Lisinopril is a prescription medication indicated for the treatment of hypertension and congestive heart failure and may improve survival rates of myocardial infarction (heart attack). It belongs to a class of drugs called angiotensin converting enzyme (ACE) inhibitors. Angiotensin is a chemical produced in the body that constricts blood vessels, causing the blood pressure to rise. Lisinopril will block ACE, and angiotensin will not be able to exhibit its effect, thus causing blood vessels to dilate and lower the blood pressure. Because lisinopril is active in the body, many side effects are associated with its use.
Common Side Effects
Lisinopril exhibits many common side effects. Nausea, abdominal pain and vomiting have been seen in about 2 percent of individuals; diarrhea has been seen in up to 4 percent of individuals. Headache and fatigue are also common effects and can occur in about 4 percent of people. According to the Drug Information Handbook, up to 12 percent of individuals taking lisinopril can experience dizziness or lightheadedness. Avoid driving or performing any activities that require alertness when these are present.
Changes in Blood Pressure
Hypotension, which is low blood pressure, is common in 1 to 4 percent of people. In those with heart failure, hypotension occurs in 5.3 percent of people. Orthostatic hypotension is a drop in blood pressure that occurs upon standing quickly. It is present in about 1 percent of individuals and is more common in the elderly and people with heart failure.
Cough
ACE inhibitors, such as lisinopril, prevent the breakdown of a chemical called bradykinin. The accumulation of bradykinin in the body can lead to a dry cough. About 7 percent of individuals experience cough and will need to be switched to another medication. This may also lead to upper respiratory tract infections in about 2 percent of individuals.
Hyperkalemia
Hyperkalemia is an increase in potassium that can occur in 2 to 5 percent of people on lisinopril. Because lisinopril causes the release of sodium and water, potassium, which is left behind in exchange for sodium, may accumulate in the body. People with diabetes, renal dysfunction or those on potassium supplements or other drugs that can potentially increase potassium are at higher risk. If you experience fast or uneven heartbeat, muscle tightness or spasms, contact your health care provider.
Changes in Renal Function
Lisinopril may cause an increase in serum creatinine and BUN (blood urine nitrogen) in about 2 percent of people; these are measures of renal function. These effects may be temporary and decrease about two to four weeks after initiation of the drug. Lisinopril can lead to acute renal failure in about 1 percent of individuals. The risk of developing acute renal failure increases if the individual has low renal blood flow as can be seen in heart failure.
References
- "Drug Information Handbook, 15th Edition"; Charles F. Lacy, RPh, PharmD, FCSHP, Lora L. Armstrong, RPh, PharmD, BCPS. et al; 2007
- "Pharmacotherapy: A Pathophysiologic Approach"; Joseph T. Dipiro, Robert L. Talbert, et al; 2008
- Drug Information Online: Lisinopril
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