Lisinopril Uses, Dosage, Side Effects & Warnings

Generic name: lisinopril [ lyse-IN-oh-pril ]
Brand names: Prinivil, Qbrelis, Zestril
Dosage forms: oral solution (1 mg/mL), oral tablet (10 mg; 2.5 mg; 20 mg; 30 mg; 40 mg; 5 mg)
Drug class: Angiotensin Converting Enzyme Inhibitors

Medically reviewed by Sanjai Sinha, MD. Last updated on May 2, 2023.

What is lisinopril?

Lisinopril is an ACE inhibitor. ACE stands for angiotensin converting enzyme.

Lisinopril is used to treat high blood pressure (hypertension) in adults and children who are at least 6 years old.

Lisinopril is also used to treat congestive heart failure in adults, or to improve survival after a heart attack.

Warnings

Do not use lisinopril if you are pregnant. It could harm the unborn baby. Stop using this medicine and tell your doctor right away if you become pregnant.

You should not use this medicine if you have ever had angioedema. Do not take lisinopril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use lisinopril together with any medication that contains aliskiren (such as Amturnide, Tekturna, Tekamlo).

You may also need to avoid taking lisinopril with aliskiren if you have kidney disease.

Before taking this medicine

You should not use lisinopril if you are allergic to it, or if you:

• have a history of angioedema;

• recently took a heart medicine called sacubitril; or

• are allergic to any other ACE inhibitor, such as benazepril, captopril, enalapril, fosinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril.

Do not take lisinopril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use lisinopril together with any medication that contains aliskiren (such as Tekturna or Tekamlo).

You may also need to avoid taking lisinopril with aliskiren if you have kidney disease.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

Do not use lisinopril if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away. This medicine can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control while taking this medicine.

It is not known whether lisinopril passes into breast milk or if it could harm a nursing baby. You should not breastfeed while using this medicine.

How should I take lisinopril?

Take lisinopril exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Drink plenty of water each day while you are taking this medicine.

Lisinopril can be taken with or without food.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Your blood pressure will need to be checked often. Your kidney function and electrolytes may also need to be checked.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking this medicine. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking lisinopril.

If you need surgery, tell the surgeon ahead of time that you are using lisinopril.

If you have high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture and heat. Do not freeze the oral liquid.

Dosing information

Usual Adult Dose for Hypertension:

Initial dose: 10 mg orally once a day; 5 mg orally once a day
Maintenance dose: 20 to 40 mg orally once a day
Maximum dose: 80 mg orally once a day

Comments:
-The initial dose is 5 mg orally once a day in patients receiving a diuretic.
-The 80 mg dose is used but does not appear to give greater effect.
-If blood pressure is not controlled with lisinopril alone, a low dose of a diuretic may be added (e.g., hydrochlorothiazide, 12.5 mg). After the addition of a diuretic, it may be possible to reduce the dose of lisinopril.

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 2.5 to 5 mg orally once a day
Maintenance dose: Dosage should be increased as tolerated
Maximum dose: 40 mg orally once a day

Comments:
-The diuretic dose may need to be adjusted to help minimize hypovolemia, which may contribute to hypotension. The appearance of hypotension after the initial dose of lisinopril does not preclude subsequent careful dose titration with the drug.

Usual Adult Dose for Myocardial Infarction:

Initial dose: 5 mg orally (within 24 hours of the onset of acute myocardial infarction)
Subsequent doses: 5 mg orally after 24 hours, then 10 mg orally after 48 hours.
Maintenance dose: 10 mg orally once a day. Dosing should continue for at least 6 weeks.

Comments:
-Therapy should be initiated at 2.5 mg in patients with a low systolic blood pressure (less than or equal to 120 mm Hg and greater than 100 mmHg) during the first 3 days after the infarct. If prolonged hypotension occurs (systolic blood pressure less than 90 mmHg for more than 1 hour) therapy should be withdrawn.

Usual Adult Dose for Diabetic Nephropathy:

Initial dose: 10 to 20 mg orally once a day
Maintenance dose: 20 to 40 mg orally once a day
Dosage may be titrated upward every 3 days

Comments:
-Not an approved indication.

