1. What is lisinopril?
Lisinopril belongs to a class of drugs known as angiotensin-converting enzyme (ACE) inhibitors. It works by relaxing blood vessels, allowing blood to flow more easily. Other ACE inhibitors include:
The angiotensin-converting enzyme is responsible for producing the chemical, angiotensin II. Angiotensin II causes muscles surrounding blood vessels to contract, causing them to narrow. This can cause blood pressure to increase and means the heart has to work harder to pump blood around the body.
ACE inhibitors like lisinopril counteract this mechanism and reduce blood pressure.
Zestril, Prinivil, and Qbrelis are some of the brand names for lisinopril.
2. What is lisinopril/HCTZ?
When ACE inhibitors alone are not able to sufficiently lower blood pressure, they will often be combined with another treatment. Lisinopril can be combined with hydrochlorothiazide (HCTZ), a diuretic medicine commonly known as a water pill. Lisinopril/HCTZ is sold under the brand names Prinzide and Zestoretic.
Lisinopril/HCTZ may be used to treat high blood pressure after other medicines have not worked effectively or have caused unwanted side effects.
Diuretics are also a first-line treatment for high blood pressure. Diuretics help treat high blood pressure by stopping the reabsorption of electrolytes such as sodium, chloride, magnesium, and potassium, which are then flushed out through urine along with excess water.
The removal of excess water and electrolytes from blood vessels helps blood flow and lowers your blood pressure.
3. What is lisinopril used for?
isinopril is a drug that is used as a first-line treatment for high blood pressure. This helps prevent heart attacks, strokes, and kidney diseases. Lisinopril is used to treat heart failure and helps prevent future strokes and heart attacks.
Lisinopril is also prescribed after a heart attack and to prevent the progression of renal disease in hypertensive patients with diabetes mellitus and kidney problems.
Other first-line treatments for high blood pressure include:
- Angiotensin II receptor blockers (ARBs)
- Calcium channel blockers
Your doctor will take factors such as your age, sex, race, blood pressure level, and other conditions into consideration when deciding the most suitable treatment options.
ACE Inhibitors are sometimes prescribed in combination with other blood pressure medicines, such as diuretics.
If you do not respond to one type of treatment or have an adverse or allergic reaction, your doctor may try a different medication or a combination of two drugs.
However, some types of drugs are not routinely used in combination, such as ARBs and ACE inhibitors.
Treatment for hypertension will usually come with recommendations for healthy lifestyle changes, such as adopting a diet that is low in fat and salt, maintaining a healthy weight, exercising (within one’s capabilities), not smoking, and moderating the amount of alcohol you drink (or abstaining completely).
4. How does lisinopril work?
The angiotensin-converting enzyme converts angiotensin I to angiotensin II, which regulates blood pressure by constricting the arterial muscles.
ACE inhibitors like lisinopril work by reducing the activity of the enzyme and thus reducing the production of angiotensin II, therefore relaxing the arterial muscle and expanding blood vessels. This helps lower blood pressure and means the heart does not have to work too hard to pump blood around the body.
This improves the symptoms of heart failure and can help protect the kidney in people with diabetic kidney disease by slowing down the disease.
5. How long does it take for lisinopril to work?
Lisinopril starts to work within a few hours after taking it, but may take two to four weeks before you get the full benefit of this medication.
If you’re taking lisinopril to treat high blood pressure, you may not feel any different, but this doesn’t mean that the drug isn’t working.
It is important to keep taking it because, like most blood pressure lowering medications, lisinopril is often required for the rest of your life, even if it has successfully lowered your blood pressure.
Continued use will help keep your blood pressure under control and may help mitigate the risk of heart failure.
Tell your doctor if your condition does not get better or if it gets worse.
6. What are the most common side effects of lisinopril?
The most common side effects of lisinopril occur when you begin treatment and your body adjusts. Dizziness or lightheadedness, particularly when you stand or sit up quickly, is common in the first few days of your treatment. Other common side effects include:
- A dry cough
- Sexual dysfunction
- Mild itching or rash
- Tiredness and fatigue
- Blurred vision
You should speak to your doctor if these symptoms are severe, persistent, or you have any other concerns.
More serious side effects, although rare, can include:
- Signs of liver problems, such as yellowing of the skin and eyes
- Signs of kidney problems, such as blood in your urine, passing little or no urine, or swollen ankles
- Signs of heart problems, such as rapid or irregular heartbeat, chest pain, or chest tightness
- Signs of lung problems, such as shortness of breath or wheezing
- Signs of high potassium, such as muscle weakness, slow or irregular heartbeat, or tingly feeling
If you experience any of these serious side effects, you should contact a doctor immediately.
Allergic reactions to lisinopril are rare. A serious allergic reaction should be treated as an emergency; signs of a serious allergic reaction include:
- Swelling of your face, lips, tongue, or throat
- A skin rash that may include itchy, red, swollen, blistering, or peeling skin
- Tightness in your chest or throat
- Wheezing or trouble breathing
If you believe you or someone else is having a serious allergic reaction, seek immediate medical attention or call the emergency services. You should never take an ACE inhibitor again after having a serious allergic reaction.
Although this covers the most common and serious side effects of lisinopril, please check the information leaflet for an extensive list.
7. What is the correct dosage of lisinopril?
Lisinopril comes in the form of tablets (2.5, 5, 10, 20, 30 and 40 mg), taken orally, usually once a day, with a starting daily dose of 10 mg for adults.
The dose of lisinopril will be different for different patients. Your doctor may check your blood pressure and ask of any side effects in deciding your dose.
The usual dose range for adults is 20-40 mg daily. Your doctor may start you on a lower dose and gradually increase it as necessary.
