Lisinopril (Prinivil, Zestril) is an oral drug with several medical uses. It is most commonly prescribed for high blood pressure (hypertension) and heart failure, or, following a heart attack, to prevent further damage to the heart. For most people the side effects of lisinopril are minor.
Cough
A persistent dry cough is lisinopril's most common side effect, affecting five to ten percent of patients. Being elderly, female, or white increases the likelihood of developing a cough. Although the cough is not harmful, it is the most common reason patients stop taking lisinopril. Coughing will stop within 10 days of stopping lisinopril.
Low Blood Pressure
Some patients experience a sharp drop in blood pressure with the first dose of lisinopril. This drop is more likely to occur in people who start with very high blood pressure, people also taking a diuretic (water pill) or people who are dehydrated or have low sodium levels. The side effect can be prevented by starting treatment with a low dose of lisinopril and temporarily stopping diuretics two to three days before starting lisinopril. If low blood pressure occurs, it can cause lightheadedness or fainting, and the patient should lie down. Within a few doses this side effect stops.
High Potassium Levels
High potassium levels (hyperkalemia) can occur in patients who are also taking potassium supplements, salt substitutes or a potassium-sparing diuretic such as spiranolactone. Because high potassium can be very dangerous, anyone taking lisinopril should not use a salt substitute or take potassium supplements unless these are prescribed by a doctor.
Impaired Taste
Lisinopril can change the sense of taste. Tasting can either be diminished--foods seem to have no flavor--or it can be altered so that foods do not taste as expected.
Sexual Side Effects
An infrequent side effect is decreased interest in sex. Men may experience difficulty having an erection.
Swelling
An allergic reaction called angioedema can cause swelling of the face, mouth, throat, and tongue, swelling of the eyes and swelling of the hands, feet, or lower legs. This reaction affects less than one percent of people taking lisinopril, but it can result in fatal complications if not treated in time.
Kidney Failure
Kidney failure related to lisinopril is a concern only for a small group of people: those who have stenosis (narrowing) of the arteries that supply blood to the kidneys. No one with this condition should take lisinopril.
Increased Risk of Infection
A rare side effect of lisinopril is called neutropenia, meaning loss of one kind of white blood cells, which are necessary for fighting infections. This complication is most likely to occur in people with kidney disease, lupus or scleroderma. Anyone with these conditions should have frequent tests to measure white blood cell counts.
Birth Defects
Lisinopril can cause birth defects. It should not be taken by women planning to become pregnant. Women of child-bearing age should use a method of birth control.
Other Side Effects
Some people taking lisinopril experience cramps, diarrhea, nausea and fatigue, but these adverse effects are infrequent.
References
- Pharmacology for Nursing Care, Richard A. Lehne, PhD, 2006
- Mayo Clinic: Lisinopril
- MedlinePlus: Lisinopril
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