Side effects of lisinopril – NHS

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 of lisinopril happen in more than 1 in 100 people. Talk to your doctor or pharmacist if these side effects bother you or do not go away:

A dry, tickly cough that does not get better

Cough medicines do not usually help for coughs caused by lisinopril, and sometimes the cough gets better on its own. Talk to your doctor if it bothers you or stops you 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 or lightheaded, especially when you stand up or sit up quickly

This is more likely to happen when you start taking lisinopril or move on to a higher dose. 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 you do not faint, then sit until you feel better.

Do not drive, rike a bike or operate tools or machinery until the dizziness passes. GOV.UK has more information on the law on drugs and driving.

Headaches

Make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if the headaches last longer than a week or are severe.

Being sick (vomiting)

Take small, frequent sips of fluids, such as water or squash, to prevent dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.

Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor first.

If you take contraceptive pills and you’re being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

If you get vomiting from a stomach bug or illness, tell your doctor. You may need to stop taking lisinopril for a while until you feel better.

Diarrhoea

Drink plenty of fluids, such as water or squash, to prevent dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.

Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor first.

If you take contraceptive pills and you have severe diarrhoea, your contraception may not protect you from pregnancy. Check the pill packet for advice.

If you get diarrhoea from a stomach bug or illness, tell your doctor. You may need to stop taking lisinopril for a while until you feel better.

Itching or a mild skin rash

It may help to take an antihistamine, which you can buy from a pharmacy. Check with the pharmacist to see what type is suitable for you.

Blurred vision

Do not drive, ride a bike or use tools or machinery while this is happening. If it lasts for more than a day or two, speak to your doctor as they may need to change your treatment.

Serious side effects

It happens rarely, but some people may have serious side effects when taking lisinopril.

Call a doctor or call 111 straight away if:

• the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin – this can be a sign of liver problems
• you’re paler than usual, feel tired, faint or dizzy, have any sign of bleeding (for example bleeding from the gums or bruising more easily than usual), a sore throat, a fever, or you get infections more easily – these can be signs of a blood or bone marrow disorder
• you have severe stomach pain – this can be a sign of an inflamed pancreas (acute pancreatitis)
• you have swollen ankles or blood in your pee or you’re not peeing at all – these can be signs of kidney problems

Immediate action required: Call 999 or go to A&E now if:

• you have weakness on one side of your body, trouble speaking or thinking, loss of balance or blurred eyesight – these can be signs of a stroke
• you have a faster heart rate, chest pain and tightness in your chest – these can be signs of heart problems
• you have shortness of breath, wheezing and tightening of the chest – these can be signs of lung problems

Find your nearest A&E

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to lisinopril.

Immediate action required: Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
• your throat feels tight or you’re struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who’s unwell may also have a rash that’s swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

Long term side effects

Taking lisinopril for a long time can sometimes cause your kidneys to not work as well as they should. Your doctor will check how well your kidneys are working with regular blood tests.

Other side effects

These are not all the side effects of lisinopril. For a full list, see the leaflet inside your medicines packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 17 December 2021

Next review due: 17 December 2024

Lisinopril Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

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Lisinopril FT

Precautions

Anaphylactoid and possible associated reactions

Presumably because angiotensin-converting enzyme inhibitors interfere with the metabolism of eicosanoids and polypeptides, including endogenous bradykinin, patients receiving ACE inhibitors (including lisinopril) may experience a range of adverse reactions, including serious reactions.

