Lisinopril

Lisinopril is an ACE inhibitor used to treat high blood pressure and heart failure, and after a heart attack. This guide covers lisinopril uses, how it works, dosage, side effects, precautions, drug interactions, use in pregnancy and breastfeeding and its approximate price in India.

What Is Lisinopril?

Lisinopril is an ACE inhibitor. It is commonly used for high blood pressure (hypertension) and heart failure. It blocks the conversion of angiotensin I into angiotensin II, a substance that narrows blood vessels. Lisinopril helps the vessels relax, which makes it easier for the heart to pump blood.

How Lisinopril Works

Lisinopril lowers the formation of angiotensin II, which lowers blood pressure. Controlling high blood pressure is an important part of reducing long-term risks such as stroke and kidney problems. Lisinopril does not guarantee that these will be prevented in every person.

When Lisinopril Is Used

Based on the US prescribing information [1][2]

• Hypertension: in adults and in children aged 6 years and older.
• Heart failure: to reduce signs and symptoms of systolic heart failure.
• Acute heart attack: to reduce the risk of death in hemodynamically stable patients, treatment starting within 24 hours of the attack.

The NHS also lists kidney problems caused by diabetes among its uses [4]. Your doctor decides whether lisinopril is suitable for you. Lifestyle measures such as diet and exercise support treatment. They do not replace prescribed medicine.

Lisinopril Dosage and How to Take It

The figures below are examples from US prescribing information [1][2]. They are not a recommendation for any individual.

• Hypertension (adults): the usual starting dose is 10 mg once daily. People already taking a diuretic may start at 5 mg once daily [1].
• Heart failure (adults): the usual starting dose is 5 mg once daily, used with diuretics and usually digitalis, then increased as tolerated [2].
• After a heart attack: the US label describes a short stepwise schedule over the first 48 hours, continued for at least six weeks. This is a clinician-managed protocol, not a self-dosing schedule [1][2].
• Kidney impairment: a lower starting dose is used when kidney function is reduced [2].
• Children: the US label does not recommend lisinopril in children under 6 years, or in those with a glomerular filtration rate below 30 [2].

Your dose depends on your condition, blood pressure, kidney function, other medicines and response to treatment. Take this medicine only as advised by your doctor or healthcare professional. Do not start, stop, or change the dose on your own.

Side Effects of Lisinopril

Common [2][4]:

• dizziness, especially on standing up quickly
• headache
• tiredness
• low blood pressure
• a dry cough that does not go away
• nausea, vomiting or diarrhoea

Seek emergency care immediately for:

• swelling of the tongue, lips, face or throat
• difficulty breathing
• a swollen throat or a raised, itchy rash [1][4]

These can be signs of angioedema or a severe allergic reaction (anaphylaxis). They are not something to diagnose yourself.

Contact your doctor promptly for:

• yellowing of the skin or eyes. The US label says patients who develop jaundice should stop the ACE inhibitor and receive medical treatment [2]. Your doctor will give you instructions.
• fainting or marked dizziness, which can come from symptomatic low blood pressure [2].
• passing much less urine than usual, which can be a sign of kidney problems [2][4].
• symptoms that may point to high potassium or kidney problems, which blood tests check for [2][4].

If you feel dizzy or drowsy, avoid driving or using machinery until the symptoms pass [4].

Lisinopril Precautions and Monitoring

Formal contraindications in the US label

• previous angioedema or hypersensitivity linked to an ACE inhibitor [1]
• hereditary or idiopathic angioedema [1]
• co-use with aliskiren in people with diabetes [1]
• use within 36 hours of switching to or from sacubitril/valsartan [3]

Precautions:

• Lisinopril should be used with caution in kidney dysfunction or low blood pressure [2].
• The label advises that potassium be monitored periodically [2].
• Kidney function may also be checked. Your treating doctor decides which tests you need and how often.
• Tell your doctor if you are dehydrated, vomiting, or have diarrhoea, because that can affect blood pressure and kidney function. Do not stop any medicine on your own.
• Alcohol may increase the risk of low blood pressure [4].

Lisinopril Drug Interactions

Tell your doctor and pharmacist about all prescription, over-the-counter, herbal and supplement products you use. This list is not complete.

Contraindicated:

• Sacubitril/valsartan: the interval must be 36 hours when switching to or from it, because of angioedema risk [3].
• Aliskiren in people with diabetes [1].

Use with caution or monitoring:

• NSAIDs (such as ibuprofen): may worsen kidney function and weaken the blood pressure effect [2].
• Diuretics: starting lisinopril may cause a large fall in blood pressure. Potassium-sparing diuretics can raise potassium [2].
• Potassium supplements and potassium-containing salt substitutes: can raise potassium [2].
• Lithium: lithium toxicity has been reported, so levels are monitored [2].
• ARBs and other RAS blockers: combining them raises the risk of low blood pressure, high potassium and kidney changes [2].

Not all combinations of blood-pressure medicines are prohibited. Your doctor decides which are appropriate.

Lisinopril in Pregnancy and Breastfeeding

Pregnancy. The US label carries a boxed warning for fetal toxicity. Medicines of this type can injure or cause the death of a developing baby. When pregnancy is detected, the label advises discontinuing lisinopril as soon as possible [1]. The NHS says it is not usually used in pregnancy and may affect the baby’s kidneys, skull, lungs and joints [4].

• If you are pregnant or think you may be: contact your prescriber promptly for instructions and an alternative treatment plan. Do not wait for your next routine appointment.
• If you are planning a pregnancy: speak to your doctor before trying to conceive.
• Any replacement medicine must be chosen by your doctor.

Breastfeeding. The two sources do not agree:

• US label (Zestril): it is not known whether lisinopril passes into human milk. The label says a decision should be made whether to stop nursing or stop the drug [2].
• NHS: lisinopril may be taken while breastfeeding, but it passes into breast milk in small amounts, and a doctor may suggest enalapril instead [4].

The decision depends on your circumstances. Discuss it with your doctor.

Lisinopril Brands, Strengths and Approximate Price in India

These are listing-based MRPs from retailer pages, for the exact pack shown. They are not official prices and they vary by pharmacy, city and date. This table is not a complete list of lisinopril brands in India. Brands, strengths and combinations are not interchangeable without professional advice.

How HealthPil Can Help

Medicines should be started, adjusted, or stopped only under the guidance of a qualified healthcare professional. If you have questions about lisinopril, its side effects, or your blood pressure or heart treatment plan, you can consult a doctor, such as a cardiologist, through HealthPil.