Lisinopril treats hypertension, or high blood pressure. Its brand names include Prinivil and Zestril. Lisinopril belongs to the class of medications known as ACE inhibitors, which work to lower blood pressure by inhibiting the conversion of the hormone angiotensin I into angiotensin II, a potent vasoconstrictor. Lisinopril has other beneficial health effects, especially in patients who have conditions such as diabetes in addition to hypertension.
Common Side Effects
Discontinuation of lisinopril because of side effects occurs in fewer than 6 percent of patients, according to Drugs.com. Most side effects are mild, including hypotension, or low blood pressure, dizziness when getting up from a sitting or lying position, fatigue, headache, dry cough, decreased libido, diarrhea, sweating, nausea and impotence. Goodman and Gilman's "The Pharmacological Basis of Therapeutics" lists skin rashes and taste disturbances as other possible side effects.
Cough
Approximately 20 percent of patients taking lisinopril or other ACE inhibitors experience a dry cough during treatment, according to "Pharmacotherapy: A Pathophysiologic Approach" by Joseph DiPiro and colleagues. Some patients find this to be an intolerable side effect, because it does not subside as treatment continues. Switching to a similar class of medication, known as angiotensin receptor blockers, or ARBs, might be an option. Discuss this and any other side effects with your health care provider.
Effect of Lisinopril on Kidneys
Although lisinopril helps to preserve kidney function, which can decline over time with untreated elevated blood pressure, patients with preexisting kidney problems are at a higher risk of experiencing side effects from lisinopril, according to "Pharmacotherapy: A Pathophysiologic Approach." Patients with kidney problems may need to begin treatment with lisinopril at very small doses and have frequent lab testing of their kidney function to ensure lisinopril is safe to take.
Hyperkalemia
Lisinopril can increase the levels of potassium in the body, which is known as hyperkalemia. For most patients, this is not a concern, but for people who take potassium supplements or other medications that increase potassium levels, like the aldosterone inhibitor spironolactone or potassium-sparing diuretics, levels of potassium may rise to dangerous levels and result in serious symptoms, according to "The Pharmacological Basis of Therapeutics." Patients with compromised kidney function have higher risk of developing hyperkalemia; their health care providers will frequently assess their potassium levels.
Angioedema
Angioedema is a serious side effect associated with lisinopril and other ACE-inhibitors, according to "The Pharmacological Basis of Therapeutics." Symptoms include severe swelling of the face and lips, and sometimes the tongue and throat. Angioedema can also occur in the gastrointestinal tract, presenting with symptoms including abdominal cramping and swelling. Angioedema occurs in about 2 percent of patients taking lisinopril. African-Americans have a higher chance of developing this side effect than Caucasians do. If angioedema occurs, the patient must discontinue lisinopril immediately and seek emergency medical attention. Speak to your health care provider about safe alternatives to lower blood pressure if you can not take lisinopril.
Contraindication
Pregnancy contraindicates the use of Lisinopril and all other ACE-inhibitors. Lisinopril is not first-line therapy for women women of child-bearing age. If a woman becomes pregnant, she must discontinue use of lisinopril immediately, according to "The Pharmacological Basis of Therapeutics.
References
- "Goodman & Gilman's The Pharmacological Basis of Therapeutics"; J. G. Hardman et al; 2001
- "Pharmacotherapy: A Pathophysiologic Approach"; J. T. DiPiro et al; 2005
- Drugs.com: Lisinopril
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