Angioedema of the head and neck: There have been reports of swelling of the face, extremities, lips, tongue, glottis and/or larynx in patients receiving ACE inhibitors. This can happen at any time during treatment. A higher incidence of angioedema has been reported with ACE inhibitors in black patients compared to non-black patients. In such cases, the use of the drug should be immediately discontinued, appropriate therapy and monitoring should be provided until the symptoms are completely and sustainably resolved. Even in cases where the observed swelling of the tongue is not accompanied by difficulty in breathing, patients may require long-term observation, since treatment with antihistamines and corticosteroids may not be enough. There are very rare reports of deaths due to swelling of the larynx or tongue. Patients with tongue, glottis, or larynx involvement are likely to experience airway obstruction, especially in cases of previous airway surgery. To ensure the patency of the respiratory tract, measures of appropriate therapy should be taken immediately, for example, subcutaneous administration of adrenaline 1: 1000 (0. 3 ml to 0.5 ml) (see “Side effect”). Patients with a history of non-ACE inhibitor angioedema may be at an increased risk of developing it when taking ACE inhibitors.

Bowel edema has been reported in patients treated with ACE inhibitors.

Presents with abdominal pain with or without nausea or vomiting; in some cases without a history of angioedema of the face and with a normal level of C-1 esterase. Angioedema was diagnosed by procedures such as abdominal computed tomography or ultrasound, or at the time of surgery, and the symptoms resolved after the ACE inhibitor was discontinued. Intestinal angioedema should be included in the differential diagnosis of abdominal pain in patients receiving ACE inhibitors.

Anaphylactoid reactions during desensitization: Life-threatening anaphylactoid reactions have been observed in patients receiving desensitizing treatment against hymenoptera venom and concomitant use of ACE inhibitors. In patients, these reactions can be avoided with temporary discontinuation of ACE inhibitors, but they may reappear after re-appointment.

Anaphylactoid reactions during hemodialysis: Sudden and potentially life-threatening anaphylactoid reactions have been reported in some patients using high-flux membranes (eg, AN69®) and the simultaneous use of ACE inhibitors. In such patients, dialysis should be stopped immediately and active therapy for anaphylactic reactions should be initiated. In these situations, the use of antihistamines does not lead to the disappearance of symptoms. In these patients, consideration should be given to using a different type of dialysis membrane or switching to a different class of antihypertensive drug. Anaphylactoid reactions have also been reported in patients undergoing LDL apheresis (low-density lipoprotein plasmapheresis) using dextran sulfate.

Hypotension

Excessive hypotension is rarely observed in patients with uncomplicated arterial hypertension receiving lisinopril as monotherapy. In patients with heart failure taking lisinopril, there is usually some decrease in blood pressure with a peak between 6 and 8 hours after a dose. However, discontinuation of therapy due to symptomatic hypotension when the instructions are followed is usually not necessary; care should be taken at the start of treatment. (see “Method of application and dose”).

Risk of excessive hypotension, sometimes associated with oliguria and/or progressive azotemia, rarely with acute renal failure and/or death, occurs in the following conditions: heart failure with systolic blood pressure below 100 mm Hg, hyponatremia, high doses of diuretics, recent heavy diuresis or increase in the dose of a diuretic, dialysis, salt wasting any of these ology. It is advisable to discontinue diuretics (except in patients with heart failure), reduce the diuretic dose, or increase salt intake with caution prior to initiating Lisinopril therapy in patients at risk of excessive hypotension. (see “Side effect”, “Interaction with other drugs”).

Treatment with Lisinopril should not be initiated in acute myocardial infarction in patients at risk of further severe hemodynamic deterioration after treatment with vasodilators (eg, systolic blood pressure of 100 mmHg or less) or cardiogenic shock.

In patients at risk of excessive hypotension, therapy should be started under medical supervision and these patients should be closely monitored during the first two weeks of treatment and whenever the dose of Lisinopril and/or diuretic is increased. This also applies to patients with coronary artery disease or cerebrovascular disease, in whom an excessive decrease in blood pressure can lead to myocardial infarction or stroke.

If hypotension occurs, the patient should be placed in a horizontal position and, if necessary, administer 0.9% sodium chloride intravenously. Transient hypotension is not a contraindication for further use of the drug after normalization of blood pressure by increasing blood volume. If symptomatic hypotension develops, dose reduction or discontinuation of treatment with lisinopril or a concomitant diuretic may be required.

