Lisinopril side effects, warnings, interactions, and safety information

Lisinopril is a generic medication used to treat high blood pressure but can come with side effects. Know the warnings and drug interactions of lisinopril before taking this medication.

Lisinopril side effects | Cough | Dizziness | Serious side effects | Severe allergic and skin reactions | High potassium levels | How long do side effects last? | Warnings | Interactions | How to avoid side effects | FAQs

Lisinopril is a generic drug commonly used to treat high blood pressure. Also available under the brand names Zestril, Prinivil, and Qbrelis, lisinopril (in combination with other medications) also helps increase life expectancy after a heart attack (myocardial infarction), and can be used to improve symptoms in people with congestive heart failure. 

Lisinopril belongs to a family of drugs called angiotensin-converting enzyme inhibitors (ACE inhibitors) that work by preventing an enzyme from making angiotensin II. Angiotensin II narrows blood vessels, increases blood pressure, and makes the heart work harder. By relaxing blood vessels, lisinopril lowers blood pressure and allows more blood to flow. Lisinopril and other ACE inhibitors are known for being effective and well-tolerated, so they are often the first drugs prescribed for hypertension. Still, side effects, drug interactions, and other problems are possible when taking lisinopril.

RELATED: What is lisinopril?

Common side effects of lisinopril

Most people taking lisinopril will experience few and only minor side effects. Lisinopril’s most common side effects are:

• Cough
• Dizziness
• Low blood pressure
• Headache
• Cough
• Elevated levels of potassium in the blood
• Fainting
• Kidney problems
• Fatigue
• Sensitivity to light

The side effects experienced often depend on the condition being treated. People taking lisinopril for high blood pressure (hypertension) mostly experience dizziness, headache, and dry cough as side effects. Low blood pressure, kidney problems, and fainting are more commonly reported by people taking lisinopril for heart failure or heart attack.

Cough

Cough is a common side effect of all drugs in the ACE inhibitor class of drugs. An ACE inhibitor-associated cough is usually dry and persistent. The cough can appear right away or may appear weeks or months after the medication is started. The cough can be very bothersome, and can interfere with daily activities as well as sleep. People who develop this cough should consult their healthcare provider for medical advice.

Dizziness

Dizziness is a common side effect associated with ACE inhibitors such as lisinopril. People who experience dizziness should stand up slowly while holding onto something sturdy for support. Dizziness can lead to falls and fractures, so patients who experience dizziness should report symtpoms immediately to their healthcare provider, to see if an alternative treatment may be needed.  

Serious side effects of Lisinopril

Serious side effects of lisinopril may include:

• Severe allergic reactions (including Stevens-Johnson syndrome or toxic epidermal necrolysis)
• High blood potassium
• Dangerously low blood pressure
• Kidney dysfunction or kidney failure
• Liver problems leading to liver failure  (watch for yellowing of the skin or whites of the eyes, fatigue, and stomach pain)
• Blood problems (low red blood cell or white blood cell counts) 
• Swollen pancreas
• Head, neck, face, throat, and digestive system swelling (angioedema)

Severe allergic and skin reactions

In rare cases, lisinopril can cause reactions that can be severe or life-threatening. Patients with symptoms of a severe allergic reaction—hives, difficulty breathing, or swelling around the face, lips, tongue, or throat—should get emergency medical help right away. Lisinopril can also cause severe skin reactions, in rare cases. Patients should get emergency medical help if symptoms of a severe skin reaction occur—red or purple rash, blistering or peeling skin, fever, burning eyes, or sore throat.  

High potassium levels

Lisinopril can cause increased levels of potassium, or hyperkalemia. Healthcare providers will monitor potassium levels in patients who take lisinopril. Symptoms of high potassium may include nausea, weakness, numbness and tingling, chest pain, irregular heartbeat, and muscle cramps or pain. People who have kidney problems, diabetes, or take certain medications (potassium supplements or potassium-sparing diuretics) are at higher risk of hyperkalemia.

How long do side effects last?

Most lisinopril side effects such as headache, dry cough, dizziness, low blood pressure, elevated blood potassium, and other temporary side effects will go away when the medication is discontinued. Other times, the side effects become less noticeable with continuing treatment. A dry cough is a common side effect that usually clears up in a few weeks to a few months when lisinopril is discontinued. People with a bothersome cough should consult their healthcare provider. 

Low blood pressure and high potassium are common side effects, but if blood pressure falls too low or potassium levels rise too high, immediate medical treatment is required. Even these severe conditions improve in a few hours or days with medical treatment. 

Other severe side effects such as blood problems and severe allergic reactions may take several days of medical treatment to resolve. Kidney and liver dysfunction are more serious and may develop into chronic conditions. To prevent this, blood tests will be regularly performed to spot any liver or kidney problems before they become too serious. 

Report side effects to your healthcare provider. If you have any serious side effects such as difficulty breathing, seek emergency medical treatment. 

Lisinopril contraindications and warnings

For various reasons, some people may not be able to take lisinopril and others may need to be monitored more vigilantly than others.

Abuse and dependence

Lisinopril is not a controlled substance, and does not cause physical dependence or withdrawal, and is not associated with drug abuse.

Overdose

A lisinopril overdose is not expected to be toxic but will cause blood pressure to fall. Extremely low blood pressure is a serious and potentially fatal medical condition, so if an overdose is suspected, seek emergency medical care. 

