Key takeaways:
Lisinopril (Zestril, Qbrelis) is an angiotensin-converting enzyme (ACE) inhibitor. It’s prescribed to treat high blood pressure, heart failure, and heart attacks. Common lisinopril side effects include low blood pressure, dizziness, and headache.
Some people may experience a dry cough from lisinopril that requires them to stop taking it. Less common lisinopril side effects include diarrhea, blurry vision, and high potassium levels.
Serious lisinopril side effects include severe skin reactions, liver or kidney problems, and angioedema (swelling of the face, lips, and tongue). If you believe you’re experiencing a serious side effect, seek emergency medical care.
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Almost half of all U.S. adults are living with hypertension (high blood pressure). When left untreated, this can raise the risk of serious health complications, such as heart disease or strokes. Angiotensin-converting enzyme (ACE) inhibitors are one of the first-choice options to manage high blood pressure.
Lisinopril (Zestril, Qbrelis) is a commonly prescribed ACE inhibitor. It’s FDA approved to treat high blood pressure, heart failure, and heart attacks. This once-daily oral medication is widely used and generally well-tolerated. But there are side effects you should be aware of — especially if you’re just starting it.
Lisinopril side effects at a glance
Most lisinopril side effects are mild and temporary. They often go away on their own after your body adjusts to the medication. While rare, more serious side effects are possible. It’s good to know about both mild and serious lisinopril side effects. That way, you know when to seek help for potential problems.
Common or mild lisinopril side effects include:
Dizziness
Mildly low blood pressure
Fatigue (feeling more weak or tired than usual)
Dry cough
Diarrhea
Headache
Blurry vision or double vision
Nausea
Dry mouth
Lightheadedness or fainting
Sun sensitivity
Mildly elevated potassium levels
Mildly elevated creatinine levels (a kidney waste product)
Smell or taste changes
Ringing in the ears
Rare but serious lisinopril side effects and risks include:
Severely low blood pressure
Chest pain
Severely elevated potassium levels
Severely elevated creatinine levels
Vision loss
Angioedema (swelling of the face, lips, and tongue)
Severe skin rashes
Kidney damage
Liver damage
Allergic reactions
This medication also has a boxed warning that it may cause harm to an unborn fetus. This is the FDA’s strictest warning for medications. You shouldn’t take lisinopril if you’re pregnant or trying to become pregnant. If you become pregnant while taking lisinopril, contact your prescriber right away. They’ll likely switch you to a blood pressure medication that’s safer to take while you’re expecting.
Let’s discuss 14 lisinopril side effects to be aware of and what to do if they occur.
1. Dizziness
Dizziness is one of the most common lisinopril side effects. It usually happens shortly after starting the medication or after raising your dose. It usually improves over time as your body gets used to lisinopril. But dizziness can lead to falls, which can be especially dangerous for older adults.
If you feel dizzy, find a place to sit or lie down until it passes. And be careful when changing positions, such as going from sitting to standing. Try standing up slowly while holding on to a sturdy surface. Staying hydrated can also help limit dizziness.
If your dizziness doesn’t improve or worsens, let your prescriber know. It could be a sign that your blood pressure is too low or there’s something more serious going on.
2. Low blood pressure and fatigue
Lisinopril lowers your blood pressure. This can make you feel weaker or more tired than usual. Mild fatigue is often a sign that lisinopril is working. And fatigue often improves as your body adjusts to the medication.
Your prescriber will likely start you with a lower lisinopril dosage and then slowly raise the dose, if needed. This helps keep your blood pressure in an ideal range and gives your body time to adjust to the medication.
Though, in some cases, lisinopril can lower your blood pressure too much (hypotension). This can cause more severe fatigue, along with dizziness or even fainting.
Severely low blood pressure can be dangerous. So let your prescriber know if you have consistently low blood pressure readings or any hypotension symptoms. They can make a dosage change or suggest a different blood pressure medication.