Leukopenia/neutropenia/agranulocytosis

In a study with another ACE inhibitor, captopril, its ability to cause agranulocytosis and bone marrow depression was shown, less often in uncomplicated patients, but more often in patients with renal insufficiency, especially in combination with collagenoses. Marketing experience has shown in rare cases the development of leukopenia / neutropenia and bone marrow depression, while a causal relationship with lisinopril cannot be excluded. Periodic monitoring of white blood cell counts in patients with collagenoses and kidney disease should be considered.

Liver failure

Rarely, ACE inhibitors have been associated with a syndrome that begins with cholestatic jaundice or hepatitis and progresses to fulminant hepatic necrosis and (sometimes) death. The mechanism of this syndrome is unknown. Patients receiving ACE inhibitors who develop jaundice or elevated liver enzymes should stop taking the drug and receive appropriate medical advice.

Aortic stenosis/hypertrophic cardiomyopathy: As with all vasodilators, lisinopril should be used with caution in patients with left ventricular outflow obstruction.

Impaired renal function: Due to RAAS inhibition, changes in renal function can be expected in susceptible patients. In patients with severe CHF, where renal function is dependent on RAAS activity, treatment with ACE inhibitors, including lisinopril, may be associated with oliguria and/or progressive azotemia and rarely with acute renal failure and/or death.

In hypertensive patients with unilateral or bilateral renal artery stenosis, an increase in blood urea nitrogen and serum creatinine is possible. These changes are usually reversible upon discontinuation of the drug and/or diuretic therapy. In such patients, renal function should be monitored during the first few weeks of therapy.

In some patients with arterial hypertension or heart failure without previously diagnosed kidney disease, increases in blood urea nitrogen and serum creatinine are usually minor and transient, especially when taken with diuretics. Changes are most likely in patients with pre-existing renal insufficiency. Dose adjustment and/or discontinuation of the diuretic and/or lisinopril may be required.

In acute acute myocardial infarction, treatment with lisinopril should be initiated with caution in patients with signs of impaired renal function (serum creatinine concentration greater than 2 mg/dL). If renal dysfunction develops during treatment (serum creatinine greater than 3 mg/dL or twice the initial value), the physician should consider discontinuing treatment.

Evaluation of patients with hypertension, heart failure, myocardial infarction should always include an assessment of renal function (see “Method of application and dosage”).

Hyperkalemia: Risk factors for developing hyperkalemia include renal insufficiency, diabetes mellitus, concomitant use of potassium-sparing diuretics, potassium supplements and/or potassium-containing salt substitutes.

Hyperkalemia can lead to serious, sometimes fatal, arrhythmias.

Lisinopril should be used with caution with these agents and frequent monitoring of serum potassium levels is recommended. (see “Interaction with other drugs”).

Cough: By inhibiting the degradation of endogenous bradykinin with all ACE inhibitors, persistent unproductive cough is possible, which stops after discontinuation of therapy.

Surgery / anesthesia: In patients undergoing general surgery or anesthesia with drugs that cause hypotension, lisinopril may block the formation of angiotensin II against the background of compensatory secretion of renin. If arterial hypotension due to this mechanism is noted, it is necessary to replenish the volume of fluid.

Hypoglycemia: In patients with diabetes mellitus taking oral antidiabetic drugs or insulin, it is necessary to maintain constant glycemic control during the first month of therapy with ACE inhibitors. (see “Interaction with other drugs”).

Double blockade of the renin-angiotensin-aldosterone system is associated with an increased risk of hypotension, hyperkalemia and renal dysfunction (including acute renal failure) compared with monotherapy. Dual blockade of the RAAS with Lisinopril, ARB II, or Aliskiren cannot be recommended for any patient, especially for patients with diabetic nephropathy (see “Interaction with other medicinal products”, “Pharmacological properties”).

