lisinopril
Lisinopril (Zestril) is an angiotensin-converting enzyme (ACE) inhibitor that's a first-choice medication used for lowering blood pressure. It's also approved to treat symptoms of heart failure and also to lower the risk of death after a heart attack. Lisinopril (Zestril) is a tablet that's taken by mouth, typically once daily. It's also available as an oral solution. Some common side effects of this medication include cough, dizziness, and headache.
What is Lisinopril (Zestril)?
What is Lisinopril (Zestril) used for?
- High blood pressure
- Heart failure
- Lower the risk for death after a heart attack
How Lisinopril (Zestril) works
Lisinopril (Zestril) is an angiotensin-converting enzyme (ACE) inhibitor. It relaxes your blood vessels by blocking a protein (called ACE) from squeezing your blood vessels.
Drug facts
Side effects of Lisinopril (Zestril)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dizziness (up to 19%)
- Low blood pressure (7-11%)
- Higher creatinine levels (7-10%)
- Headache (6%)
Less Common Side Effects
- Cough
- Feeling faint
Lisinopril (Zestril) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Angioedema (severe swelling): swelling of the face, arms or legs, lips, tongue, or throat
- Dangerously low blood pressure: dizziness, lightheadedness, pale skin, feeling faint
- Serious kidney problems: urinating less often than usual, swelling in your feet, ankles, or hands, unexplained weight gain
- High blood potassium levels: nausea, muscle weakness, abnormal heartbeat
- Serious liver problems: swelling of your stomach, yellowing of your skin or the whites of your eyes, confusion, dark or brown urine
- Severe allergic reaction: swelling of your lips, tongue, throat, or face, trouble breathing, rash
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The following Lisinopril (Zestril) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Blurred vision
cloudy urine
confusion
decrease in urine output or decrease in urine-concentrating ability
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
sweating
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Decreased interest in sexual intercourse
inability to have or keep an erection
lack or loss of strength
loss in sexual ability, desire, drive, or performance
rash
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Lisinopril (Zestril)
Pros
- A first-choice blood pressure medication
- Taken by mouth once per day
- Can be taken by children as young as 6 years old for treatment of high blood pressure
- Available as a liquid (Qbrelis), good option for people who've difficulty swallowing tablets
Cons
- More likely to cause a dry cough, compared to ARBs
- Can't be taken during pregnancy or breastfeeding
- Might not work as well for lowering high blood pressure in black people
Pharmacist tips for Lisinopril (Zestril)
- Take lisinopril (Zestril) with or without food at any time of day.
- You can track how well lisinopril (Zestril) is working for you by checking your blood pressure regularly at home. Write down your blood pressure readings and bring them to your appointments with your provider so you can discuss how well lisinopril (Zestril) is working for you.
- You might feel dizzy when you start taking lisinopril (Zestril), and when your provider raises your dose. This should get better over time as you continue taking the medication and your body gets used to your new blood pressure. Stand up slowly and carefully from a sitting or lying down position to avoid falling.
- Let your provider know if you feel faint or pass out after taking lisinopril (Zestril). They might need to switch you to a different blood pressure medication.
- Make sure to drink enough water to stay hydrated while you're taking lisinopril (Zestril), especially on hot days or after exercising. Your blood pressure might drop too much if you don't have enough fluids in your body. This can worsen dizziness and raise your risk of falls.
- Mark your calendar with your appointments to see your provider and to get any blood work done when you take lisinopril (Zestril). Your provider might order tests (e.g., potassium level, kidney health, blood pressure) during treatment and might change your dose of lisinopril (Zestril) based on your lab results.
- Lisinopril (Zestril) can interact with a lot of other medications. For example, you should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), while taking lisinopril (Zestril) unless your provider says it's okay. This is because taking NSAIDs and lisinopril (Zestril) together can cause kidney problems. Make sure to tell your provider about all the medications you're taking before starting lisinopril (Zestril).
- Make sure to have a healthy diet, including a low-salt diet, while taking lisinopril (Zestril) to help lower your blood pressure. Depending on your risk factors and other medical problems, it's possible you might be able to stop taking lisinopril (Zestril) if your blood pressure is well-controlled through healthy eating and exercise.
- Don't take lisinopril (Zestril) if you're pregnant. If you're pregnant or thinking of getting pregnant, contact your provider right away. Your provider might prescribe you a different medication that's safer during pregnancy. Or, they might recommend ways to help control your blood pressure with lifestyle changes instead.
More tips for Qbrelis (lisinopril) 1 mg/mL liquid:
- Only use an oral syringe or medication dose cup from the pharmacy to measure out your dose of Qbrelis (lisinopril). Never use household spoons because they aren't accurate, which can cause you to take the wrong dose.
