Lisinopril

Lisinopril is a medicine to treat high blood pressure and heart failure.

It's also prescribed after a heart attack and in diabetic kidney disease.

Lisinopril helps prevent future strokes and heart attacks. It also improves your survival if you're taking it after a recent heart attack or for heart failure.

And it also slows down diabetic kidney disease.

This medicine is only available on prescription. It comes as tablets.

It also comes as a liquid for people who find it hard to swallow tablets, but this has to be ordered specially by your doctor.

Lisinopril is also available combined with another blood pressure medicine called hydrochlorothiazide.

NHS coronavirus advice

If you have coronavirus, or think you might have it, keep taking your blood pressure medicines as usual.

There is no clear evidence that taking angiotensin-converting enzyme (ACE) inhibitors like lisinopril will cause complications.

Updated: 17 March 2020

• Lisinopril lowers your blood pressure and makes it easier for your heart to pump blood around your body.
• Your very first dose of lisinopril may make you feel dizzy, so it's best to take it at bedtime. After that you can take lisinopril at any time of day.
• Some people get a dry, irritating cough with lisinopril.
• If you get severe diarrhoea or vomiting from a stomach bug or illness, tell your doctor. You may need to stop taking lisinopril for a while until you feel better.
• Drinking alcohol with lisinopril can make you feel dizzy or lightheaded.
• Lisinopril is also called by the brand name Zestril. When it's mixed with hydrochlorothiazide, it can be called Carace Plus, Lisoretic and Zestoretic.

Lisinopril can be taken by adults and children aged 6 years and over.

If you have diabetes, check your blood sugar (glucose) more often, particularly in the first few weeks. This is because lisinopril can lower the sugar level in your blood.

Lisinopril is not suitable for everyone.

To make sure lisinopril is safe for you, tell your doctor if you:

• have had an allergic reaction to lisinopril or any other medicine in the past
• are trying to get pregnant, are already pregnant or breastfeeding
• are having dialysis or any other type of blood filtration
• have heart, liver or kidney problems
• have unstable or low blood pressure
• have diabetes
• are going to have a major operation (surgery) or general anaesthetic to put you to sleep
• have recently had diarrhoea or vomiting
• are on a low-salt diet
• are going to have desensitisation treatment to reduce your allergy to insect stings
• have a blood problem, such as a low white blood cell count (neutropenia or agranulocytosis)

It's usual to take lisinopril once a day.

Your doctor may suggest that you take your first dose before bedtime because it can make you dizzy.

After the very first dose, you can take lisinopril at any time of day. Try to take it at the same time every day.

Dosage

The dose of lisinopril you take depends on why you need the medicine. Take it as instructed by your doctor.

To decide your dose, your doctor will check your blood pressure and ask you if you're getting any side effects.

You may also have blood tests to check how well your kidneys are working and the amount of potassium in your blood.

Depending on why you're taking lisinopril, the usual starting dose is between 2.5mg and 10mg once a day.

This will be increased gradually over a few weeks to a usual dose of:

• 20mg once a day for high blood pressure (the maximum dose is 80mg once a day)
• 10mg once a day after a recent heart attack
• 20mg to 35mg once a day for heart failure
• 10mg to 20mg once a day for diabetic kidney disease

Doses are usually lower for children.

How to take it

You can take lisinopril with or without food. Swallow lisinopril tablets whole with a drink.

If you're taking lisinopril as a liquid, it'll come with a plastic syringe or spoon to help you measure out the right dose.

If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not give the right amount of medicine.

Will my dose go up or down?

You'll probably be prescribed a low dose of lisinopril at first so it does not make you feel dizzy.

This will usually be increased gradually until you reach the right dose for you.

If you have side effects with lisinopril, you may stay on a lower dose.

Important

Take lisinopril even if you feel well, as you'll still be getting the benefits of the medicine.

What if I get ill while I'm taking it?

If you get severe diarrhoea or vomiting for any reason, stop taking lisinopril.

When you're able to eat and drink normally, wait for 24 to 48 hours, then start to take it again.

If you have questions about this, contact your doctor or pharmacist.

What if I forget to take it?