Restrictions

A contraindication is any condition that makes lisinopril too hazardous to take, so the drug will never be used in a person with a contraindication. Lisinopril contraindications are:

• Pregnancy. Because of the risk for birth defects and fetal death, pregnant women are never given lisinopril.
• ACE inhibitor allergies. Anyone with a history of hypersensitivity reactions to lisinopril or any other ACE inhibitor will not be prescribed lisinopril or any other ACE inhibitor.
• ACE inhibitor-associated angioedema. Angioedema is swelling of the head, neck, and even the digestive system. Normally an allergic reaction, angioedema can be a side effect of lisinopril and other ACE inhibitors. Anyone who has experienced angioedema taking lisinopril or any other ACE inhibitor will never be given lisinopril. 
• Hereditary or idiopathic angioedema. Some people are born with a condition called hereditary angioedema where they are deficient in a protein that helps control how much fluid passes out of blood vessels. They periodically suffer bouts of angioedema, usually triggered by things like stress, foods, sunlight, injuries, or infections. People with hereditary angioedema or any unexplained bout of angioedema (called idiopathic angioedema) will never be given an ACE inhibitor. 

Other people may require close monitoring to avoid serious side effects. Because of the risk of kidney problems, low blood pressure, high blood potassium, low blood sodium, and dehydration, lisinopril will require extra monitoring for side effects when given to people with kidney problems, low blood pressure, low blood volume, high blood potassium, low sodium, or who are on dialysis. Because of the risk for angioedema, lisinopril will require extra care when given to people with certain types of heart disease, blood vessel problems, or autoimmune diseases.

In general, contraindications, restrictions, and cautions specific to any single ACE inhibitor, such as lisinopril, almost always apply to all ACE inhibitors. Someone having problems with one ACE inhibitor will rarely be prescribed another. 

Race

Lisinopril and other ACE inhibitors are less effective at lowering blood pressure in African American patients. It is also more likely to cause angioedema in this population.

Pregnancy and nursing

Lisinopril should never be taken by pregnant women. Lisinopril can cause birth defects and fetal or newborn death. If you take lisinopril and find out that you are pregnant or think you may be pregnant, notify your doctor immediately.

Women who are breastfeeding should generally avoid taking lisinopril or other ACE inhibitors. Although its safety has not been studied in nursing infants, healthcare providers will either choose a different drug or ask the woman to discontinue nursing while taking lisinopril.

Children

The U.S. Food and Drug Administration (FDA) has approved lisinopril as safe and effective in children as young as 6 years of age as treatment for high blood pressure. Healthcare providers occasionally prescribe lisinopril off-label for children as young as 1 year old, but the drug has not been established as safe and effective for children this young.

Seniors

People aged 65 years and older can be given lisinopril. Dosage reductions will not be required, but healthcare providers may monitor elderly patients carefully for side effects.

Lisinopril interactions

Lisinopril has several effects on the body, so it can cause some problems when combined with other drugs.

Some drugs are never combined with lisinopril because of the risk of low blood pressure, high blood potassium, angioedema, or kidney damage:

• Aliskiren 
• Marplan (isocarboxazid)
• Sacubitril

Other types of drugs will also interact with lisinopril and require caution, monitoring, or dosing modifications.

• RAAS inhibitors. ACE inhibitors act on a delicate hormone system called RAAS that governs blood pressure as well as the body’s elimination of water and electrolytes. Lisinopril should not be used with other ACE inhibitors such as enalapril, benazepril, captopril, ramipril, or quinapril. RAAS inhibitors also include a family of blood pressure drugs called angiotensin receptor blockers (ARBs) which include valsartan and losartan. Lisinopril (or any ACE inhibitor) is generally not taken in combination with an ARB, but the combination may be prescribed in rare, specific cases. Taking more than one RAAS inhibitor increases the risk of low blood pressure, high potassium, dehydration, angioedema, and kidney problems.
• Potassium. Because of the risk of high potassium, anyone taking lisinopril will be advised to avoid eating too much potassium or taking potassium supplements, potassium drugs, or using potassium salt substitutes.
• Potassium-sparing diuretics. Some diuretics—drugs that increase the body’s elimination of water and electrolytes through the urine—are designed to prevent the kidneys from eliminating potassium. Taking potassium-sparing diuretics with lisinopril raises the risk of high serum potassium.
• Aminoglycoside antibiotics. Aminoglycoside antibiotics treat bacterial infections but can damage, sometimes severely, the ears and the kidneys. Combining them with lisinopril increases the likelihood of ear or kidney damage.
• NSAIDs (nonsteroidal anti-inflammatory drugs). Healthy patients should be able to take NSAIDs such as aspirin, naproxen, ibuprofen, or indomethacin when taking lisinopril. NSAIDs can damage the kidneys, so people who are elderly, dehydrated, or have kidney problems will be advised to avoid NSAIDs while taking lisinopril. 
• Lithium. Used to treat bipolar disorder, lithium damages the kidneys, so the combination with lisinopril raises the risk of kidney problems.
• mTOR inhibitors. This very small class of drugs is used to either suppress the immune system after an organ transplant (everolimus or sirolimus) or treat advanced kidney cancer (temsirolimus). Combining these drugs with lisinopril raises the risk of angioedema.
• Diabetes medications. Lisinopril increases the effects of drugs designed to lower blood sugar, raising the risk of hypoglycemia (low blood sugar). Monitor blood sugar carefully when taking lisinopril.
• Blood pressure drugs. Taking more than one blood pressure drug is normal. However, there’s always a danger that blood pressure may fall too far. Any combination therapy will require regular blood pressure monitoring.
• Tricyclic antidepressants, antipsychotics, sedatives, benzodiazepines, barbiturates, opioids, muscle relaxers, alpha-2 agonists, and erectile dysfunction medications. All of these medications lower blood pressure as a side effect, so combining them with lisinopril or any other blood pressure medication might cause hypotension. Blood pressure will need to be monitored when combining these drugs with lisinopril.
• Medications that raise blood pressure. Many common drugs raise blood pressure. The most common are stimulants, ADHD medications, wakefulness agents, decongestants, corticosteroids, antidepressants, sympathomimetic drugs (like epinephrine), and migraine drugs. By raising blood pressure, they neutralize the benefits of blood pressure-lowering drugs such as lisinopril. Again, blood pressure will need to be monitored and treatments or dosing modified.