In some cases, when the combined use of Lisinopril and ARB II is absolutely indicated, careful supervision of a specialist and mandatory monitoring of renal function, water and electrolyte balance, blood pressure is necessary. This refers to the appointment of candesartan or valsartan as adjunctive therapy to lisinopril in patients with CHF. Conducting a double blockade of the RAAS under the close supervision of a specialist and mandatory monitoring of kidney function, water and electrolyte balance and blood pressure is possible in patients with CHF with intolerance to aldosterone antagonists (spironolactone), who have persistent symptoms of CHF, despite other adequate therapy.

It should be remembered that patients with CHF in combination with renal insufficiency (or without it) and connective tissue diseases need strict medical supervision in a hospital at the stage of selecting the dose of Lisinopril and diuretics, since it is in such patients, and especially with severe CHF, that a pronounced decrease in blood pressure is most often possible as a result of the use of diuretics in high doses, hyponatremia or dysfunction kidneys.

In patients with arterial hypertension lisinopril can cause a sharp decrease in blood pressure, especially after the first dose. Most often, arterial hypotension occurs in patients with a deficiency of electrolytes or fluids, receiving diuretics, following a low-salt diet, after vomiting or diarrhea, or after hemodialysis. In such patients, therapy should be initiated under strict medical supervision, preferably in a hospital, at low doses and the dosage adjusted with caution. At the same time, monitoring of kidney function and serum potassium levels is necessary. If possible, diuretic treatment should be discontinued.

Similar rules should be followed when prescribing Lisinopril to patients with coronary artery disease and cerebrovascular insufficiency in whom a sharp drop in blood pressure can lead to myocardial infarction or stroke. In this case, a transient hypotensive reaction is not a contraindication for taking the next dose of the drug.

Before you start taking Lisinopril, if possible, you should normalize the concentration of sodium in the blood and / or replenish the lost volume of fluid, carefully monitor the effect of the initial dose on the patient’s blood pressure level.

In elderly patients from the same dose of Lisinopril, a higher plasma concentration of lisinopril can be created, therefore, special care is required when selecting the dosage of lisinopril in this case, despite the fact that no differences in the antihypertensive effect of lisinopril-containing drugs between elderly and young patients have been identified. For patients over 65 years of age, an initial dose of lisinopril 2.5 mg/day is recommended, as well as monitoring of blood pressure and renal function.

When changes in laboratory parameters against the background of the use of lisinopril (see section “Side Effects”) act individually depending on the severity of these changes and the specific clinical situation. In serious cases, decide on the abolition of lisinopril and the appropriate corrective measures. In all cases, timely monitoring of laboratory parameters is very important.

For example, the concentration of electrolytes and creatinine in the blood serum and the indicators of blood cells should be monitored, especially at the beginning of lisinopril therapy, as well as while using it with immunosuppressants, cytostatics, allopurinol and procainamide.

In some patients with arterial hypertension without obvious renal dysfunction, with simultaneous therapy with lisinopril and diuretics, there may be an increase in the level of urea and blood creatinine. In such a situation, it may be necessary to reduce the dose of the ACE inhibitor or stop the diuretic.

Therapy with lisinopril may lead to an increase in the level of potassium ions in the blood, especially against the background of existing renal or heart failure. Under these conditions, the use of potassium-sparing diuretics or potassium preparations is undesirable. It is also necessary to regularly monitor the level of potassium in the blood.

In view of the fact that the potential risk of agranulocytosis and neutropenia cannot be excluded, periodic monitoring of the blood picture is required. After the abolition of ACE inhibitors, agranulocytosis and neutropenia disappear.

In patients with reduced renal function or after taking sufficiently high doses of lisinopril, rare cases of proteinuria have been noted. In clinically significant proteinuria (>1 g/day), lisinopril should only be used after a careful comparison of the expected benefit and potential risk, as well as with regular monitoring of clinical and laboratory parameters.

Some issues of the tactics of using lisinopril in the presence of changes in laboratory parameters are reflected in other sections of the instructions (“Method of application and dose”, “Interaction with other drugs”).

Pregnancy and lactation

Pregnancy

The use of ACE inhibitors is not recommended during the first trimester of pregnancy and is contraindicated during the second and third trimester of pregnancy (see “Contraindications”).