3. Dry cough
One of lisinopril’s most well-known side effects is a dry cough. People often describe it as a tickling or scratching sensation in the throat. Lisinopril can cause a build-up of certain proteins in the body. It’s thought that higher levels of these proteins can cause airways to tighten, leading to this cough.
People who experience a dry cough often report it happening within the first few weeks or months of taking lisinopril. But it can happen at any time. For some people, this lisinopril side effect is mild or gets better with time. For others, it can be very bothersome or persistent.
Talk to your prescriber if you develop an unexplained cough after starting lisinopril. They may recommend switching to an angiotensin II receptor blocker (ARB) medication, such as losartan (Cozaar, Arbli). ARBs work similarly to ACE inhibitors but are much less likely to cause a cough.
4. Diarrhea
Diarrhea is a possible lisinopril side effect, but it isn’t very common. You can take lisinopril with or without food, but taking your doses with food may help lessen diarrhea. Avoiding spicy or greasy foods can also help manage this lisinopril side effect.
If you experience loose stools, make sure to stay well hydrated. But let your prescriber know if you have severe or ongoing issues with diarrhea. This isn’t typical with lisinopril, so they can help determine the cause(s) and best next steps.
5. Headache
Taking lisinopril can also cause headaches. This may be more common when first starting lisinopril or after a dosage change.
Headaches from lisinopril generally improve over time. Drinking extra fluids and getting enough rest at night can help manage headaches. If needed, pain relievers such as acetaminophen (Tylenol) can provide temporary relief until your body adjusts to the medication.
Let your prescriber know if your headaches worsen or don’t improve.
Good to know: Check your healthcare team before taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), for headaches. NSAIDs interact with lisinopril, raising the risk of kidney damage (a rare lisinopril side effect). They also make it harder for blood pressure medications to work their best.
6. Blurry vision
Some people reported experiencing blurry vision and double vision while taking lisinopril. But this side effect isn’t common. If you experience it, avoid driving or performing other activities that require focus.
You may notice slightly blurry vision is more noticeable when you first start taking lisinopril or after a dose increase. This may be a sign that the medication is helping to lower your blood pressure. If this is the case, it should resolve on its own once your body adjusts to lisinopril.
If blurry vision doesn’t go away or is accompanied by fainting or fatigue, contact your prescriber. These are possible symptoms of low blood pressure. It could mean your lisinopril dose is too high for you.
7. High creatinine levels
Lisinopril temporarily slows down how fast your kidneys remove waste from your bloodstream. This can raise blood levels of a kidney waste product called creatinine. Most people only experience slightly high creatinine levels with lisinopril. And the increase is typically reversible.
But high creatinine levels can be a sign that your kidneys are under stress or not working as expected. If your creatinine levels are severely high or don’t return to normal, you may need a lower lisinopril dosage. In severe cases, you might need to stop the medication altogether.
High creatinine levels don’t usually cause symptoms, especially if changes are mild. So your prescriber should schedule routine blood tests to check your kidney function while you’re taking lisinopril. Going for these tests as scheduled can help your prescriber catch this side effect early and take steps to address it.
8. High potassium levels
People taking lisinopril may also develop high potassium levels (hyperkalemia). Usually, this side effect is mild. But severely high potassium is also possible.
If left untreated, high potassium can lead to life-threatening problems, such as abnormal heart rhythms. People with other risk factors, such as diabetes, may be more likely to develop high potassium. There are also many other medications that can raise the risk of this side effect, such as spironolactone (Aldactone).
High potassium often has no symptoms. Going for regular blood tests can help your prescriber make sure your potassium stays within its target range. Depending on how high your potassium level is, they may recommend changes to your medication(s) to address it.
9. Chest pain
Chest pain is a potentially serious lisinopril side effect.
Chest pain has many causes, such as heartburn or muscle strain. Still, even mild symptoms might be something more serious. So, it’s important to let your prescriber know if you notice any chest pain while taking lisinopril. They can help identify what’s causing your pain.