How to avoid lisinopril side effects

When taken for hypertension by otherwise healthy patients, lisinopril generally has few and mostly manageable side effects. People taking lisinopril for heart failure or heart attack, however, are more likely to experience side effects, especially serious side effects. A few tips can help minimize or manage lisinopril side effects while ensuring maximum benefit from the treatment.

1. Tell the healthcare provider about all medical conditions

When getting a lisinopril prescription from a healthcare professional, tell them about all your medical conditions, particularly:

• Liver problems
• Kidney disease
• Any history of angioedema (face, neck, or gastrointestinal swelling)
• Any history of high potassium
• Diabetes
• Pregnancy or any pregnancy plans
• Breastfeeding an infant
• Any history of allergic reactions to ACE inhibitors
• Any upcoming surgery involving anesthesia

2. Tell the healthcare provider about all medications being taken

Lisinopril side effects could be made worse by other drugs. Always carry a list of prescription drugs, over-the-counter medicines, and vitamins or supplements being taken and share it with both the prescribing healthcare professional and the pharmacist before filling a prescription for lisinopril, especially drugs like

• Sacubitril, aliskiren, or isocarboxazid 
• Any angiotensin receptor blocker (ARB) such as valsartan 
• Any other ACE inhibitor
• Diuretics or “water pills” such as hydrochlorothiazide or furosemide
• Lithium

3.

Take lisinopril as directed

Follow all the directions on the prescription label or provided by a healthcare professional. Do not take more or less than prescribed until you’ve consulted with a doctor or healthcare professional. 

4. Drink plenty of fluids 

Many lisinopril side effects can be avoided by drinking plenty of fluids. ACE inhibitors affect kidney function, so dehydration is a common problem, causing side effects such as high blood potassium, low blood pressure (hypotension), and low blood volume. Excess sweating, vomiting, or diarrhea can also lower blood pressure.

5. Stand up and move slowly

If dizziness is a problem, try standing up and moving slowly to minimize this side effect and prevent fainting or falling. Do not drive or operate machinery until you know how lisinopril affects you.

6. Check blood pressure as recommended by your healthcare provider

Lisinopril lowers blood pressure. To make sure the drug is working and to prevent blood pressure from getting too low, purchase a blood pressure monitor and check blood pressure regularly. Watch for signs of low blood pressure such as dizziness, lightheadedness, and fainting. Call a healthcare provider if any of these side effects are experienced.

7. Watch for signs of high blood potassium

Lisinopril commonly causes blood potassium to increase, usually very slightly. Sometimes, though, blood potassium can rise too high and become a medical problem. To catch it early, look for signs of high blood potassium such as abdominal pain, nausea, chest pain, irregular heartbeat, and muscle weakness. If you notice these symptoms, contact your healthcare provider as soon as possible for medical advice. 

8. Watch for signs of angioedema

Angioedema is swelling of the tissues under the skin. It’s similar to hives but the swelling is deeper and usually doesn’t itch. Angioedema is often an allergic reaction, but lisinopril can cause angioedema by the way it works in the body. Angioedema is a serious and potentially life-threatening medical problem. If it gets too severe, it can block airways and cause death by asphyxiation. Get immediate medical attention at any sign of angioedema such as:

• Swelling of the face, lips, tongue, or throat
• Trouble breathing or swallowing
• Stomach or chest pain

Frequently asked questions about lisinopril

What is the most common side effect of lisinopril?

The most common side effects in people taking lisinopril for high blood pressure are dry cough, dizziness, and headache. People taking lisinopril for heart failure or heart attack tend to experience low blood pressure, fainting, and kidney problems as the most common side effects. 

What is the safest blood pressure medication?

Blood pressure medications, like any other medications, come with various risks and benefits. What works well and is tolerated well in one person may not work as well or not be tolerated in another. Your healthcare provider will take a detailed health history and review all the medications you take in order to determine which blood pressure medication is safest for you.  

Does lisinopril affect sleep?

Lisinopril is not expected to affect sleep directly. However, people who develop a persistent cough from lisinopril may find that the cough affects sleep. Patients taking lisinopril who develop a cough that is bothersome should consult their healthcare provider for medical advice.

Is it better to take lisinopril in the morning or night?

Lisinopril is generally taken once daily, and can be taken in the morning or evening. It is best to take lisinopril at the same time every day, at a time that is convenient and that you will remember to take it. If you have trouble remembering to take your medication, you can set a reminder or use an app to help you remember. 

Does lisinopril help anxiety?

Lisinopril is not used to treat anxiety. There is no mention of anxiety treatment or relief in the drug information for lisinopril. In some cases, a drug from a different type of blood pressure medication class, called beta blockers (such as metoprolol or atenolol), may be used off-label to help with anxiety symptoms.  

How should I store lisinopril? 

Store lisinopril at room temperature, away from heat, light, and moisture. Keep lisinopril out of reach and out of sight of children and pets. 

What if I miss a dose of lisinopril?

