Lisinopril Side Effects
Brand Names: Prinivil, Zestril
Please note - some side effects for Lisinopril may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).
Side Effects of Lisinopril - for the Consumer
Lisinopril
All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Lisinopril:
Seek medical attention right away if any of these SEVERE side effects occur when using Lisinopril:Cough; diarrhea; dizziness; headache; tiredness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the hands, eyes, mouth, face, lips, or tongue; hoarseness); chest pain; dark urine; decreased urination; difficulty swallowing; infection (eg, fever, chills, persistent sore throat); irregular or slow heartbeat; stomach pain (with or without nausea or vomiting); symptoms of low blood pressure (eg, fainting, severe dizziness, lightheadedness); yellowing of the skin or eyes.
Lisinopril/Hydrochlorothiazide
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Lisinopril/Hydrochlorothiazide:
Seek medical attention right away if any of these SEVERE side effects occur when using Lisinopril/Hydrochlorothiazide:Dizziness; headache; lightheadedness; nausea; persistent nonproductive cough; tiredness; vomiting.
TopSevere allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain or discomfort; confusion; dark urine; fainting; fast, slow, or irregular heartbeat; increased thirst; joint pain, stiffness, or swelling; muscle cramps or weakness; numbness or tingling of hands or feet; persistent and unusual stomach pain; persistent sore throat or fever; red, swollen, or blistered skin; severe dizziness or lightheadedness; shortness of breath; sudden unusual weight loss or gain; trouble swallowing; unusual bruising or bleeding; unusual or severe weakness or tiredness; vision changes; yellowing of the skin or eyes.
Lisinopril Side Effects - for the Professional
Lisinopril
ADVERSE REACTIONSLisinopril has been found to be generally well tolerated in controlled clinical trials involving 1969 patients with hypertension or heart
failure. For the most part, adverse experiences were mild and transient.
Hypertension
In clinical trials in patients with hypertension treated with Lisinopril, discontinuation of therapy due to clinical adverse experiences
occurred in 5.7percent of patients. The overall frequency of adverse experiences could not be related to total daily dosage within the
recommended therapeutic dosage range.
For adverse experiences occurring in greater than 1 percent of patients with hypertension treated with Lisinopril or Lisinopril plus
hydrochlorothiazide in controlled clinical trials, and more frequently with Lisinopril and/or Lisinopril plus hydrochlorothiazide than
placebo, comparative incidence data.
Heart Failure
In patients with heart failure treated with Lisinopril for up to four years, discontinuation of therapy due to clinical adverse experiences
occurred in 11.0 percent of patients. In controlled studies in patients with heart failure, therapy was discontinued in 8.1 percent of patients treated
with Lisinopril for 12 weeks, compared to 7.7 percent of patients treated with placebo for 12 weeks.
The following table lists those adverse experiences which occurred in greater than 1 percent of patients with heart failure treated with
Lisinopril or placebo for up to 12 weeks in controlled clinical trials, and more frequently on Lisinopril than placebo.
Also observed at less then 1 percent with Lisinopril but more frequent or as frequent on placebo than Lisinopril in controlled trials were asthenia,
angina pectoris, nausea, dyspnea, cough, and pruritus.
Worsening of heart failure, anorexia, increased salivation, muscle cramps, back pain, myalgia, depression, chest sound abnormalities,
and pulmonary edema were also seen in controlled clinical trials, but were more common on placebo than Lisinopril.
In the two-dose ATLAS trial in heart failure patients, withdrawals due to adverse events were not different between the low and high
groups, either in total number of discontinuation (17-18 percent) or in rare specific events (1 percent). The following adverse events, mostly
related to ACE inhibition, were reported more commonly in the high dose group:
Acute Myocardial Infarction
In the GISSI-3 trial, in patients treated with Lisinopril for six weeks following acute myocardial infarction, discontinuation of therapy
occurred in 17.6 percent of patients.
Patients treated with Lisinopril had a significantly higher incidence of hypotension and renal dysfunction compared with patients not
taking Lisinopril.
In the GISSI-3 trial, hypotension (9.7 percent), renal dysfunction (2.0 percent), cough (0.5 percent), post infarction angina (0.3 percent), skin rash and generalized edema (0.01 percent), and angioedema (0.01 percent) resulted in withdrawal of treatment. In elderly patients treated with Lisinopril,
discontinuation due to renal dysfunction was 4.2 percent.
