14 Lisinopril Side Effects You Should Know About

Almost half of all U.S. adults have hypertension (high blood pressure). When left untreated, it can raise the risk of serious health complications like heart disease or strokes. Medications like angiotensin-converting enzyme (ACE) inhibitors are some 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.

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Common or mild lisinopril side effects include:

• Dizziness

• Mildly low blood pressure

• Fatigue

• Dry cough

• Diarrhea

• Headache

• Blurry vision

• Nausea

• Lightheadedness or fainting

• Mildly elevated potassium levels

• Mildly elevated creatinine levels (a kidney waste product)

Rare but serious lisinopril side effects and risks include:

• Severely low blood pressure

• Chest pain

• Severely elevated potassium levels

• Severely elevated creatinine levels

• Angioedema (swelling of the face, lips, and tongue)

• Severe skin rashes

• Kidney damage

• Liver damage

• Allergic reactions

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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.

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 caused by low blood pressure. But even if it’s not, severe dizziness warrants urgent medical attention.

2. Low blood pressure and fatigue

Lisinopril lowers blood pressure. But in some cases, it can lower blood pressure too much (hypotension). Low blood pressure might make you extra tired. But feeling fatigued can also be a sign that lisinopril is starting to work. In this case, tiredness should be mild and go away as your body adjusts. In rare cases, hypotension can become serious and cause some people to faint.

EXPERT PICKS: WHAT TO READ NEXT

• What does it feel like to take lisinopril? Hear from real people how lisinopril helps them manage their blood pressure and what side effects they experience.

• Mixing medications: Read what pharmacists have to say about these potential lisinopril interactions, plus alternatives and dosage changes that can help.

• What’s the best time to take lisinopril? And for how long should you expect it to lower your blood pressure? Find answers to these questions, plus expert tips on taking lisinopril.

Your prescriber will likely start you with a lower lisinopril dosage and then raise the dose if needed. This helps keep your blood pressure in an ideal range and gives your body time to adjust.

Severely low blood pressure can be dangerous. Make sure to let your prescriber know if you have low blood pressure readings or any hypotension symptoms, like dizziness or fatigue. Your prescriber can make dosage changes or suggest a different blood pressure medication if needed.

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, potentially 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, like losartan (Cozaar, Arbli). ARBs work similarly to ACE inhibitors but are much less likely to cause a cough.

4. Diarrhea

Diarrhea is an uncommon lisinopril side effect. Although you can take lisinopril with or without food, 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. They can help you figure out the cause.

5. Headache

Taking lisinopril can also cause headaches. This may be more common when first starting lisinopril or after a dose change. Headaches may happen because lisinopril is working to lower blood pressure.

Headaches from lisinopril generally improve over time. Drinking extra fluids and getting enough rest at night can help manage headaches. If needed, pain relievers like acetaminophen (Tylenol) can help temporarily relieve them 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 (Advi, 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 well.

6. Blurry vision

Some people have reported blurry vision while taking lisinopril. But this side effect isn’t common. If you experience it, avoid driving or performing 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 can raise blood levels of creatinine (a kidney waste product). High levels of creatinine can mean that your kidneys are under stress or not working as expected. This lisinopril side effect happens because it temporarily slows down how your kidneys remove waste from your bloodstream.

Most people only experience slightly high creatinine levels with lisinopril. And the increase is typically reversible. But if your levels are severely high or don’t return to normal, you may need to take a lower dose or lisinopril. In severe cases, you might need to stop the medication altogether.

High creatinine levels don’t usually cause symptoms, especially if changes are mild. Your prescriber should have you go for 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.

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, like 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 level is staying within its target range. Depending on how high your potassium level is, they may recommend switching to a different medication or adjusting your medication routine.

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. But if you have trouble breathing, your swelling is rapid, or you can feel your tongue or throat swelling, call 911 or seek emergency medical attention.

11. Severe skin rash

People taking ACE inhibitors, such as lisinopril, have experienced severe skin rashes and reactions, but this is very rare. These include hives, eczema-like rashes, and itching. Some people taking lisinopril have also reported life-threatening skin reactions, such as Stevens-Johnson syndrome.

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 widespread, or you also have other symptoms like a fever, seek medical help 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. You should also let them know if you notice symptoms of liver damage. These can include dark urine, jaundice (yellowing of the skins 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 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 trying to get pregnant, immediately tell your prescriber. They’ll likely recommend stopping lisinopril and switching you 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?

Medications that lower blood pressure can sometimes cause sexual side effects. But lisinopril doesn’t usually cause erectile dysfunction (ED). In fact, regularly taking lisinopril may even improve ED symptoms if you already have them.

But it’s always a good idea to talk to your prescriber if you develop new or worsening ED symptoms. There are many causes for ED. And there are a lot of other medications that 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.

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Written by:

Kevin Le, PharmD, BCPS, BCPPS

Kevin Le, PharmD, BCPS, BCPPS is a clinical pharmacy specialist in solid organ transplant at Ann & Robert H. Lurie Children’s Hospital of Chicago. He has been working as a pediatric pharmacist since 2016.

Written by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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