If you miss a dose of lisinopril, take it as soon as you can. However, if it is almost time for the next dose, skip the missed dose. Do not take two doses to try to make up for a missed dose.

Related resources:

• Angiotensin-converting enzyme inhibitor-induced dry cough, Chest Journal
• C1 esterase inhibitor deficiency, StatPearls
• Hereditary angioedema, StatPearls
• Lisinopril, Epocrates
• Lisinopril, StatPearls
• Lisinopril drug summary, Prescriber’s Digital Reference
• Lisinopril tablet prescribing information, U.S. National Library of Medicine
• Qbrelis prescribing information, U. S. National Library of Medicine

What Are the Side Effects of Lisinopril?

1. What are the side effects of lisinopril? 
2. What is high blood pressure, exactly?
3. Why is it important to treat high blood pressure? 
4. Main uses of lisinopril
5. Side effects: lisinopril and hydrochlorothiazide 
6. Who should not take lisinopril 
7. Drug interactions with lisinopril

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Lisinopril is a medication used to lower high blood pressure. And usually, that’s a good thing. But sometimes, the pendulum can swing too far in the other direction, making your blood pressure drop too low. The result? If your blood pressure is too low, it’s going to be hard for blood to reach your brain. This makes you feel dizzy, and can even cause fainting. 

Other side effects of lisinopril include a dry or chronic cough. Actually, it’s the main reason people stop taking these drugs. About one in 10 people who take medications like lisinopril eventually develops a cough, which is more commonly seen in people who are older, female, or who are taking cholesterol-lowering drugs (Brugts, 2014). 

Here’s more on what to expect in terms of side effects, drug interactions, and who should avoid lisinopril.

Lisinopril, part of a class of drugs known as ACE inhibitors, effectively treats cardiovascular conditions—including high blood pressure, heart failure, and heart attacks—but also has a wide range of potential side effects to be aware of (Lopez, 2020). 

The most common one is a dry or chronic cough—a signature side effect of ACE inhibitors (Yilmaz, 2019). If you are older, female, or are taking medications to lower cholesterol, you may be more likely to develop a cough, which is also cited as the main reason people (roughly 4%) stop taking these drugs (Brugts, 2014). Other regularly reported side effects include dizziness, chest pain, headaches, fainting, and fatigue. 

Serious reactions don’t happen as often, but can quickly evolve into severe or life-threatening situations. Here are the most important ones to note (FDA, 2014):

• Low blood pressure: Lisinopril can cause hypotension, or low blood pressure. If you have heart disease, heart failure, or kidney disease, taking this medication can put you at risk of blood pressure dropping too low.
• Worsening kidney function: Use this drug with caution if you have any type of kidney condition. Lisinopril may impact kidney function, pushing patients with fragile renal systems into kidney failure. 
• High potassium levels: Also known as hyperkalemia occurs when there’s an excessive amount of potassium in the blood. Although many cases are mild and easy to correct, untreated hyperkalemia can lead to life-threatening heart problems (Simon, 2020). Risk factors for high potassium include diabetes, kidney problems, and using any supplements or substitutes that contain potassium.
• Severe allergic reactions: Lisinopril can trigger life-threatening allergic reactions including angioedema, which is rapid swelling in parts of the body, particularly the face and throat.  

If you have an underlying health condition, talk to a healthcare provider before taking either of these medications as some conditions can increase your risk for side effects. 

How lisinopril works in the body

Lisinopril

Last updated: Jan 06, 2021

8 min read

Think of your blood vessels like highways. They carry your blood from place to place. High blood pressure is essentially traffic on those highways and when it’s too high, it can cause damage both to the blood vessels themselves and to the organs served by those blood vessels (kind of like filling a water balloon using a fire hose).  

There are a few ways to lower high blood pressure. Lisinopril and other ACE inhibitors have two main effects. They both make the highways (blood vessels) wider, and they reduce the amount of water in your blood, reducing the “traffic.” 

More than 108 million people in the United States have high blood pressure, which is among the biggest risk factors for heart disease, and heart disease is the leading cause of death in the country (Whelton, 2017; Kochanek, 2017). 

Along with the risk for heart disease, untreated high blood pressure increases the likelihood for serious health complications, such as kidney failure and stroke. 

What exactly causes high blood pressure? There are many risk factors for hypertension, including family history, age, and underlying health issues (AHA, 2017). Research has found that racial disparities in healthcare also affect how hypertension is diagnosed and treated. This is especially true in the United States, where Black, Indigenous, and people of color have a significantly higher risk for developing high blood pressure compared to white people (Whelton, 2017).

While some of these risk factors cannot be changed, others—like not getting enough exercise, eating an unhealthy diet, drinking too much alcohol, and smoking—can be changed by adopting a heart-healthy lifestyle (AHA, 2017).

Main uses of lisinopril

Lisinopril, also found under the brand name Zestril, works by relaxing blood vessels, which in turn lowers blood pressure and allows more oxygen-rich blood to reach the heart. Lisinopril comes in oral tablets taken daily, and is available in 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, and 40 mg doses (FDA, n.d.). This drug has been found to be safe when treating hypertension in adults and children ages 6 and up. Here are more details on the FDA-approved uses for lisinopril (FDA, 2014):

• Hypertension: By American Heart Association (AHA) standards, normal blood pressure levels are less than 120/80 mmHg (AHA, n.d.). If you have high blood pressure, ACE inhibitors like lisinopril can be prescribed to control levels and prevent heart disease from developing.
• Heart failure: Uncontrolled high blood pressure greatly increases the risk for heart failure. In combination with other treatments—such as hydrochlorothiazide, another common blood pressure medication—lisinopril can decrease the chance of death in people living with heart failure (Lopez, 2020). 
• Myocardial infarction: Lisinopril is also used to treat myocardial infarction—or what’s commonly known as a heart attack. Giving lisinopril to a stable patient within 24 hours of a heart attack can help improve their survival rate.