For children aged 6 years old and over, the dosage is usually based on weight. The starting dose is usually 0.07 mg per kilogram (kg) of body weight per day, which may be increased as needed. However, the dose is usually not more than 0.61 mg per kg of body weight or 40 mg per day.
It is important to follow your doctor’s instructions. If you have any concerns regarding your dosage of lisinopril, please speak to your doctor.
8. Who can take lisinopril?
Lisinopril can be taken by adults and children over 6 years old.
Lisinopril isn’t suitable for everyone; you should discuss all past or present medical conditions with your doctor. If you have a history of heart, liver, or kidney problems, diabetes, or low blood pressure, lisinopril may not be the most suitable medication. Other conditions may also influence your doctor’s choice of medication.
It is also important to discuss other medications – both over the counter and prescription – or supplements that you take.
Other lifestyle factors, such as your diet, may also be relevant (particularly if you have a low-salt diet). If you have diabetes, you may need to take additional care regarding your blood sugar levels, which can be lowered by lisinopril.
9. How long does lisinopril stay in your system?
A drug stays in your body for approximately 5.5 x the elimination half-life of that particular drug.
Lisinopril has a half-life of about 12 hours.
It will therefore take approximately 66 hours (about 3 days) for lisinopril to be cleared from your system.
10. What time should I take lisinopril?
Although there’s no conclusive evidence that taking lisinopril either in the morning, afternoon, or evening leads to better or worse results, it is advisable to take lisinopril around the same time every day.
It could also be important to schedule when you take lisinopril and when you take other medications or supplements, to avoid interactions.
Lisinopril may also make you dizzy, so your doctor may suggest you take your first dose before going to bed. After the first dose, you can decide which time of day suits you best and aim to take it consistently.
11. Is lisinopril safe during pregnancy or when breastfeeding?
Lisinopril is not recommended for use during pregnancy or when breastfeeding as it may possibly cause fatal harm to fetuses and neonates.
Small amounts of lisinopril may pass into breast milk and might cause low blood pressure in the baby.
Talk to your doctor immediately if you plan on becoming pregnant, are pregnant or before/while breastfeeding as other medications might be a better alternative.
12. Can I take other drugs with lisinopril?
There are many drugs that may interact with lisinopril, which may reduce the effectiveness of your treatment or cause harmful side effects.
It is not recommended that lisinopril is taken together with:
Lisinopril is not usually recommended in combination with potassium, diuretics that conserve potassium (such as spironolactone), drugs that may increase the level of potassium in the blood (such as ARBs including losartan and valsartan), or birth control pills containing drospirenone, as these combinations may raise your potassium levels to dangerous levels.
Other medications, including aspirin, NSAIDS (such as ibuprofen), indomethacin, and naproxen can raise your blood pressure, worsen your heart failure or reduce the effects of ACE inhibitors.
Drugs used to treat asthma, heart failure, or allergies (such as ephedrine and noradrenaline), and drugs that suppress your immune system (e.g. ciclosporin) may interact with the way lisinopril works.
This is not an extensive list of drugs with which lisinopril may interact. It is important you discuss all medications you take with your doctor.
Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
13. What foods shouldn’t I eat while taking lisinopril?
ACE inhibitors are designed to lower blood pressure, but they also elevate potassium levels in the body. Therefore, potassium-rich foods can be problematic for people taking ACE inhibitors. Some of these foods include:
- Bananas, oranges, and green, leafy vegetables
- Potatoes and sweet potatoes
As a result, people taking ACE inhibitors like benazepril (sold under the brand name Lotensin, among others), captopril (Capoten), and lisinopril may develop dangerous heart tremors if they eat too much food that is high in potassium.
Grapefruit and grapefruit juice have also shown to reduce your ability to absorb drugs like lisinopril and should therefore be avoided while taking it. It slows down how quickly the body is able to break down the medication, which could cause lisinopril levels in the blood to rise.
Talk to your doctor before using salt substitutes because they often contain potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.
14. Can I drink alcohol while taking lisinopril?
Although alcohol does not interact with lisinopril directly, it is recommended that you avoid alcohol for at least a few days when you start taking lisinopril or when your dose is increased.
Some of the side effects of lisinopril, such as dizziness, are caused by the blood pressure-lowering effect of the drug. Alcohol also lowers your blood pressure, so the combination can exacerbate the symptoms.
If you live with other conditions, such as heart failure, it is important to discuss your alcohol consumption with your doctor and follow the advice you are given.
15. What else should I know about taking lisinopril?
- Angioedema (swelling of the airways and facial areas) is one of the signs of an allergic reaction. As mentioned, allergic reactions to lisinopril are rare, but it is believed that if you have experiences angioedema (unrelated to ACE inhibitors) in the past you are at greater risk. People of African American descent also appear to be at a greater risk than the general population.
- High daily doses of lisinopril (80 mg) have shown only modest benefits over moderate doses (20 mg). Accordingly, your doctor may try combining lisinopril with another type of medication (such as a diuretic) or prescribe a different medication altogether (such as valsartan) should lisinopril prove ineffective.
- It does not matter whether you take lisinopril with food or not, so meals do not need to be taken into consideration.
- Lisinopril should be stored at room temperature, away from moisture and heat.
- If you miss a dose, take it as soon as you realize. If it is almost time for your next dose, skip the missed dose and stick to your usual schedule. Do not take a double dose to make up for the one you’ve missed.
The content on this page is provided for informational purposes only. If you have any questions or concerns about your treatment, you should talk to your doctor, pharmacist, or healthcare professional. This is particularly important if you are taking multiple medications or have any existing medical conditions.
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