If you experience chest pain that feels severe, worsens with physical activity, or causes nausea or vomiting, call 911 or go to the nearest ER. These are possible symptoms of a heart attack.
10. Swelling of face, lips, tongue (angioedema)
A rare but serious lisinopril side effect is angioedema. Angioedema is a type of swelling, usually of the face, neck, or mouth. And it can become life-threatening. Although it may appear like an allergic reaction (anaphylaxis) to lisinopril, it’s not.
Researchers believe that angioedema from lisinopril may be due to a buildup of certain proteins in the body. Too much of these proteins can lead to swelling. In severe cases, swelling blocks the airways and can cause trouble breathing. People taking lisinopril can experience angioedema at any time — even if they’ve been taking it for a while.
People more likely to develop angioedema while taking lisinopril include:
Black adults of African descent
Women
Older adults
People who smoke
People who take certain medications, such as aspirin or other NSAIDs
Your prescriber can help you understand your risk of angioedema. If your risk is high, they may recommend a different type of medication. Certain people, however, should avoid taking lisinopril. This includes people who have experienced angioedema with a different ACE inhibitor. It also includes those who have hereditary angioedema or idiopathic angioedema (swelling with no clear cause).
If you develop swelling while taking lisinopril, let your prescriber know as soon as possible. They may recommend stopping lisinopril. If you have trouble breathing, your swelling is rapid, or you can feel your tongue or throat swelling, call 911 or go to the nearest ER.
11. Severe skin rash
People taking lisinopril and other ACE inhibitors may experience severe skin reactions, but this is very rare. Symptoms include hives, eczema-like rashes, and itching. Some people taking lisinopril have also reported life-threatening skin reactions, such as Stevens-Johnson syndrome, that involve blisters and peeling skin.
If you develop a skin rash at any time while taking lisinopril, contact your prescriber — even if it seems mild. If the rash is severe or you also have other symptoms, such as a fever, seek emergency medical care right away.
12. Liver damage
Another rare but serious lisinopril side effect is liver damage. This typically develops during the first year after starting the medication. But it can happen at any time. Typically, liver damage from lisinopril is temporary and reversible.
If you have a history of liver problems, let your healthcare team know. They may want you to go for liver function tests regularly while taking lisinopril. You should also let them know if you notice symptoms of liver damage. These can include dark urine, jaundice (yellowing of the skin or eyes), or severe stomach pain.
13. Birth defects
You shouldn’t take lisinopril if you’re pregnant or trying to become pregnant. ACE inhibitors have a boxed warning to avoid them during pregnancy. This is because they can harm a growing fetus. Lisinopril can affect a fetus’ kidney development. It can also lower the amount of amniotic fluid (the protective liquid around the fetus in the womb).
If you become pregnant or are trying to get pregnant, tell your prescriber right away. They’ll likely recommend stopping lisinopril and switching to a safer blood pressure medication, such as methyldopa or labetalol.
14. Allergic reactions
Allergic reactions aren’t the same thing as side effects. But it’s still important to know about them, especially when you first start taking a medication. Allergic reactions to lisinopril are very rare but can become serious.
Some allergic reactions, such as hives, may be mild. Others, such as anaphylaxis (swelling of the throat), are life-threatening. It can be difficult to know if a reaction will become severe. So if you believe you're having an allergic reaction, contact your prescriber. And if your symptoms seem severe, call 911 or go to the nearest ER.
Does lisinopril cause erectile dysfunction?
Not usually. Medications that lower blood pressure can sometimes cause sexual side effects. But lisinopril doesn’t typically cause erectile dysfunction (ED). In fact, regularly taking lisinopril may even improve ED symptoms if you already have them.
Talk to your prescriber if you develop new or worsening ED symptoms while taking lisinopril. There are many causes for ED. And a lot of other medications can contribute to it. Your prescriber can help determine what might be causing ED. They can also recommend steps you can take to help manage your symptoms.