Use of these drugs during the second and third trimesters of pregnancy reduces kidney function and increases morbidity and risk of fetal and neonatal death. As a result of oligohydramnios, pulmonary hypoplasia and skeletal deformities of the fetus are possible. Potential neonatal side effects include skull hypoplasia, anuria, hypotension, renal failure, and death. When pregnancy is established, Lisinopril should be discontinued as early as possible and switched to alternative antihypertensive agents with an established safety profile for use during pregnancy.

In the absence of an appropriate alternative to ACE inhibitors for a particular patient, she should be informed of the potential risk to the fetus. It is necessary to conduct serial ultrasound examinations. If oligohydramnios is detected, the drug should be discontinued, unless it is vital for the mother. Patients and doctors should be aware that oligohydramnios can occur when the fetus already has irreversible damage.

If ACE inhibitors are used during the second trimester of pregnancy, it is recommended to monitor kidney function and skull development using ultrasound. Newborns whose mothers took lisinopril should be carefully monitored for the presence of arterial hypotension, oliguria and hyperkalemia. In animal experiments, no data on the teratogenic effects of lisinopril have been obtained. There are also no data on the negative effects of the drug on the fetus if used during the first trimester of pregnancy.

Breastfeeding

It is not known whether lisinopril passes into breast milk. Since many drugs are secreted in human milk and because of the risk of severe adverse reactions in infants when using ACE inhibitors, a decision should be made to stop breastfeeding or stop lisinopril, taking into account its importance to the mother.

Pediatric use

Contraindicated in children and adolescents under 18 years of age.

Influence on the ability to drive vehicles and other complex mechanisms
Evidence on this problem in the context of the use of therapeutic dosages of lisinopril-containing agents is currently not available, however, given the possible occurrence of dizziness, their use (including Lisinopril) in such situations should be exercised with caution.

Arpimed

What Lisinopril is and what it is used for

Lisinopril is the active ingredient in Lisinopril.

Lisinopril belongs to the group of angiotensin converting enzyme inhibitors (ACE inhibitors).

Lisinopril is used for the following conditions:

• to treat high blood pressure (hypertension).
• for the treatment of heart failure
• if you have recently had a heart attack (myocardial infarction)
• for the treatment of kidney disease caused by type II diabetes in people with high blood pressure.

Lisinopril dilates blood vessels, which reduces high blood pressure. It helps your heart pump blood better to all parts of your body.

What you need to know before you use Lisinopril

Do not take Lisinopril,

insufficiency in adults, as the risk of angioedema (rapid swelling under the skin in places such as the throat) increases.
• if your family members have had a severe allergic reaction (angioedema) to ACE inhibitors or you have had a serious allergic reaction (angioedema) without a known cause.
• if you are more than 3 months pregnant (avoid Lisinopril in early pregnancy – see section Pregnancy).
• if you have diabetes or kidney problems and are taking a blood pressure medicine containing aliskiren.

If you are not sure if any of the above applies to you, ask your doctor or pharmacist for advice before taking Lisiznopril.

If you have a dry cough that persists for a long time after starting treatment with Lisinopril, talk to your doctor.

Warnings and precautions

Talk to your doctor or pharmacist before taking lisinopril if:

• if you have narrowing (stenosis) of the aorta (heart artery) or stenosis of the heart valves (mitral valves)
• if you have a narrowing (stenosis) of the renal artery.
• if you have an increase in the thickness of the heart muscle (called hypertrophic cardiomyopathy).
• if you have problems with your blood vessels (vascular collagenosis)
• if you have low blood pressure. You may feel dizzy, especially when standing up.
• if you have kidney problems or are on kidney dialysis.
• if you have liver problems.
• if you have diabetes.
• if you are taking any of the following medicines, your risk of angioedema is increased (symptoms include rapid subcutaneous swelling in places such as the throat):