Other clinical adverse experiences occurring in 0.3 percent to 1.0 percent of patients with hypertension or heart failure treated with Lisinopril in
controlled clinical trials and rarer, serious, possibly drug-related events reported in uncontrolled studies or marketing experience are
listed below, and within each category are in order of decreasing severity:
Body as a Whole: Anaphylactoid reactions, syncope,
orthostatic effects, chest discomfort, pain, pelvic pain, flank pain, edema, facial edema, virus infection, fever, chills, malaise.
Cardiovascular: Cardiac arrest; myocardial infarction or cerebrovascular accident possibly secondary to excessive hypotension
in high risk patients; pulmonary embolism and infarction, arrhythmias (including ventricular
tachycardia, atrial tachycardia, atrial fibrillation, bradycardia and premature ventricular contractions), palpitations, transient ischemic
attacks, paroxysmal nocturnal dyspnea, orthostatic hypotension, decreased blood pressure, peripheral edema, vasculitis.
Digestive: Pancreatitis, hepatitis (hepatocellular or cholestatic jaundice), vomiting, gastritis,
dyspepsia, heartburn, gastrointestinal cramps, constipation, flatulence, dry mouth.
Hematologic: Rare cases of bone marrow depression, hemolytic anemia, leukopenia/neutropenia and thrombocytopenia.
Endocrine: Diabetes mellitus.
Metabolic: Weight loss, dehydration, fluid overload, gout, weight gain.
Cases of hypoglycemia in diabetic patients on oral antidiabetic agents or insulin have been reported in post-marketing experience.
Musculoskeletal: Arthritis, arthralgia, neck pain, hip pain, low back pain, joint pain, leg pain, knee pain, shoulder pain, arm pain,
lumbago.
Top
Side Effects by Body System
Cardiovascular
Hypotension is most likely in patients who are sodium and intravascular volume depleted. In large studies, patients have reported "heart pounding" and chest pain, although the relationship to lisinopril is questionable.
A possible relationship between lisinopril use and a case of penile angioedema has been published. After six days of lisinopril therapy, a 74-year-old patient complained of penile "swelling". Lisinopril was suspected as the cause of the angioedema and was discontinued. The localized angioedema resolved within a few days following discontinuation.
Cardiovascular side effects have included hypotension (0.6% to 1.0% of patients) and angioneurotic edema (0.2% of patients). Angina pectoris, orthostatic hypotension, and palpitations are each reported in approximately 1% of patients. Patients with heart failure are more likely to experience hypotension. In one study the incidence of hypotension-related undesirable side effects was only 0.6% compared to 4% in patients with CHF.
Renal
Renal side effects have included new (usually mild) or worsened renal insufficiency which has rarely developed during ACE inhibitor therapy. Patients with renal artery stenosis should not receive lisinopril or any other ACE inhibitor. Proteinuria has also been reported.
Patients with renal artery stenosis maintain glomerular filtration by efferent arteriolar vasoconstriction, which is blocked by lisinopril.
Although lisinopril may be associated with a rise in serum creatinine and BUN, GFR has been shown to remain unchanged or improve in most patients.
Nervous system
Nervous system side effects have included dizziness in up to 13% and headache in up to 6% of patients. Paresthesias are reported in 1% of patients.
Respiratory
A retrospective study has revealed a significantly higher incidence of discontinuation of angiotensin converting enzyme inhibitor therapy due to cough among black patients compared with non-black patients (9.6% vs. 2.4%).
Several agents have been studied for treating cough with ACE inhibitors. No long term trials exist to allow a definitive treatment option. Cromolyn has the most data showing some benefit. Other agents studied include baclofen, theophylline, sulindac, and benzonatate.
Respiratory side effects have included a reversible dry cough in up to 3% of patients. Cough has appeared as common in women as men, but in some reviews women have reported cough more often than men. Other respiratory system side effects are limited to stridor secondary to hypersensitivity to lisinopril.
Metabolic
A rise in serum potassium is due to a mild reduction in serum aldosterone concentrations.
Metabolic side effects are unusual and have included a moderate, often clinically insignificant rise in serum potassium. Lisinopril and other ACE inhibitors appear to have a beneficial effect on plasma insulin levels. Cases of hypoglycemia have been reported in diabetic patients receiving ACE inhibitors when concurrently treated with oral antidiabetic agents or insulin.
Gastrointestinal
Gastrointestinal side effects have included diarrhea (4%), nausea (3%), and vomiting (1%). Taste disturbances and constipation are reported in less than 1% of patients. Acute pancreatitis has been associated with lisinopril.