What is lisinopril commonly used to treat?

Lisinopril

Last updated: Aug 22, 2020

6 min read

Lisinopril is frequently prescribed with diuretics, or “water pills.” Diuretics help treat high blood pressure by removing excess fluid from your body through your pee. Hydrochlorothiazide (HCTZ), also known under the brand name Zestoretic, is a diuretic often used in tandem with lisinopril (FDA, n.d.). Here are the most common side effects of this combination medication (DailyMed, 2019):

• Dizziness
• Cough
• Fatigue
• Low blood pressure
• Muscle cramps
• Gastrointestinal issues (indigestion, nausea, vomiting, diarrhea)
• Rash
• Weakness
• Upper respiratory infection
• Erectile dysfunction 

There are groups of people who should stay away from lisinopril completely. If you have kidney problems, hypotension, a history of angioedema, liver disease, or have had allergic reactions to ACE inhibitors in the past, avoid using lisinopril (FDA, 2014).  

ACE inhibitors of any kind are not safe for pregnant women, and could result in permanent damage or death to a fetus (FDA, 2014). The safety of lisinopril has not yet been established for women nursing infants. If you’re nursing, speak to a healthcare provider who may recommend another type of medication. Children under age 6 should not use lisinopril.  

There is a wide range of drugs lisinopril is known to interact with. Some interactions are insignificant, but others can trigger mild to severe reactions. Using lisinopril if you’re already taking medication for high blood pressure, for example, could result in an excessive drop in blood pressure. Below are some of the main drug interactions to watch out for (FDA, 2014):

• Diuretics (water pills): ACE inhibitors are sometimes combined with diuretics to improve symptoms. If you’re on diuretics, starting lisinopril can cause an excessive drop in blood pressure, as well as a spike in potassium levels.
• Antidiabetics: Drugs used to manage diabetes work by regulating blood sugar levels in the body. Mixing antidiabetics, like insulin and oral hypoglycemic medications, with lisinopril can enhance the effects and increase the risk for hypoglycemia (low blood sugar).
• Nonsteroidal anti-inflammatories (NSAIDs): NSAIDs are popular drugs used to treat pain and inflammation. Certain patient populations, like those with chronic kidney disease, are advised to avoid NSAIDs as the medication has been linked to kidney damage. Taking lisinopril with NSAIDs could further harm the kidneys, in some cases putting patients into renal failure.
• Aliskiren: Aliskiren is a generic drug that helps control high blood pressure. When combined with ACE inhibitors, aliskiren (which falls into a class of drugs called renin inhibitors) can cause severe problems, such as kidney failure, hypotension, and hyperkalemia. People living with diabetes or existing kidney problems should not use these medications together. 
• Lithium: Lithium is a prescription medication used to manage bipolar disorder. There are a number of drugs, including ACE inhibitors, that when taken at the same time as lithium can cause a lithium overdose. Lithium toxicity is usually reversible, but to avoid it from occurring, lithium levels should be monitored while taking lisinopril.  
• Gold: While not the most common therapy, people living with rheumatoid arthritis and other autoimmune diseases can be given gold injections to improve symptoms (UpToDate, 2019). Reactions between gold and lisinopril are rare, but they can happen. Reported side effects when taking these two medications together may cause facial flushing, nausea, vomiting, and low blood pressure.
• Alcohol: Drinking alcohol can amplify the effects of lisinopril, which may cause side effects like dizziness, lightheadedness, and fainting.

Heart-healthy diet: what is it and 9 tips to following one

Heart health

Last updated: Dec 22, 2021

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This isn’t a full list of drugs that can interact with lisinopril. Beyond drug interactions, avoid taking any potassium supplements or salt substitutes containing potassium while using lisinopril.  

As we’ve established, there are many risk factors for developing hypertension, including diabetes, a family history of high blood pressure, obesity, and lack of physical activity—to name a few (Oparil, 2018). There are also a number of steps you can take to improve your heart health, and lower your risk for hypertension. Eat a diet rich in fruits and vegetables. Keep physically active to help achieve and maintain a healthy weight. Stay away from smoking, and cut back on how much alcohol you drink. Making changes like these now can help prevent health problems in the future. Talk to a healthcare provider before taking lisinopril, or if you experience any adverse or unexpected reactions while on the medication.

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14. UpToDate. (October 2019). Major side effects of gold therapy. Retrieved on October 18, 2020 from https://www.uptodate.com/contents/major-side-effects-of-gold-therapy
15. U.S. Food and Drug Administration (FDA). (June 2018). Highlights of Prescribing Information, ZESTRIL. Retrieved Oct. 17, 2020 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/019777s064lbl.pdf
16. U.S. Food and Drug Administration (FDA). (n.d.). ZESTORETIC (lisinopril and hydrochlorothiazide). Retrieved Oct. 15, 2020 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019888s045lbl.pdf
17. Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Himmelfarb, C. D., et al. (2017). 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension, 71(6). Retrieved from https://doi.org/10.1161/HYP.0000000000000065. Retrieved from https://www.ahajournals.org/doi/10.1161/HYP.0000000000000065 
18. Yilmaz, I. (2019). Angiotensin-Converting Enzyme Inhibitors Induce Cough. Turkish Thoracic Journal, 20(1). Retrieved from doi: 10.5152/TurkThoracJ.2018.18014. Retrieved from https://turkthoracj.org/en/angiotensin-converting-enzyme-inhibitors-induce-cough-131056 

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.

