Lisinopril helps to prevent future strokes and heart attacks. It also improves your survival if you’re taking it after a recent heart attack or for heart failure. It also slows down diabetic kidney disease.
This medicine is only available on prescription. It comes as tablets. It also comes as a liquid for people who find it hard to swallow tablets, but this has to be ordered specially by your doctor.
Lisinopril is also available combined with another blood pressure medicine called hydrochlorothiazide.
- Lisinopril lowers your blood pressure and makes it easier for your heart to pump blood around your body.
- Your very first dose of lisinopril may make you feel dizzy, so it’s best to take it at bedtime. After that you can take lisinopril at any time of day.
- Some people get a dry, irritating cough with lisinopril.
- Drinking alcohol with lisinopril can make you feel dizzy or lightheaded.
- Lisinopril is also called by the brand name Zestril. When it’s mixed with hydrochlorothiazide it can be called Carace Plus, Lisoretic and Zestoretic.
Who can and can't take lisinopril
Lisinopril can be taken by adults and children aged 6 and over.
If you have diabetes, check your blood sugar (glucose) more often, particularly in the first few weeks. This is because lisinopril can lower the sugar level in your blood.
Lisinopril isn't suitable for everyone.
To make sure lisinopril is safe for you, tell your doctor if you:
- have had an allergy to lisinopril or another heart medicine in the past
- are pregnant or breastfeeding
- have ever had a serious allergic reaction where your face, tongue or throat swells (angioedema), or a member of your family has had a serious allergic reaction to a heart medicine
- are having dialysis or any other type of blood filtration
- have heart, liver or kidney problems
- have unstable or low blood pressure
- have diabetes or decreased kidney function and you are taking a medicine called aliskiren to lower your blood pressure
- have recently had diarrhoea or vomiting or you are on a low salt diet
- are going to have desensitisation treatment to reduce your allergy to bee or wasp stings
- are going to have an anaesthetic
- have a collagen vascular disease (a group of diseases that affect your connective tissue) such as scleroderma or systemic lupus erythematosus
How and when to take
It's usual to take lisinopril once a day.
Your doctor may suggest that you take your first dose before bedtime, because it can make you dizzy. After the very first dose, you can take lisinopril at any time every day. Try to take it at the same time every day.
How much will I take?
The dose of lisinopril you take depends on why you need the medicine. Take it as instructed by your doctor.
To decide your dose, your doctor will check your blood pressure and ask you if you are getting any side effects. You may also have blood tests to check how well your kidneys are working and the amount of potassium in your blood.
Depending on why you're taking lisinopril, the usual starting dose is between 2.5mg and 10mg once a day. This will be increased gradually over a few weeks to a usual dose of:
- 20mg once a day for high blood pressure (the maximum dose is 80mg once a day)
- 10mg once a day after a recent heart attack
- 20mg to 35mg once a day for heart failure
- 10mg to 20mg once a day for diabetic kidney disease
Doses are usually lower for children.
How to take it
You can take lisinopril with or without food. Swallow lisinopril tablets whole with a drink.
If you're taking lisinopril as a liquid, it will come with a plastic syringe or spoon to help you measure out the right dose. If you don't have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not give the right amount of medicine.
Will my dose go up or down?
You will probably be prescribed a low dose of lisinopril at first so it doesn't make you feel dizzy. This will usually be increased gradually until you reach the right dose for you. If you have side effects with lisinopril you may stay on a lower dose.
Take lisinopril even if you feel well, as you will still be getting the benefits of the medicine.
What if I forget to take it?
If you miss a dose of lisinopril, take it as soon as you remember. If you don't remember until the following day, skip the missed dose. Do not take a double dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways that are suitable for you and your medicines.
What if I take too much?
If you take too many lisinopril tablets, contact your doctor or nearest hospital straight away.
An overdose of lisinopril can cause low blood pressure, dizziness, sleepiness and palpitations.
The amount of lisinopril that can lead to an overdose varies from person to person.
If you take too much lisinopril by accident, call your doctor or go to your nearest hospital straight away.
If you need to go to hospital, don't drive yourself - get someone else to drive you or call for an ambulance. Take the box or leaflet inside the packet plus any remaining medicine with you.
Like all medicines, lisinopril can cause side effects in some people but many people have no side effects or only minor ones.
Common side effects
These common side effects happen in more than 1 in 100 people. Talk to your doctor or pharmacist if these side effects bother you or don’t go away:
- dry, tickly cough
- feeling dizzy or light headed, especially when you stand up or sit up quickly. This is more likely to happen when you start taking lisinopril or move onto a higher dose
- diarrhoea and vomiting
Serious side effects
It happens rarely, but some people may have serious side effects when taking lisinopril.
Tell a doctor straightaway if you get:
- yellow skin or eyes – this is a sign of liver problems.