Frequently asked questions
No, weight gain isn’t a reported lisinopril side effect. But it can happen with other blood pressure medications, such as beta blockers. Keep in mind that getting regular exercise and following a nutritious diet can help prevent unwanted weight gain and keep your heart healthy. But don’t hesitate to talk to your healthcare team if you’re concerned about weight changes that occur while taking lisinopril. They can help determine the cause and the best way to address it.
No, lisinopril isn’t a beta blocker. It belongs to a class of medications called angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors and beta blockers can both help manage high blood pressure. But they work differently and have different side effects to consider. Beta blockers work by affecting certain receptors in your heart and blood vessels. ACE inhibitors work by blocking a certain enzyme (protein) in your kidneys. Your prescriber will choose the right blood pressure medication(s) for your needs based on your personal history.
Check with your prescriber before taking potassium supplements if you also take lisinopril. It’s also best to avoid salt substitutes that contain potassium chloride. Lisinopril raises blood potassium levels on its own. Adding potassium from other sources may cause your levels to go too high. Other notable lisinopril interactions include lithium (Lithobid), diuretics (water pills), and nonsteroidal anti-inflammatory drugs (NSAIDs). Always check with your prescriber or pharmacist before taking another medication or supplement with lisinopril.
No, lisinopril isn’t a “high risk” medication. High-risk medications are those that can cause serious harm if you take the wrong dose or receive it in error. Lisinopril doesn’t fall into this category. But that doesn’t mean it’s risk free. Lisinopril can cause side effects just like any other medication. But most are mild and resolve on their own with time. Always discuss potential lisinopril side effects with your healthcare team if you have questions or concerns.
No, weight gain isn’t a reported lisinopril side effect. But it can happen with other blood pressure medications, such as beta blockers. Keep in mind that getting regular exercise and following a nutritious diet can help prevent unwanted weight gain and keep your heart healthy. But don’t hesitate to talk to your healthcare team if you’re concerned about weight changes that occur while taking lisinopril. They can help determine the cause and the best way to address it.
No, lisinopril isn’t a beta blocker. It belongs to a class of medications called angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors and beta blockers can both help manage high blood pressure. But they work differently and have different side effects to consider. Beta blockers work by affecting certain receptors in your heart and blood vessels. ACE inhibitors work by blocking a certain enzyme (protein) in your kidneys. Your prescriber will choose the right blood pressure medication(s) for your needs based on your personal history.
Check with your prescriber before taking potassium supplements if you also take lisinopril. It’s also best to avoid salt substitutes that contain potassium chloride. Lisinopril raises blood potassium levels on its own. Adding potassium from other sources may cause your levels to go too high. Other notable lisinopril interactions include lithium (Lithobid), diuretics (water pills), and nonsteroidal anti-inflammatory drugs (NSAIDs). Always check with your prescriber or pharmacist before taking another medication or supplement with lisinopril.
No, lisinopril isn’t a “high risk” medication. High-risk medications are those that can cause serious harm if you take the wrong dose or receive it in error. Lisinopril doesn’t fall into this category. But that doesn’t mean it’s risk free. Lisinopril can cause side effects just like any other medication. But most are mild and resolve on their own with time. Always discuss potential lisinopril side effects with your healthcare team if you have questions or concerns.
The bottom line
Lisinopril (Zestril, Qbrelis) is an angiotensin-converting enzyme (ACE) inhibitor that’s commonly prescribed to manage high blood pressure. Common lisinopril side effects include dizziness, headache, and a dry cough. Less common side effects include diarrhea, blurred vision, and high potassium levels.
Serious lisinopril side effects include angioedema, kidney or liver problems, and severe skin rashes. Allergic reactions are also rare but possible. Make sure to discuss lisinopril side effects with your prescriber before starting it. And reach out to them if you find any become bothersome or seem severe.
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