Liprosil 450 – instructions for use, dosage, composition, analogues, side effects / Pillintrip

Page reviewed by pharmacist Fedorchenko Olga Valerievna Last update 1969-12-31

Attention!
The information on this page is for healthcare professionals only!
The information is collected from open sources and may contain significant errors!
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Name of the medicine

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Liprosil 450

Therapeutic indications

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Indication is a term used to list a condition or symptom or illness for which a drug is prescribed or used by a patient. For example, acetaminophen or paracetamol is used by a patient for a fever, or a doctor prescribes it for a headache or body aches. Currently, fever, headache and body aches are signs of paracetamol. The patient must be aware of the indications of the drugs used for general conditions because they can be taken over the counter in the sense of a pharmacy without a doctor’s prescription.

Liprosil 450 (Liprosil 450 tablets, USP) is indicated as adjunctive therapy to diet for:

1. Treatment of adult patients with very high serum triglyceride levels (hyperlipidemia types IV and V) who pose a risk of pancreatitis and who do not respond adequate to certain dietary efforts to control them. Patients who pose this risk typically have serum triglycerides over 2000 mg/dl and have elevated VLDL-cholesterol as well as fasting chylomicrons (type V hyperlipidemia). Subjects who consistently have a total serum or plasma triglyceride level below 1000 mg/dL are unlikely to pose a risk of pancreatitis. Therapy with liprosil 450 may be considered for those subjects with elevated triglyceride levels between 1000 and 2000 mg/dl who have a history of pancreatitis or recurrent abdominal pain typical of pancreatitis. It is recognized that some type IV patients with triglycerides below 1000 mg/dl may, through dietary or alcohol indiscretion, convert to the type V pattern with massive triglyceride elevations accompanying fasting chylomicronemia, but the effect of Liprosil 450 therapy on the risk of pancreatitis in these situations was not intended. way studied. Drug therapy is not indicated in patients with type I hyperlipoproteinemia who have elevated plasma chylomicrons and triglycerides but who have normal levels of very low density lipoprotein (VLDL). Examination of plasma refrigerated for 14 hours is useful in distinguishing hyperlipoproteinemia types I, IV, and V.
2. Reduced risk of developing coronary artery disease only in type IIb patients with no history or symptoms of existing coronary artery disease who have had an inadequate response to weight loss, dietary therapy, exercise, and other pharmacological agents (such as bile acid sequestrants and nicotinic acid, known to lower LDL and increase HDL cholesterol) and who have the following triad of lipid abnormalities: low HDL cholesterol in addition to elevated LDL cholesterol and elevated triglycerides. The National Cholesterol Education Program has identified a serum HDL cholesterol value consistently below 35 mg/dl as an independent risk factor for coronary heart disease. Patients with significantly elevated triglycerides should be closely monitored while on Liprosil 450 treatment. In some patients with high triglyceride levels, treatment with Liprosil 450 is associated with a significant increase in LDL cholesterol. BECAUSE THE POTENTIAL TOXICITY OF SUCH MALIGANITY, LOCK DISEASE, ABDOMINAL PAIN LEADING TO APPENDECTOMY AND OTHER ABDOMINAL OBSERVATIONS, INCREASED INCREASE IN NON-CORONARY MORTALITY, AND A 44% RELATIVE INCREASE OVER OF THE TEST PERIOD IN AGE ALLOCAUTION MORTALITY LOOKED WITH A CHEMICALLY AND PHARMACOLOGICALLY RELATED DRUG, KLIFIBRAT, THE POTENTIAL BENEFITS OF LIPROSIL 450 IN THE TREATMENT OF TYPE IIA PATIENTS WITH LDL-CHOLESTEROL ELEVATIONS DO NOT JUST RELEASE RISKS. Liprosil 450 IS ALSO NOT INDICATED FOR THE TREATMENT OF LOW HILSTEROL PATIENTS AS THEIR ONLY LAYER

In a subgroup analysis of patients in the Helsinki Heart Study with above-average HDL-cholesterol values ​​at baseline (greater than 46.4 mg/dl), the incidence of serious coronary events was similar between the Liprosil 450 and placebo subgroups.

The initial treatment for dyslipidemia is dietary therapy specific to the type of lipoprotein disorder. Overweight and excessive alcohol consumption may be important contributors to hypertriglyceridemia and should be managed prior to any drug therapy. Exercise can be an important supportive measure and is associated with increased HDL cholesterol levels. Diseases that contribute to hyperlipidemia, such as hypothyroidism or diabetes mellitus, should be sought and adequately treated. Estrogen therapy is sometimes associated with a massive increase in plasma triglyceride levels, especially in patients with familial hypertriglyceridemia. In such cases, discontinuation of estrogen therapy may eliminate the need for specific drug therapy for hypertriglyceridemia. The use of drugs should only be considered when reasonable attempts have been made to obtain satisfactory results through non-other methods. If a decision is made to take medication, the patient should be instructed that this does not diminish the importance of diet.

Liprosil 450 helps lower cholesterol and triglycerides (fatty acids) in the blood. High levels of these types of fat in the blood are associated with an increased risk of atherosclerosis (clogged arteries).

Liprosil 450 is used with diet to treat very high cholesterol and triglyceride levels in people with pancreatitis.

Liprosil 450 is also used to reduce the risk of stroke, heart attack, or other heart complications in people with high cholesterol and triglyceride levels who have not been helped by other treatments.