- paleness, feeling tired, faint or dizzy, purple spots, any sign of bleeding (for example bleeding from the gums or bruising more easily than usual), sore throat and fever and getting infections more easily - these are signs of blood or bone marrow disorder
- a faster heart rate, chest pain and tightness in your chest - these are signs of heart problems
- shortness of breath or a cough - these are signs of lung problems
- severe tummy pain - this is a sign of an inflamed pancreas
- swollen ankles, blood in your pee or not peeing at all - these are signs of kidney problems
Serious allergic reaction
In rare cases, it’s possible to have a serious allergic reaction to lisinopril.
A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.
The warning signs of a serious allergic reaction are:
- getting a skin rash that may include itchy, red, swollen, blistered or peeling skin
- tightness in the chest or throat
- having trouble breathing or talking
- unusual hoarseness
- swelling of the mouth, face, lips, tongue, or throat
These are not all the side effects of lisinopril. For a full list see the leaflet inside your medicines packet.
You can report any suspected side effect to the UK safety scheme.
How to cope with side effects
What to do about:
- dry irritating cough – cough medicines don’t usually help for coughs caused by lisinopril. Sometimes, the cough gets better on its own. Talk to your doctor if it bothers you or stops you from sleeping as another medicine may be better. Even if you stop taking lisinopril, the cough may take up to a month to go away.
- feeling dizzy - if lisinopril makes you feel dizzy when you stand up, try getting up very slowly or stay sitting down until you feel better. If you begin to feel dizzy, lie down so that you don't faint, then sit until you feel better.
- headaches - make sure you rest and drink plenty of fluids. Don’t drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if they last longer than a week or are severe.
- diarrhoea and vomiting - drink plenty of water in small, frequent sips. It may also help to take oral rehydration solutions. You can buy these from a pharmacy or supermarket to prevent dehydration. Don’t take any other medicines to treat diarrhoea or vomiting without speaking to a pharmacist or doctor. If you get diarrhoea or vomiting from a stomach bug, or illness, tell your doctor. You may need to temporarily stop taking lisinopril until you feel better.
Pregnancy and breastfeeding
Lisinopril is not normally recommended in pregnancy or when breastfeeding. However, it may be prescribed if your doctor thinks the benefits of the medicine outweigh the risks.
If you're trying to get pregnant or you are already pregnant, talk to your doctor about the benefits and possible harms of taking lisinopril. These will depend on how many weeks pregnant you are and the reason why you're taking it. There may be other treatments that are safer for you.
Lisinopril and breastfeeding
Small amounts of lisinopril may get into breast milk. This can cause low blood pressure in the baby.
Talk to your doctor, as other medicines might be better while you are breastfeeding.
Talk to your doctor if you're trying to get pregnant, you're already pregnant, or if you want to breastfeed while you're taking lisinopril.
Cautions with other medicines
There are some medicines that may interfere with the way lisinopril works.
Tell your doctor if you’re taking:
- anti-inflammatory medicines such as ibuprofen, indomethacin or a high dose of aspirin (a dose of 75mg daily of aspirin is safe to take with lisinopril)
- medicines to treat low blood pressure, shock, heart failure, asthma or allergies, such as ephedrine, noradrenaline or adrenaline
- medicines to treat high blood pressure
- other medicines which can lower your blood pressure such as some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), anaesthetics or medicines for an enlarged prostate gland
- medicines that suppress your immune system, such as ciclosporin, tacrolimus or some medicines that treat cancer
- water tablets such as furosemide
- medicines which can increase the amount of potassium in your blood such as spironolactone, triamterene, amiloride, potassium salts, trimethoprim (for infections) and heparin (for thinning blood)
- steroid medicines such as prednisolone
- allopurinol (for gout)
- procainamide (for heart rhythm problems)
- temsirolimus (for cancer)
- sirolimus, everolimus (for prevention of graft rejection)
- medicines for diabetes
- racecadotril (for diarrhoea)
- lithium (for mental health problems)
Mixing lisinopril with herbal remedies or supplements
There's very little information about taking herbal remedies and supplements with lisinopril.
For safety, speak to your pharmacist or doctor before taking any herbal or alternative remedies with lisinopril.
Tell your doctor or pharmacist if you are taking any other medicines, including herbal medicines and supplements.
How does lisinopril work?
How long does lisinopril take to work?
How long will I take lisinopril for?
Is lisinopril safe to take for a long time?
What will happen if I stop taking it?
Can I come off lisinopril now my blood pressure is lower?
Can I drink alcohol with it?
Are there similar medicines to lisinopril?
What are the differences between lisinopril and other ACE inhibitors?
Is lisinopril addictive?
Will it affect my contraception?
Will it affect my fertility?
Is there any food or drink I need to avoid?
Can I drive or ride a bike?
Can lifestyle changes help?