• sirolimus, everolimus, and other mTOR inhibitors (used to prevent rejection of organ transplants).
• Racecadotril, a drug used to treat diarrhea;
• Vildagliptin, a medicine used to treat diabetes

• if you are taking any of the following medicines used to treat high blood pressure:

• angiotensin II receptor blockers (ARBs) (called sartans – eg trimettan, telmisartan, irbesartan), especially if you have diabetes-related kidney problems
• aliskiren

Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (such as potassium) in your blood at regular intervals. See also << Do not take Lisinopril>>

• if you have recently had diarrhea or vomiting.
• if your doctor has told you to control the amount of salt in your diet.
• if you have high cholesterol and are undergoing a treatment called <>.
• You must tell your doctor if you are pregnant or think you may be pregnant. Lisinopril is not recommended in early pregnancy and should not be used if the pregnancy is more than 3 months old, as taking the drug at this stage can cause serious harm to the baby (see section Pregnancy).
• If you are black, Lisinopril may be less effective. You can easily develop a side effect of angioedema (a severe allergic reaction).

If you are not sure if any of the above apply to you, ask your doctor or pharmacist before taking Lisinopril.

Insect sting allergy treatment

Tell your doctor if you are undergoing or about to receive treatment to reduce the effects of allergies due to insect stings (desensitization). If you take Lisinopril during this treatment, it may cause a severe allergic reaction.

Operations

If you are going to have surgery (including dental surgery), tell your doctor or dentist that you are taking Lisinopril. This is because your blood pressure may drop (hypotension) if you are given certain local or general anesthetics while you are taking Lisinopril.

Children and adolescents

Lisinopril has been studied in children. For more information, contact your doctor. Lisinopril is not recommended for use in children under 6 years of age or in children with severely impaired renal function.

Drug interactions

Tell your doctor if you are taking, have recently taken or plan to take any other medicines, as Lisinopril may affect how other medicines work and some medicines can affect how Lisinopril works.

If necessary, your doctor may adjust the dose of Lisinopril or take other precautions.

In particular, tell your doctor or pharmacist if you are taking any of the following medicines:

• • Other medicines to lower high blood pressure.
  • Angiotensin II receptor blockers (ARBs) or aliskiren (see section <> <>)
  • Diuretic tablets (diuretics)
  • Beta-blockers such as atenolol and propranolol.
  • Nitrates (for the treatment of heart disease).
  • Non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of pain and arthritis.
  • Aspirin (acetylsalicylic acid) if you are taking more than 3 grams per day.
  • Medicines for depression and psychiatric problems, including lithium.
  • Potassium supplements (including salt substitutes), potassium-sparing diuretics, and other medicines that can increase blood potassium levels (eg, trimethoprim and cotrimoxazole for infections caused by bacteria; cyclosporine, an immunosuppressant drug used to prevent rejection of organ transplants; and heparin, a drug used to thin the blood and prevent blood clots).
  • Insulin or oral hypoglycemic agents.
  • Medicines used to treat asthma.
  • Nasal or sinus congestion medicines or other cold medicines (including over-the-counter medicines).
  • Medicines that suppress the body’s immune response (immunosuppressants).
  • Allopurinol (for the treatment of gout).
  • Procainamide (for the treatment of heart disease).
  • Medicines containing gold, such as sodium aurothiomalate, which can be given by injection.

The following medicines may increase the risk of angioedema (symptoms include swelling of the face, lips, tongue or throat, difficulty swallowing or breathing).

• Drugs used to dissolve blood clots (tissue plasminogen activator), usually treated in a hospital.
• Drugs most commonly used to prevent rejection of organ transplants (sirolimus, everolimus and other mTOR inhibitors). See Section “Special instructions and precautions”.
• Racecadotril, a drug used to treat diarrhea;
• Vildagliptin, a drug used to treat diabetes.

Pregnancy and lactation

Pregnancy:

Consult your healthcare professional if you are pregnant, think you may be pregnant, or are planning to become pregnant.