Liprosil 450 may also be used for purposes not listed in this medication guide.

Dosage and administration

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General: Lipid levels should be measured on >1 occasion to ensure levels are consistently abnormal. Before initiating therapy with Liprosil 450, every attempt should be made to control serum lipids with an appropriate diet, limit alcohol intake, exercise and weight loss in obese patients, and to control other medical problems such as diabetes mellitus or hypothyroidism that may contribute to abnormal lipid levels. The patient should continue a standard cholesterol-lowering diet during treatment with Liprosil 450. Periodic serum lipid determinations should be obtained during treatment with Liprosil 450. Liprosil 450 should be discontinued or additional therapy should be instituted if the lipid response is insufficient after 3 months.

Recommended daily dose: 900-1200 mg. Maximum daily dose: 1500 mg.

The 900 mg dose is given as a single dose ½ hour before dinner. The dose of 1200 mg is given in 2 doses, ½ hour before the morning and evening meals.

Use in patients with hepatic dysfunction: See Contraindications and Precautions.

Use in patients with renal dysfunction: See Contraindications and Precautions.

Contraindications

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What is the most important information I should know about Liprosil 450?

Special Warnings and Precautions

Description Special Warnings and Precautions Liprosil 450 is an automatic translation from the original language.
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Use Liprosil 450 as directed by your doctor. Check the label on the medication for exact dosing instructions.

• Take Liprosil 450 by mouth twice a day 30 minutes before your morning and evening meals, unless otherwise directed by your doctor.
• If you are also taking a bile acid binding resin (such as colestipol), do not take it within 2 hours before or after taking Liprosil 450. Talk to your doctor if you have questions.
• Take Liprosil 450 on a regular schedule to get the most benefit from it.
• If you miss a dose of Liprosil 450, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and return to your regular dosing schedule. Do not take 2 doses at the same time.

Ask your doctor any questions you have about how to use Liprosil 450.

There are both specific and general uses for a drug or medication. A medicine can be used to prevent a disease, treat a disease for a period, or treat a disease. It can also be used to treat a specific symptom of a disease. The use of the drug depends on the form that the patient takes. It may be more useful in the form of an injection or sometimes in the form of a tablet. The drug may be used for a single alarm symptom or life-threatening condition. While some medications can be stopped after a few days, some medications must be continued for a long period of time to benefit from them.

Liprosil 450 is used with diet and exercise to treat high levels of triglycerides (fats) in the blood.

Interaction with other drugs

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What other drugs will affect Liprosil 450?

HMG-CoA reductase inhibitors

Simultaneous administration of Liprosil 450 with simvastatin is contraindicated. The risk of myopathy and rhabdomyolysis is increased with combination therapy with liprosil 450 and HMG-CoA reductase inhibitors. Myopathy or rhabdomyolysis with or without acute renal failure has been observed as early as three weeks after the start of combination therapy or after several months. There is no guarantee that periodic monitoring of creatine kinase will prevent severe myopathy and kidney damage.

Anticoagulants

CAUTION SHOULD BE EXERCISED WHEN WARFARIN IS GIVEN IN CONNECTION WITH Liprosil 450. THE DOSAGE OF WARFARIN SHOULD BE REDUCED TO CREATE PROTHROMBIN TIME ON WILLING M LEVEL TO PREVENT BLEEDING PLANT DEFINITIONS PROTHROMBIN IS DEFINITELY DEFINED WHAT THE LEVEL PROTHROMBIL

CYP2C8 Substrates

Liprosil 450 is an inhibitor of CYP2C8 and may enhance the effects of drugs primarily metabolized by CYP2C8 (eg, dabrafenib, loperamide, montelukast, paclitaxel, pioglitazone, rosiglitazone). Therefore, while using Liprosil 450, it may be necessary to reduce the dosage of drugs that are mainly metabolized by the CYP2C8 enzyme.

Repaglinide

In healthy volunteers, co-administration with Liprosil 450 (600 mg twice daily for 3 days) resulted in an 8.1-fold increase in repaglinide AUC (range 5.5 to 15.0-fold) and 28.6 times (range 18. 5 to 80.1). -fold) plasma concentration of repaglinide 7 hours after. In the same study, Liprosil 450 (600 mg twice a day for 3 days) + itraconazole (200 mg in the morning and 100 mg in the evening on the first day, then 100 mg twice a day on days 2-3) resulted in 19.4- (range 12.9 to 24.7-fold) higher repaglinide AUC and 70.4-fold (range 42.9 to 119.2-fold) higher plasma repaglinide concentration 7 hours post-dose. In addition, Liprosil 450 alone or Liprosil 450 + itraconazole prolonged the hypoglycemic effects of repaglinide. The combined use of Liprosil 450 and repaglinide increases the risk of severe hypoglycemia and is contraindicated.

Dasabuvir

Co-administration of Liprosil 450 with dazabuvir increased dazabuvir AUC and Cmax (ratios: 11.3 and 2.01, respectively) due to inhibition of CYP2C8. Increased exposure to dazabuvir may increase the risk of QT prolongation, so co-administration of Liprosil 450 with dazabuvir is contraindicated.

OATP1B1 Substrates

Liprosil 450 is an inhibitor of the OATP1B1 transporter and may enhance the effects of drugs that are substrates of OATP1B1 (eg, atrasentan, atorvastatin, bosentan, ezetimibe, fluvastatin, glyburide, SN-38 [active metabolite of irinotecan ], rosuvastatin, pitavastatin, pravastatin, rifampin, valsartan, olmesartan).