- Store Qbrelis (lisinopril) at room temperature.
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Common questions about Lisinopril (Zestril)
Most people will notice a drop in their blood pressure starting about an hour after they take lisinopril (Zestril). But it can take up to 6 hours before you experience its maximum effect on your blood pressure. Since each dose of lisinopril (Zestril) only works for up to 24 hours, you'll need to take this medication regularly daily in order to control your blood pressure long-term.
No, lisinopril (Zestril) isn't a beta blocker. But rather, it belongs to a class of medication called ACE inhibitors. While both beta blockers and ACE inhibitors can help lower blood pressure, they do so in different ways. ACE inhibitors, like lisinopril (Zestril), are considered first-choice medications for blood pressure, but beta blockers are not. In general, your provider might consider a beta blocker for you only if you can't take ACE inhibitors or if you have certain medical conditions. Ask your provider if you have more questions about how lisinopril (Zestril) works or what blood pressure medications are the best for you.
Dry cough is a well-known side effect of ACE-inhibitors, like lisinopril (Zestril). It's possible for you to get a cough from taking lisinopril (Zestril). This side effect can appear at anytime during treatment. If you get a cough from lisinopril (Zestril), talk to your provider. They'll likely stop lisinopril (Zestril) and choose a different blood pressure medication that's much less likely to cause this side effect, such as an angiotensin II receptor blocker (ARB).
Weight gain isn't a known side effect of lisinopril (Zestril). If you've more questions about lisinopril (Zestril) and weight gain, talk with your provider.
No, lisinopril (Zestril) isn't a diuretic or "water pill" and it shouldn't make you urinate more than usual. But your provider might prescribe lisinopril (Zestril) along with water pills if you have high blood pressure or heart failure.
You can take lisinopril (Zestril) with hydrochlorothiazide if both medications are prescribed for you by your provider. In fact, the American Heart Association's blood pressure guidelines recommend adding a thiazide diuretic, like hydrochlorothiazide, to lisinopril (Zestril) for certain people who need more blood pressure control. There's a combination pill available called Zestoretic (lisinopril / hydrochlorothiazide) that contains both medications. in a single tablet. Talk with your provider if you've questions about your blood pressure medications.
Both lisinopril (Zestril) and losartan (Cozaar) are first-choice medications for lowering blood pressure, but they're not the same. (1) One difference is lisinopril (Zestril) is an angiotensin-converting enzyme (ACE) inhibitor, whereas losartan (Cozaar) is an angiotensin II receptor blocker (ARB). Both medications work on the same system in your body, but in different ways. (2) A second difference is side effects. Lisinopril (Zestril) is more likely to cause a dry cough than losartan (Cozaar). If you get a dry cough from lisinopril (Zestril), your provider might consider switching you to losartan (Cozaar). (3) A third difference is formulation. Lisinopril (Zestril) is available as a tablet and a liquid, whereas losartan (Cozaar) only comes as a tablet. Refer to this article for more information on how both medications compare to each other.
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Risks and warnings for Lisinopril (Zestril)
Lisinopril (Zestril) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Not for use during pregnancy
Lisinopril (Zestril) can cause severe and sometimes life-threatening harm to unborn babies so it shouldn't be used during pregnancy. If you find out that you're pregnant while taking lisinopril (Zestril), stop and let your provider know right away. If you're pregnant before starting lisinopril (Zestril) or thinking of becoming pregnant during treatment, discuss with your provider about safer options to treat your blood pressure.
Angioedema (swelling)
- Risk factors: Black people | Having angioedema in the past
People who take medications that contain an ACE inhibitor, like lisinopril (Zestril), can experience a rare, but serious side effect called angioedema. This involves swelling in different parts of the body, including the face, throat, and tongue. Swelling of the tongue or throat area can be potentially life-threatening, since it can make it difficult to breathe. Angioedema can happen at any time during treatment. You're more likely to experience angioedema if you're Black, an older adult, or female. Get medical attention immediately if you experience swelling in any of the areas mentioned above, stomach pain, or difficulty breathing. You'll have to stop taking lisinopril (Zestril) if this happens.
Low blood pressure
- Risk factors: Not enough fluid in your body | Having diarrhea or vomiting for a long time | Low salt levels in your body | Taking higher doses of diuretic medications
Sometimes, taking lisinopril (Zestril) can cause your blood pressure to drop too much. This can cause you to feel dizzy, tired, or lightheaded. This side effect is more common when you first start lisinopril (Zestril) or when the dose is raised. Make sure to stay well-hydrated. If your blood pressure drops too much and you feel dizzy, make sure to sit down slowly while holding onto something and let your provider know. If you fall and hit your head, get medical help right away. If you feel dizzy, lightheaded, faint, tired, or confused while taking lisinopril (Zestril), contact your provider right away.