Usual Geriatric Dose for Hypertension:

Initial dose: 2.5 to 5 mg orally once a day
Maintenance dose: Dosages should be increased at 2.5 mg to 5 mg per day at 1 to 2 week intervals.
Maximum dose: 40 mg orally once a day

Usual Pediatric Dose for Hypertension:

Pediatric patients greater than or equal to 6 years of age:
Initial dose: 0.07 mg/kg orally once a day (Maximum initial dose is 5 mg once a day)
Maintenance dose: Dosage should be adjusted according to blood pressure response at 1 to 2 week intervals.
Maximum dose: Doses above 0.61 mg/kg or greater than 40 mg have not been studied in pediatric patients

Comments:
-This drug is not recommended in pediatric patients less than 6 years old or in pediatric patients with glomerular filtration rate less than 30 mL/min.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What to avoid

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Lisinopril can decrease sweating and you may be more prone to heat stroke.

Do not use potassium supplements or salt substitutes while taking this medicine, unless your doctor has told you to.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Lisinopril side effects

Get emergency medical help if you have signs of an allergic reaction to lisinopril: hives; severe stomach pain, difficult breathing; swelling of your face, lips, tongue, or throat. You may be more likely to have an allergic reaction if you are African-American.

Lisinopril may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• fever, sore throat;
• high potassium – nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement;
• kidney problems – little or no urination, swelling in your feet or ankles, feeling tired or short of breath; or
• >liver problems – nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects of lisinopril may include:

• headache;
• dizziness;
• cough; or
• chest pain.

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.

What other drugs will affect lisinopril?

Tell your doctor about all your current medicines and any you start or stop using, especially:

• a diuretic or “water pill”;

• lithium;

• gold injections to treat arthritis;

• insulin or oral diabetes medicine;

• a potassium supplement;

• medicine to prevent organ transplant rejection – everolimus, sirolimus, tacrolimus, temsirolimus; or

• NSAIDs (nonsteroidal anti-inflammatory drugs) – aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with lisinopril, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Popular FAQ

Lisinopril, a commonly prescribed angiotensin converting enzyme (ACE) inhibitor, does not lead to any measurable weight gain or weight loss based on clinical studies conducted by the manufacturer. Continue reading

Qbrelis (generic name: lisinopril) is an oral solution available in 1 mg/mL strength. The oral solution allows for easier weight-based dosing for children. Adult patients who have trouble swallowing lisinopril tablets may also benefit from Qbrelis. Continue reading

More FAQ

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Related treatment guides

• Diabetic Kidney Disease
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• Heart Attack
• Alport Syndrome

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use lisinopril only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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Lisinopril Pill Images – What does lisinopril look like?

What does Lisinopril look like?

Note: Multiple pictures are displayed for those medicines available in different strengths, marketed under different brand names and for medicines manufactured by different pharmaceutical companies. Multi ingredient medications may also be listed when applicable.
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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Lisinopril tablets | Borimed

Lisinopril is recommended to be taken orally once a day, at about the same time. Eating does not affect the absorption of lisinopril tablets. The dose should be determined individually according to the patient’s response and blood pressure.

Hypertension: The recommended initial dose for patients not taking other antihypertensive drugs is 10 mg/day, the usual maintenance dose is 20 mg/day, it can be increased to 80 mg/day depending on the response of blood pressure. If this dose is not enough, treatment with Lisinopril may be supplemented with other antihypertensive drugs. To achieve a full hypotensive effect, 2 to 4 weeks of therapy are required – the effect is achieved with the accumulation of the dose.

Patients taking diuretics

Symptomatic hypotension may occur after initiation of treatment with lisinopril. This is likely in patients taking diuretics while being treated with lisinopril. Such patients are advised to take the drug with caution due to the likelihood of increased excretion of electrolytes from the body and / or a decrease in the volume of interstitial fluid. If possible, diuretic treatment should be discontinued 2-3 days prior to initiation of lisinopril therapy. For hypertensive patients who cannot stop diuretic treatment, lisinopril therapy should be initiated at a dose of 5 mg. It is necessary to monitor kidney function and serum potassium levels. Subsequent doses of lisinopril should be titrated according to blood pressure response. If necessary, diuretic therapy can be resumed.