Hypersensitivity
In at least two cases of lisinopril-associated angioedema of the face and neck, the affected patients did not have a history of reactive airways disease. Patients with intestinal angioedema generally present with abdominal pain (with or without nausea or vomiting) and in some cases there was no prior history of facial angioedema, and C-1 esterase levels were normal. These symptoms resolve after stopping the ACE inhibitor.
Hypersensitivity reactions to lisinopril, as with some other angiotensin converting enzyme (ACE) inhibitors, may be life-threatening. Angioedema occurs in approximately 0.2% of patients. Angioedema of the face, extremities, lips, tongue, glottis and/or pharynx have been reported rarely in patients receiving ACE inhibitors. Obstructive laryngeal and glossal angioedema due to lisinopril is a rare, but potentially fatal reaction. In addition, intestinal angioedema has been reported in patients treated with ACE inhibitors. It is recommended that any patient with dyspnea, dysphagia, or significant facial angioedema stop therapy immediately and avoid ACE inhibitor therapy in general.
Dermatologic
Dermatologic side effects are rare. Reversible rash, alopecia, erythema, and pruritus are reported in 1% or less of patients. In addition, cutaneous pseudolymphoma has been reported.
Hematologic
Hematologic side effects, including neutropenia and fatal aplastic anemia, have rarely been associated with lisinopril or other ACE inhibitors. A case of Henoch-Schonlein purpura complicated by polyarthritis has been associated with lisinopril.
A 64-year-old woman with aortic insufficiency, coronary artery disease, and atrial fibrillation developed fever and anorexia associated with pancytopenia within seven days after starting furosemide, digoxin, warfarin, and lisinopril. She died despite intensive supportive measures. Autopsy revealed bone marrow aplasia and changes consistent with hepatorenal failure. There was no evidence of infection or autoantibody disease. At least one other (reversible) case has been reported.
Psychiatric
Although angiotensin converting enzymes are found in many areas of the central nervous system, the mechanism for ACE inhibitor-induced mania is unclear. They are lipophilic and are not known to cross the blood-brain barrier. ACE inhibitors have been shown to alter the metabolism of enkephalins and modulate cholinergic activity. Interestingly, one case of captopril-induced hallucinations was successfully treated with naloxone.
Psychiatric complications have rarely been attributed to use of ACE inhibitors, including memory impairment, confusion, somnolence, irritability, and nervousness. A single case of mania has been associated with the use of lisinopril in an elderly woman who had previously tolerated enalapril.
Hepatic
Hepatic side effects associated with the use of ACE inhibitors have included a rare syndrome that begins with cholestatic jaundice and progresses to fulminant hepatic necrosis and (sometimes) death. Experts recommend discontinuation of therapy with this drug if jaundice or markedly elevated hepatic serum enzymes develop.
Endocrine
Endocrine side effects including case reports indicating development of the syndrome of inappropriate secretion of antidiuretic hormone have been reported.
Other
Other side effects have included olfactory disturbance.
TopMore Lisinopril resources
- lisinopril Advanced Consumer (Micromedex) - Includes Dosage Information
- Lisinopril Professional Patient Advice (Wolters Kluwer)
- Lisinopril Prescribing Information (FDA)
- Lisinopril Monograph (AHFS DI)
- Lisinopril
- Lisinopril MedFacts Consumer Leaflet (Wolters Kluwer)
- Prinivil Prescribing Information (FDA)
- Prinivil Consumer Overview
- Zestril Prescribing Information (FDA)
- Zestril Consumer Overview
Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This information does not endorse drugs, diagnose patients, or recommend therapy. This drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of information provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.
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Lisinopril
Generic Name: lisinopril (lyse IN oh pril)
Brand Names: Prinivil, Zestril
What is lisinopril?
Lisinopril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme.
Lisinopril is used to treat high blood pressure (hypertension), congestive heart failure, and to improve survival after a heart attack.
Lisinopril may also be used for purposes other than those listed in this medication guide.
What is the most important information I should know about lisinopril?
Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Lisinopril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment.
Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of lisinopril. Do not use salt substitutes or potassium supplements while taking lisinopril, unless your doctor has told you to.
Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking lisinopril. Drink plenty of water each day while you are taking this medication.
What should I discuss with my healthcare provider before taking lisinopril?
Do not use this medication if you are allergic to lisinopril or to any other ACE inhibitor, such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).
If you have certain conditions, you may need a dose adjustment or special tests to safely take lisinopril. Before you take this medication, tell your doctor if you have:
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kidney disease (or if you are on dialysis);
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liver disease;
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heart disease or congestive heart failure;
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diabetes; or
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a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis.