If you miss a dose of lisinopril, take it as soon as you remember.

If you do not remember until the following day, skip the missed dose. Do not take a double dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you.

You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

If you take too many lisinopril tablets by accident, contact your doctor or go to your nearest A&E.

Taking too much lisinopril can cause dizziness, sleepiness and a pounding heartbeat.

The amount of lisinopril that can lead to an overdose varies from person to person.

Call your doctor or go to A&E now if:

Like all medicines, lisinopril can cause side effects in some people, but many people have no side effects or only minor ones.

Common side effects

These common side effects happen in more than 1 in 100 people.

Talk to your doctor or pharmacist if these side effects bother you or do not go away:

• a dry, tickly cough that does not 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
• headaches
• diarrhoea or being sick (vomiting)
• itching or a mild skin rash
• blurred vision

Serious side effects

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

Call a doctor straight away if you get:

• yellow skin or the whites of your eyes turn yellow – this can be a sign of liver problems
• paleness, feeling tired, faint or dizzy, any sign of bleeding (for example bleeding from the gums or bruising more easily than usual), a sore throat, a fever, and getting infections more easily – these can be signs of blood or bone marrow disorder
• a faster heart rate, chest pain and tightness in your chest – these can be signs of heart problems
• shortness of breath, wheezing and tightening of the chest – these can be signs of lung problems
• severe stomach pain – this can be a sign of an inflamed pancreas
• swollen ankles, blood in your pee or not peeing at all – these can be signs of kidney problems
• weak arms and legs or problems speaking – these can be signs of a stroke

If you suspect that you or someone else is having a stroke, phone 999 immediately and ask for an ambulance.

Serious allergic reaction

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

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

What to do about:

• a dry tickly cough – 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 – 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.
• headaches – make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if they last longer than a week or are severe.
• diarrhoea or being sick (vomiting) – drink plenty of fluids, such as water or squash, to prevent dehydration. If you're being sick, take small, frequent sips of fluid. 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 or vomiting without speaking to a pharmacist or doctor first. If you get diarrhoea or vomiting from a stomach bug, or illness, tell your doctor. You may need to temporarily stop taking lisinopril until you feel better.
• itching or a mild 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 – avoid driving or using tools or machines 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.

Lisinopril is not normally recommended in pregnancy or when breastfeeding. But it may be prescribed if your doctor thinks the benefits of the medicine outweigh the risks.

If you're trying to get pregnant or are already pregnant, talk to your doctor about the benefits and possible harms of taking lisinopril.

These will depend on how many weeks pregnant you are and the reason why you're taking it. There may be other treatments that are safer.

For more information about how lisinopril can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website.

Lisinopril and breastfeeding

Small amounts of lisinopril may get into breast milk. This can cause low blood pressure in the baby.

Talk to your doctor, as other medicines might be better while you're breastfeeding.

There are some medicines that may interfere with the way lisinopril works.

Tell your doctor if you're taking:

• anti-inflammatory medicines, such as ibuprofen, indomethacin or aspirin for pain relief (low-dose aspirin – 75mg a day, is safe to take with lisinopril)
• medicines to treat low blood pressure, heart failure, asthma or allergies, such as ephedrine, noradrenaline or adrenaline
• medicines to treat high blood pressure, such as aliskeren
• other medicines that can lower your blood pressure, such as some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), anaesthetics, or medicines for an enlarged prostate gland
• medicines that damp down your immune system, such as ciclosporin or tacrolimus
• tablets that make you pee more (diuretics), such as furosemide
• medicines that can increase the amount of potassium in your blood, such as spironolactone, triamterene, amiloride, potassium supplements, trimethoprim (for infections) and heparin (for thinning blood)
• steroid medicines such as prednisolone
• allopurinol (for gout)
• procainamide (for heart rhythm problems)
• medicines for diabetes
• racecadotril (for diarrhoea)
• lithium (for mental health problems)

Mixing lisinopril with herbal remedies or supplements

There's very little information about taking herbal remedies and supplements with lisinopril.

For safety, speak to your pharmacist or doctor before taking any herbal or alternative remedies with lisinopril.