Dose selection for patients with renal insufficiency

Dosage for patients with renal insufficiency should be based on CC, as shown in the table below.
Table. Dose selection for patients with renal insufficiency

* – Dosage and/or frequency of administration must be calculated based on blood pressure response.

The dose can be gradually increased until blood pressure normalizes or until a maximum dose of 40 mg per day is reached.

Renal insufficiency : since lisinopril is excreted through the kidneys, the initial dose is determined depending on the CC (creatinine clearance): with CC 30-80 ml / min – 5-10 mg / day, with CC 10-30 ml / min – 2.5-5 mg / day, less than 10 ml / min, including patients on hemodialysis – 2.5 mg / day. The maintenance dose is determined depending on blood pressure, under the control of kidney function, the concentration of K + and Na + in the blood serum.
The maximum dose of lisinopril is 80 mg/day.

Heart failure (simultaneously with cardiac glycosides and / or diuretics ): if possible, reduce the dose of the diuretic before starting lisinopril. The initial dose is 2.5 mg and may be gradually increased to the usual maintenance dose of 5–20 mg/day.
The recommended dose increase factor after 2 weeks is no more than 10 mg.

The maximum daily dose of lisinopril is 35 mg/day.

Prior to and during treatment, blood pressure, renal function, and K concentrations should be monitored ⁺ and Na ⁺ in serum to avoid the development of hypotension accompanied by renal dysfunction.

Diabetic nephropathy: For patients with type 2 diabetes mellitus complicated by hypertension and incipient nephropathy, the daily dose is 10 mg once a day. The dose may be increased to 20 mg/day to reduce diastolic blood pressure below 90 mm. rt. Art.

Acute myocardial infarction: as appropriate, the patient should receive standard recommended therapy, such as treatment with thrombolytics, aspirin, and beta-blockers. Along with this, nitroglycerin can be used (including transdermally).
Initial dose (first 3 days after a heart attack)

Treatment with lisinopril can be started within the first 24 hours after the onset of symptoms. Treatment should not be started if systolic blood pressure is at least 100 mm Hg. Art. The initial dose of lisinopril is 5 mg orally followed by 5 mg 24 hours later, 10 mg 48 hours later, and 10 mg daily. Patients with systolic pressure not exceeding 120 mm Hg. Art., before or during therapy in the first 3 days after a heart attack, treatment should be started with a low dose of 2.5 mg. In renal insufficiency (creatinine clearance < 80 ml / min), the initial dose of lisinopril should be selected in accordance with the patient's creatinine clearance (see table).

Maintenance dose

The recommended maintenance dose is 10 mg once daily. In the event of arterial hypotension (systolic pressure less than 100 mm Hg), the maintenance daily dose should not exceed 5 mg, if necessary, this dose can be reduced to 2. 5 mg. If prolonged arterial hypotension is observed after taking lisinopril (systolic pressure remains less than 90 mm Hg for more than 1 hour), it is necessary to cancel therapy with the drug. Recommended therapy for 6 weeks, then it is necessary to re-evaluate the patient’s condition. Patients with symptoms of heart failure should continue treatment with lisinopril.

Elderly patients: No age-related changes in efficacy or safety were found in clinical trials. However, older age is associated with a decrease in kidney function, therefore, the initial dose of lisinopril must be selected in accordance with the indications given in the table. Thereafter, the dose should be adjusted according to the blood pressure response.

Use in kidney transplant patients: There is no experience with the use of lisinopril in patients with recent kidney transplantation. Therefore, taking lisinopril in this case is not recommended.
Lisinopril is not intended for the treatment of renovascular hypertension or other disorders associated with increased activity of the renin-angiotensin-aldosterone system , as the recommended initial dose for these diseases is 2.