Lisinopril

Key points about lisinopril

  • Lisinopril is used to treat high blood pressure and heart failure and to prevent kidney problems in people with diabetes
  • Lisinopril can work very quickly for hypertension (high blood pressure). If you have heart failure it may be a few weeks or months before you notice an improvement in your symptoms.
  • Find out how to take it safely and possible side effects.
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Lisinopril has many different effects on the body and is used to treat a variety of conditions. It belongs to a group of medicines called ACE inhibitors. Lisinopril may be used for:

  • high blood pressure by relaxing and widening your blood vessels and lowering your blood pressure
  • heart failure to help your heart pump blood more easily – this can help to relieve symptoms such as shortness of breath and swelling of you feet, legs and abdomen (tummy)
  • diabetic kidney disease (diabetic nephropathy) to protect your kidneys and help them to function
  • after a heart attack (myocardial infarction) to protect your heart, once you are stable.

Lisinopril can work very quickly for hypertension (high blood pressure). If you have heart failure it may be a few weeks or months before you notice an improvement in your symptoms. 

In Aotearoa New Zealand lisinopril is available as tablets (5 mg, 10 mg and 20 mg). 

  • Your doctor or pharmacist will tell you the strength that is right for you. Your dose of lisinopril will depend on what it is being used for.
  • Your doctor will usually start you on a low dose and increase the dose depending on how you respond. This allows your body to get used to the medicine and reduces side effects.
  • Always take your lisinopril exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much lisinopril to take, how often to take it and any special instructions.
  • Check with your pharmacist if your tablets are different to what you expect.

 

My dose

You can use the table below to keep track of dose changes when you start taking lisinopril.

Date Dose
   
   
   
Notes:


  • Timing: Lisinopril is usually taken once a day, in the morning. Take lisinopril at the same time each day. You can take lisinopril with or without food.
  • Limit alcohol intake while you are taking lisinopril. Alcohol can increase your chance of side effects such as dizziness and light-headedness.
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. Don't take double the dose.

Lisinopril isn't suitable if you're pregnant or planning a pregnancy. It's also not suitable if you've had a severe allergic reaction to an ACE inhibitor in the past, eg, swelling of your lips, eyes or tongue (called angioedema). Read more about who can't take ACE inhibitors. If you're already taking diuretics (water pills), your doctor will monitor you very closely when you first start taking lisinopril.

Here are some things to know when you're taking lisinopril. Other things may be important as well, so ask your healthcare provider what you should know about.

Monitoring

Your doctor will arrange for you to have blood tests and blood pressure checks before you start taking lisinopril and during your treatment, especially when you first start taking it. This is to check how it is working and to check your kidneys and potassium levels.

Have a sick day plan

If you have diarrhoea (runny poo) or vomiting (being sick) from a stomach bug, or if you're dehydrated from another illness, it’s important to let your healthcare provider know. They may advise that you decrease your dose or stop taking your lisinopril for a few days, and start again when you feel better. 

Be careful when taking some pain relief medicines

ACE inhibitors can be used to protect your kidneys from damage if you have diabetes. However, if you are taking lisinopril and diuretics (water pills), the combination of these with NSAIDs (anti-inflammatory pain relief medication) can be very harmful to your kidneys. It can cause acute kidney injury.(external link) This combination is called the ‘dangerous trio’ or ‘triple whammy’. You have a higher risk of harm to your kidneys if you are also an older adult (over 65 years) or if you're dehydrated. 

If you are taking an ACE inhibitor with a diuretic, don't use NSAIDs for pain relief. Ask your doctor or pharmacist for a safer option. Read more about NSAIDs and protecting your kidneys.

Examples of diuretics Examples of NSAIDs
  • Bendroflumetazide (Arrow-Bendrofluazide)
  • Chlortalidone (Hygroton)
  • Indapamide (Dapa-Tabs)
  • Metolazone (Zaroxolyn)
  • Furosemide (Lasix, Urex Forte)
  • Bumetanide (Burinex)
  • Spironolactone (Spiractin)
  • Ibuprofen (Nurofen, Brufen SR)
  • Diclofenac (Voltaren)
  • Naproxen (Noflam, Naprosyn)
  • Mefenamic acid (Ponstan)
  • Celecoxib (Celebrex)
  • Tenoxicam (Tilcotil)

Like all medicines, lisinopril can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Dizziness
  • Feeling light headed
  • Feeling faint or dizzy when you stand up
  • Headache
  • This is quite common when you first start taking lisinopril and usually goes way with time.
  • Be careful when getting up from either lying down or sitting to avoid falls. These effects put you at risk of falls and injuries, especially if you are an older adult (over 65 years).
  • Stand up slowly. If you do feel dizzy, sit or lie down for a few moments.
  • Tell your doctor if this continues.
  • Tickle in the throat
  • Dry, irritating cough


  • This is quite common when you first start taking lisinopril and usually goes away with time.
  • Tell your doctor if the cough is troublesome and persistent.
  • Upset tummy or feeling sick
  • Constipation or diarrhoea
  • These are common when you first start taking lisinopril but should go away with time.
  • Tell your doctor if this continues
  • Allergic reaction such as skin rash, itching, swelling of your lips, face, and mouth or difficulty breathing, such as chest tightness or wheezing
  • Tell your doctor immediately or ring Healthline 0800 611 116.
  • Signs of problems with your liver, such as yellowing of your skin or eyes, dark urine or pain in your abdomen (tummy)
  • Tell your doctor immediately or ring Healthline 0800 611 116.
Did you know that you can report a side effect from a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.(external link)

The following links provide more information on lisinopril.

Lisinopril(external link) New Zealand Formulary Patient Information

References

  1. Lisinopril(external link) New Zealand Formulary

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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