Worsening kidney problems
- Risk factors: Severe heart failure | Kidney problems | Not enough fluid in your body | Taking other medications that can cause kidney damage | History of narrow heart valves (aortic stenosis)
Lisinopril (Zestril) is usually good for the kidneys. But in some cases, it can make kidney problems worse. The risk is higher for people who have certain types of kidney problems, such as renal artery stenosis or very severe heart failure. Your provider might order lab tests every so often to make sure your kidneys are healthy and working properly. Your provider will check your kidneys before starting lisinopril (Zestril) and regularly as needed. Let your provider know if you're urinating less often than usual, as this could be a sign that your kidneys aren't working as well.
Heart problems due to high potassium
- Risk factors: Diabetes | Kidney problems | Taking other medications that also raise potassium
Lisinopril (Zestril) can raise the amount of potassium in your body, which can be dangerous. Your risk of developing high potassium is greater if you have diabetes, kidney problems, or are taking other medications that also raise potassium levels. For this reason, make sure your provider knows your full medical history and what medications you're taking before starting lisinopril (Zestril). If you experience signs of high potassium levels, such as nausea, muscle weakness, or abnormal heartbeat, tell your healthcare provider right away.
Liver problems
- Risk factors: History of liver problems | Drinking large amounts of alcohol
In some rare cases, people who took ACE inhibitors like lisinopril (Zestril) have developed a blocked bile duct. This condition can lead to liver problems or liver failure. Your provider might order blood tests to check your liver health from time to time. If you notice symptoms of liver problems, such as tiredness, stomach pain, or yellowing of your skin, let your provider know right away.
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Lisinopril (Zestril) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2.5mg | 90 tablets | $12.30 | $0.14 |
| 5mg | 90 tablets | $11.97 | $0.13 |
| 10mg | 90 tablets | $11.38 | $0.13 |
| 20mg | 30 tablets | $7.79 | $0.26 |
| 30mg | 90 tablets | $15.90 | $0.18 |
| 40mg | 90 tablets | $15.18 | $0.17 |
Typical dosage for Lisinopril (Zestril)
High blood pressure
- Adults: The typical starting dose is 5 mg to 10 mg by mouth once daily, depending on whether or not you're also taking a water pill. The typical maintenance dose ranges from 20 mg to 40 mg once daily.
- Children ages 6 years and older: Your child's provider will determine your child's dose based on their body weight. The typical starting dose is 0.07 mg/kg of body weight (up to 5 mg of lisinopril) by mouth once daily. The maximum dose is 0.61 mg/kg (up to 40 mg of lisinopril) daily.
Heart failure
- Adults: The typical starting dose is 5 mg by mouth once daily. The maximum dose is 40 mg once daily.
Heart attack
- Adults: The typical dose is 5 mg by mouth once daily for 2 days. Then continue at 10 mg daily for at least 6 weeks.
Your dose might be different if you have kidney problems.
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Interactions between Lisinopril (Zestril) and other drugs
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Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Aliskiren
- Sacubitril
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alteplase, Recombinant
- Amiloride
- Azathioprine
- Azilsartan
- Azilsartan Medoxomil
- Candesartan Cilexetil
- Canrenoate
- Eplerenone
- Eprosartan
- Everolimus
- Irbesartan
- Lithium
- Losartan
- Mercaptopurine
- Olmesartan Medoxomil
- Potassium
- Potassium Phosphate
- Sirolimus
- Spironolactone
- Telmisartan
- Triamterene
- Trimethoprim
- Valsartan
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aspirin
- Azosemide
- Bromfenac
- Bufexamac
- Bumetanide
- Bupivacaine
- Bupivacaine Liposome
- Capsaicin
- Celecoxib
- Choline Salicylate
- Clonixin
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Droxicam
- Ethacrynic Acid
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Furosemide
- Gold Sodium Thiomalate
- Ibuprofen
- Indomethacin
- Ketoprofen
- Ketorolac
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Nesiritide
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Octreotide
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenylbutazone
- Piketoprofen
- Piretanide
- Piroxicam
- Proglumetacin
- Propionic Acid
- Propyphenazone
- Proquazone
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sodium Salicylate
- Sulindac
- Tenoxicam
- Tiaprofenic Acid
- Tizanidine
- Tolfenamic Acid
- Tolmetin
- Torsemide
- Valdecoxib
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Lisinopril (Zestril) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Lisinopril (Zestril) will not be safe for you to take.
- History of angioedema
- Taking at the same time as aliskiren (Tekturna) for people with high blood sugar
- Taking at the same time or within 36 hours of neprilysin inhibitors, such as Entresto (sacubitril / valsartan)
What are alternatives to Lisinopril (Zestril)?
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