Therefore, while using Liprosil 450, it may be necessary to reduce the dosage of drugs that are substrates of OATP1B1. Combination therapy of Liprosil 450 with simvastatin or repaglinide, which are OATP1B1 substrates, is contraindicated.

In vitro studies of CYP enzymes, UGTA enzymes and OATP1B1 Transporter

In vitro studies studies have shown that Liprosil 450 is an inhibitor of CYP1A2, CYP2C8, CYP2C9, CYP2C19, OATP1B1 and UDP-glucuronosyltrans ferases (UGT) 1A1 and 1A3.

Bile gums

Liprosil 450 AUC was reduced by 30% when Liprosil 450 (600 mg) was given simultaneously with granular preparations such as colestipol (5 g). It is recommended to administer the drugs at intervals of two hours or more, since the effects of liprosil 450 were not significantly affected when it was administered two hours after the use of colestipol.

Colchicine

Myopathy, including rhabdomyolysis, has been reported with chronic administration of colchicine at therapeutic doses. The simultaneous use of Liprosil 450 may stimulate the development of myopathy. Patients with renal dysfunction and elderly patients are at increased risk. Caution should be exercised when prescribing Liprosil 450 with colchicine, especially in elderly patients or patients with renal dysfunction.

Side effects

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What are the possible side effects of Liprosil 450?

In the double-blind controlled phase of the primary preventive component of the Helsinki Heart Study, 2046 patients received Liprosil 450 for up to five years. In this study, the following adverse reactions were statistically more frequent in subjects in the Liprosil 450 group.

For adverse events reported by more than 1% of subjects, but without significant difference between groups, see Table 5.

Capsule: Additional adverse reactions reported where a causal relationship with Liprosil 450 treatment is possible: Hepatobiliary disorders: Cholestatic jaundice.

Gastrointestinal disorders : Pancreatitis.

Nervous system disorders: Dizziness, drowsiness, paresthesia, peripheral neuritis, headache.

Psychiatric disorders : Decreased libido, depression.

Visual impairment: Blurred vision.

Reproductive system and breast disorders: Impotence.

Musculoskeletal and connective tissue: Arthralgia, synovitis, myalgia, myopathy, myasthenia gravis, painful limbs, rhabdomyolysis.

Diseases of the skin and subcutaneous tissue : Exfoliative dermatitis, rash, dermatitis, pruritus, angioedema, urticaria.

Respiratory, thoracic and mediastinal disorders: Swelling of the larynx.

Blood and lymphatic disorders : Severe anemia, leukopenia, thrombocytopenia, eosinophilia, bone marrow hypoplasia.

Additional adverse reactions reported included photosensitivity, alopecia, cholecystitis and cholelithiasis.

Tablet: Gallbladder surgery was performed in 0.9% of patients with liprosilium 450 and 0.5% of patients with placebo in the primary prophylactic component, which is 64% more than not statistically different from excess gallbladder surgery, observed in the clofibrate group compared to the WHO placebo group. study. Gallbladder surgery was also performed more frequently in the Liprosil 450 group compared to the placebo group (1.9% versus 0.3%, p = 0.07) in the secondary prophylactic component. A statistically significant increase in appendectomy in the Liprosil 450 group was also observed in the secondary prophylaxis component (6 on Liprosil 450 vs 0 on placebo, p = 0. 014).

Adverse reactions of the nervous system and special senses were more common in the Liprosil 450 group. These included hypesthesia, paresthesia and taste perversion. Other adverse reactions that were more common among subjects in the Liprosil 450 treatment group, but where a causal relationship has not been established, include cataracts, peripheral vascular disease, and intracerebral hemorrhage.

From other studies, it seems likely that Liprosil 450 is causally associated with musculoskeletal symptoms as well as hepatic dysfunction and haematological changes.

Reports of viral and bacterial infections (colds, coughs, urinary tract infections) were more common in patients treated with Liprosil 450 in other controlled clinical trials of 805 patients. Additional adverse reactions reported for Liprosil 450 are listed by the system as follows. They are classified according to whether a causal relationship with Liprosil 450 treatment is probable or not established:

Additional adverse reactions that have been reported include cholecystitis and cholelithiasis.

Composition

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Each capsule contains Gemfibrozil 300 mg. Each tablet contains Gemfibrozil 600 mg.

Liprosil 450 is a non-halogenated phenoxypentanoic acid with a molecular weight of 250.35. Chemical name – 5- (2,5-dimethylphenoxy) -2,2-dimethylpentanoic acid; empirical formula C15h32O3.

Liprosil 450 is a white compound with a melting point of 58°C to 61°C. Its solubility is 0. 0019% in water and acid and over 1% in dilute base. Liprosil 450 is stable under normal conditions.

Excipients / Inactive Ingredients: Capsule: Corn Starch, Polysorbate 80, Silica. Tablet: Calcium stearate, NF; candelilla wax, FCC; microcrystalline cellulose, NF; hydroxypropyl cellulose, NF; hypromellose, USP; methylparaben, NF; Opasprey white; polyethylene glycol, NF; polysorbate 80, NF; propylparaben, NF; colloidal silicon dioxide, NF and pregelatinized starch, NF ..

Liprosil 450 price

We do not have exact data on the cost of the drug.
However, we will provide data for each active ingredient

The average cost of Gemfibrozil 600 mg per unit in online pharmacies is from $0.38 to $1.28, per package from $39 to $128.

The average cost of Gemfibrozil 300 mg per unit in online pharmacies is from $0.34 to $0.8, per package from $27 to $57.

Sources:

• https://www.drugs.