Your doctor will tell you to stop taking Lisinopril before you become pregnant or as soon as you know you are pregnant and suggest that you take another medicine instead of Lisinopril. Lisiopril is not recommended in early pregnancy and should not be used if the pregnancy is more than 3 months old, as taking the drug at this stage can cause serious harm to the baby.

Breastfeeding:

Talk to your doctor if you are breastfeeding or planning to breastfeed your baby. Lisinopril is not recommended for breastfeeding mothers, your doctor may choose a different treatment for you if you want to breastfeed, especially if the baby is newborn or born prematurely.

Effects on ability to drive and use machines

• Some people feel dizzy or tired while taking this drug. If this is observed in you, refrain from driving vehicles and do not operate machinery.
• Refrain from doing these things until you know how this drug affects you.

How to take Lisinopril

Lisinopril should be taken exactly as directed by your doctor. If you have any doubts, you should consult your doctor or pharmacist.

Your doctor may order blood tests for you after you start taking Lisinopril. They can then adjust your dose so that you take the right amount of the drug.

Directions for use

• Swallow the tablet with a glass of water.
• Try to take your tablets at the same time each day. It doesn’t matter if you take Lisinopril before or after a meal.
• Continue taking Lisinopril until your doctor tells you to stop taking it, the treatment is long. It is important to take Lisinopril every day.

First dose

• Be especially careful after taking the first dose of Lisinopril or when increasing the dose. This may result in a sharp drop in blood pressure than subsequent doses.
• Taking your first dose may make you dizzy. If this is observed, you should lie down. If you are concerned, please see a doctor as soon as possible.

Adults

Your dose depends on your health condition and whether you are taking any other medicines at the same time. Your doctor will tell you how many tablets to take each day. If you are unsure about something, ask your doctor or pharmacist for advice.

Treatment of high blood pressure

• The recommended starting dose is 10 mg once daily.
• The usual long-term dose is 20 mg once daily.

Treatment of heart failure

• The recommended starting dose is 2.5 mg once daily.
• The usual dose for long-term use is 5 to 35 mg once daily.

Treatment after a heart attack

• The recommended starting dose is 5 mg within 24 hours after a heart attack and 5 mg every other day.
• The usual dose for long-term use is 10 mg once daily.

For the treatment of kidney disease caused by diabetes

• The recommended dose is 10 mg or 20 mg once a day.

If you are older, have kidney problems, or are taking diuretics, your doctor may prescribe a lower than usual dose of the drug.

Use in children and adolescents (aged 6-16 years) with high blood pressure

• Your doctor will determine the correct dose for your child. The dose depends on the body weight of the child.
• The recommended starting dose for children weighing 20 to 50 kg is 2.5 mg once daily.
• The recommended starting dose for children weighing over 50 kg is 5 mg once daily.

If you have taken more Lisinopril than recommended

If you have taken more Lisinopril than prescribed by your doctor, contact your doctor or go to the nearest hospital.

The most likely symptoms are: dizziness, palpitations.

If you forget to take Lisinopril

• If you forget to take Lisinopril, take it as soon as you remember, but if it is time for your next dose, do not take the missed dose.
• Do not take a double dose to make up for a missed dose.

If you stop taking Lisinopril

Do not stop taking the tablets without talking to your doctor, even if you feel well.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Possible side effects

Like all medicines, Lisinopril can cause side effects, although not everyone gets them.

Tell your doctor right away if you notice any of the following effects.

• Severe allergic reactions (rare, affect 1-10 in 10,000 people).

Symptoms may include sudden onset:

• Swelling of the face, lips, tongue or throat. This may cause difficulty in swallowing.
• Severe or sudden swelling of the hands, feet and ankles.
• Difficulty breathing
• Severe itching of the skin (with blisters).
• Severe skin lesions such as sudden, unexpected rash or burning, redness or peeling of the skin (very rare, affects less than 1 in 10,000 people).
• Infection with symptoms such as fever and severe deterioration of general condition, or fever with local symptoms of infection such as sore throat/pharynx/mouth or urinary problems (very rare, affecting less than 1 in 10,000 people).