FDA pregnancy category D. Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Lisinopril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. It is not known whether lisinopril passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
See also: Lisinopril pregnancy and breastfeeding warnings (in more detail)
How should I take lisinopril?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.
Your doctor may occasionally change your dose to make sure you get the best results from this medication.
Take each dose with a full glass of water.
Lisinopril can be taken with or without food.
Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking lisinopril. Drink plenty of water each day while you are taking this medication.
To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled visits to your doctor.
If you need to have any type of surgery, tell the surgeon ahead of time that you are taking lisinopril. You may need to stop using the medicine for a short time.
If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.
Store lisinopril at room temperature away from moisture and heat.
See also: Lisinopril dosage (in more detail)
What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. Lisinopril overdose symptoms may include feeling extremely dizzy or light-headed, or fainting.
What should I avoid while taking lisinopril?
Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of lisinopril. Do not use salt substitutes or potassium supplements while taking lisinopril, unless your doctor has told you to.
Lisinopril side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
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feeling light-headed, fainting;
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urinating more or less than usual, or not at all;
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fever, chills, body aches, flu symptoms;
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tired feeling, muscle weakness, and pounding or uneven heartbeats;
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chest pain; or
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swelling, rapid weight gain.
Less serious lisinopril side effects may include:
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cough;
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dizziness, drowsiness, headache;
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depressed mood;
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nausea, vomiting, diarrhea, upset stomach; or
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mild skin itching or rash.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Lisinopril side effects (in more detail)
What other drugs will affect lisinopril?
Before taking lisinopril, tell your doctor if you are taking any of the following drugs:
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gold injections used to treat arthritis;
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lithium (Lithobid, Eskalith);
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a potassium supplement such as K-Dur, Klor-Con;
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salt substitutes that contain potassium;
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insulin or diabetes medication you take by mouth;
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aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), naproxen (Aleve, Naprosyn), and others; or
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a diuretic (water pill).
If you are using any of these drugs, you may not be able to use lisinopril or you may need dosage adjustments or special tests during treatment.
There may be other drugs not listed that can affect lisinopril. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
More Lisinopril resources
- Lisinopril Prescribing Information (FDA)
- Lisinopril MedFacts Consumer Leaflet (Wolters Kluwer)
- Lisinopril Professional Patient Advice (Wolters Kluwer)
- Lisinopril Monograph (AHFS DI)
- lisinopril Advanced Consumer (Micromedex) - Includes Dosage Information
- Prinivil Prescribing Information (FDA)
- Zestril Prescribing Information (FDA)
Compare Lisinopril with other medications
Where can I get more information?
- Your pharmacist can provide more information about lisinopril.
What does my medication look like?
Lisinopril is available with a prescription under the brand names Zestril and Prinivil.Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.
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Zestril 5 mg - capsule-shaped, pink tablets
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Zestril 10 mg - round, pink tablets
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Zestril 20 mg - round, red tablets
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Zestril 40 mg - round, yellow tablets
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Prinivil 2.5 mg - round, white tablets
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Prinivil 5 mg - shield-shaped, white, scored tablets
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Prinivil 10 mg - shield-shaped, light-yellow tablets
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Prinivil 20 mg - shield-shaped, peach-colored tablets
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Prinivil 40 mg - shield-shaped, rose-red tablets
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
- Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2010 Cerner Multum, Inc. Version: 8.02. Revision Date: 08/19/2009 12:41:47 PM.
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High Blood Pressure (Hypertension) Medications
Definition of High Blood Pressure:
Hypertension means high blood pressure. This generally means:
- systolic blood pressure is consistently over 140 (systolic is the "top" number of your blood pressure measurement, which represents the pressure generated when the heart beats)
- diastolic blood pressure is consistently over 90 (diastolic is the "bottom" number of your blood pressure measurement, which represents the pressure in the vessels when the heart is at rest)
Either or both of these numbers may be too high.
Pre-hypertension is when your systolic blood pressure is between 120 and 139 or your diastolic blood pressure is between 80 and 89 on multiple readings. If you have pre-hypertension, you are likely to develop high blood pressure at some point. Therefore, your doctor will recommend lifestyle changes to bring your blood pressure down to normal range.
Drugs associated with High Blood Pressure
The following drugs and medications are in some way related to, or used in the treatment of High Blood Pressure. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.
See also...
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Learn more about High Blood Pressure (Hypertension)
Medical encyclopedia results for:
- Drug-induced hypertension
- Essential hypertension
- High blood pressure
- Hypertension
- Renovascular hypertension
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