at least 30 minutes daily, or at least 150 minutes weekly, is the first change you should make. Healthy eating, quitting smoking, and stress management can also help in blood pressure regulation (12-13).
Conclusions
High blood pressure is a condition that needs regular and effective treatment to prevent kidney failure, stroke, or heart attack. Many medications are available for hypertension treatment; your doctor may recommend lisinopril which can significantly help your blood pressure regulation.
Take lisinopril regularly as your doctor prescribed you, and follow all other recommendations. You will need to take lisinopril for a long time, so be aware of possible side effects and tell your doctor about any adverse event that might occur. The doctor can adjust your therapy if the event is linked to your medication.
Medication treatment lasts for years and should go together with lifestyle changes. With proper treatment and a healthy lifestyle, you can control your hypertension and live a healthy and long life.
See Also
Biljana is a Master of Pharmacy, with a Healthcare Management specialization. Over 20 years of professional engagement to enable access to innovative treatments for patients in need.
Biljana is dedicated to upgrading health education evidence-based, promoting a healthy lifestyle, and embedding healthy habits.
Franco Cuevas is a physician who graduated from the National University of Córdoba, Argentina. He practices general medicine in the Emergency Department at Sanatorio de la Cañada, Córdoba. His focus is on writing medical content to improve physicians' access to relevant medical information for daily practice. He has participated in some research projects and has a special joy in teaching and writing about medical concepts.
Dr. Baran Erdik is an M.D. with further specialization in Internal Medicine/Cardiology. He traveled the world, working as a physician in New Zealand, Germany and Washington State.
After earning his Master’s in Healthcare Administration and Policy from Washington State University, graduating summa cum laude, he decided to make a turn in his career. His master’s degree opened the door for him to a different aspect of the healthcare industry which highly piqued his interest. He found his new passion in consulting for hospitals and medical practices, where he could leverage his physician experience – understanding the needs of the clinicians – as well as his studies in healthcare administration.
He has now settled down in Atlanta, consulting for healthcare facilities, and helps CSR on a wide range of issues: mergers and acquisitions, policy compliance, and savings and efficiency, among others. What he enjoys most in his work is the need to constantly adapt to challenges and changes. It makes every day different and worth going to work for.
He has also done research on evidence-based medicine, focused on how big data can be used in medicine and consulting.
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