Other side effects:

Common (affects 1-10 out of 100 people)

• Headache
• Feeling of dizziness, especially when standing up abruptly.
• Diarrhea
• Dry cough that does not go away.
• Vomiting
• Kidney problems (confirmed by blood tests)

Uncommon (affects 1-10 in 1,000 people)

• Mood changes
• Discoloration of the fingers or toes (pale blue followed by redness) or numbness or tingling in the fingers or toes.
• Change in taste sensations
• Drowsiness
• Dizziness (vertigo)
• Sleep problems
• Stroke
• Palpitations
• Runny nose
• Nausea
• Abdominal pain or indigestion
• Skin rash or itching
• Lack of erection (impotence)
• Feeling tired or weak (loss of strength)
• An excessive decrease in blood pressure may occur in people with the following conditions: coronary artery disease, narrowing of the aorta (heart artery), renal artery, or heart valves; an increase in the thickness of the heart muscle. If this happens to you, you may feel dizzy, especially when standing up abruptly.
• Changes in blood tests that show the functional state of the liver and kidneys.
• Heart attack
• Visual and auditory hallucinations

Rare (affects 1-10 in 10,000 people)

• Confusion
• Skin rash (urticaria)
• Dry mouth
• Hair loss
• Psoriasis (skin problem)
• Smell disorder
• Male breast augmentation
• Changes in certain cells or other elements of the blood. Your doctor will need to periodically take blood samples to check if Lisinopril has any effect on blood composition. Signs of exposure may include feeling tired, pale skin, sore throat, high temperature (fever), joint and muscle pain, swelling of joints or glands, or sensitivity to sunlight.
• Low blood sodium levels (symptoms may include: fatigue, headache, nausea, vomiting).
• Sudden renal failure.

Very rare (affects less than 1 in 10,000 people)

• Sinusitis (feeling of pain and stuffiness behind the cheek and eyes).
• Wheezing
• Low blood sugar (hypoglycemia). Symptoms: feeling of hunger or weakness, sweating and heart palpitations.
• Inflammation of the lungs. Symptoms: cough, shortness of breath and high temperature (fever)
• Yellowing of the skin or whites of the eyes (jaundice)
• Inflammation of the liver. May cause loss of appetite, yellowing of the skin and eyes, and dark urine
• Inflammation of the pancreas. It causes moderate to severe stomach pain
• Severe skin lesions. Symptoms include: redness, blistering and peeling
• Sweating
• Oliguria or anuria
• Liver failure
• Puffiness
• Inflammatory bowel disease

Unknown (frequency cannot be estimated from available data)

• Symptoms of depression
• Fainting

Side effects in children were comparable to those in adults.

If you experience any side effects, talk to your doctor or pharmacist. This also applies to side effects not listed in this leaflet.

Reporting side effects

If you notice any side effects, tell your doctor, pharmacist or pharmacist, including any side effects not listed in this leaflet. You can also report side effects to Arpimed LLC by going to the website www.arpimed.com and filling out the appropriate form “Report a side effect or ineffectiveness of a drug” and to the Scientific Center for Expertise of Drugs and Medical Technologies named after. Academician E.Gabrielyan, by going to the website www.pharm.am in the section “Report a side effect of a drug” and fill out the form “Map of reporting a side effect of a drug”. Scientific center hotline: +37410200505; +37496220505 By reporting side effects, you help gather more information about the safety of this drug.

How to store Lisinopril

• Lisinopril , 5 mg tablets.

The drug should be stored out of the reach of children, protected from moisture and light, at a temperature of 15 ⁰ C -25 ⁰ C .

• Shelf life – 3 years. Do not take lisinopril after the expiry date which is stated on the package. When specifying the expiration date, the last day of the specified month is meant.
• Drugs should not be disposed of into wastewater or sewers. Ask your pharmacist how to dispose of a drug you no longer need. These measures are aimed at protecting the environment.