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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Lisinopril
Generic Name
Lisinopril
Active Ingredient
LisinoprilCategory
Thiazide Diuretic [EPC]
Variants
272
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 20 mg/1 | TABLET | ORAL | 63187-775 |
| 2.5 mg/1 | TABLET | ORAL | 68071-1894 |
| 10 mg/1 | TABLET | ORAL | 68071-3122 |
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Lisinopril, you must consult a qualified healthcare professional.
| 40 mg/1 | TABLET | ORAL | 68071-3220 |
| 20 mg/1 | TABLET | ORAL | 68071-5036 |
| 10 mg/1 | TABLET | ORAL | 68645-587 |
| 40 mg/1 | TABLET | ORAL | 71335-0075 |
| 10 mg/1 | TABLET | ORAL | 72865-210 |
| 20 mg/1 | TABLET | ORAL | 72865-211 |
| 40 mg/1 | TABLET | ORAL | 0591-0409 |
| 30 mg/1 | TABLET | ORAL | 82868-009 |
| 20 mg/1 | TABLET | ORAL | 0615-8255 |
+ 38 more variants
Detailed information about Lisinopril
Lisinopril is a potent Angiotensin-Converting Enzyme (ACE) inhibitor used primarily to treat hypertension, heart failure, and to improve survival after a heart attack. It works by relaxing blood vessels to lower blood pressure and improve cardiac output.
The dosage of Lisinopril is highly individualized based on the condition being treated and the patient's response to the medication. Healthcare providers typically follow these standard guidelines:
Lisinopril is approved for the treatment of hypertension in children aged 6 years and older. The dosage is based on body weight:
Since Lisinopril is eliminated entirely by the kidneys, dosage adjustments are critical for patients with renal dysfunction. Healthcare providers use the Creatinine Clearance (CrCl) rate to determine the dose:
Because Lisinopril is not metabolized by the liver, no specific dosage adjustment is typically required for patients with liver disease. However, these patients should still be monitored closely for overall health status.
Older adults may have decreased renal function and a higher sensitivity to the blood-pressure-lowering effects of Lisinopril. Doctors often start at the lower end of the dosing spectrum and monitor for dizziness or lightheadedness when standing (orthostatic hypotension).
If you miss a dose of Lisinopril, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and return to your regular schedule. Do not 'double up' or take two doses at once to make up for a missed one, as this increases the risk of severe hypotension.
The most likely symptom of a Lisinopril overdose is severe hypotension (excessively low blood pressure), which can lead to fainting, dizziness, and shock. Other signs may include electrolyte imbalances (such as high potassium) and kidney failure. In the event of a suspected overdose, seek emergency medical attention immediately. Treatment usually involves intravenous fluids to restore blood pressure and, in extreme cases, hemodialysis to remove the drug from the blood.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or stop taking this medication without medical guidance, as stopping suddenly can cause your blood pressure to spike.
While many people tolerate Lisinopril well, some experience side effects as their body adjusts to the medication. The most common side effects include:
Lisinopril is a powerful cardiovascular medication that requires careful medical supervision. It is not suitable for everyone, and certain precautions must be taken to prevent serious adverse events. Patients must be aware that while Lisinopril effectively manages conditions like hypertension and heart failure, it is not a cure. Most patients will need to remain on antihypertensive therapy indefinitely to prevent complications like stroke or heart attack.
Lisinopril must NEVER be used in the following circumstances:
Lisinopril is categorized as Pregnancy Category D (with a Black Box Warning). It is strictly contraindicated in the second and third trimesters. If a patient becomes pregnant while taking Lisinopril, the medication must be stopped immediately. Use during the first trimester is also generally discouraged as some studies suggest a potential risk of congenital malformations, particularly of the cardiovascular and central nervous systems. Women of childbearing age should use effective contraception while on this medication.
It is not known whether Lisinopril is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from ACE inhibitors, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. Alternative antihypertensive medications with better safety data during breastfeeding (such as Methyldopa or Nifedipine) are often preferred.
Lisinopril is safe and effective for treating hypertension in children aged 6 to 16 years. However, it has not been studied in children with heart failure or in those who have recently had a heart attack. It should not be used in neonates or children with very low kidney function (GFR < 30 mL/min). Long-term effects on growth and development have not been extensively studied, but no specific concerns have emerged in clinical practice.
Lisinopril is a non-sulfhydryl Angiotensin-Converting Enzyme (ACE) inhibitor. Its primary molecular target is the ACE enzyme, a dicarboxypeptidase that catalyzes the conversion of the inactive decapeptide angiotensin I to the potent octapeptide vasoconstrictor, angiotensin II. By binding to and inhibiting ACE, Lisinopril reduces the concentration of angiotensin II in the plasma and tissues.
This inhibition leads to:
Common questions about Lisinopril
Lisinopril is primarily used to treat high blood pressure (hypertension) in both adults and children over the age of six. By lowering blood pressure, it helps prevent serious cardiovascular events such as strokes and heart attacks. Additionally, it is a key medication for managing heart failure, where it helps the heart pump blood more effectively. It is also prescribed immediately following a heart attack to improve survival rates and prevent further heart damage. Some doctors may also use it off-label to protect the kidneys in patients with diabetes.
The most frequently reported side effect of Lisinopril is a persistent, dry, hacking cough that does not produce mucus. This occurs because the drug causes a buildup of a substance called bradykinin in the lungs. Other common side effects include dizziness or lightheadedness, which often happens when you stand up too quickly. Some patients also report headaches, fatigue, or a mild upset stomach when they first start the medication. Most of these side effects are mild, but the cough may require switching to a different type of medication if it becomes bothersome.
It is generally recommended to limit or avoid alcohol while taking Lisinopril. Alcohol can have an additive effect with the medication, causing your blood pressure to drop lower than intended. This can lead to significant dizziness, lightheadedness, and even fainting, especially when you are first starting the drug or increasing your dose. Alcohol can also contribute to dehydration, which further increases the risk of kidney strain while on an ACE inhibitor. If you choose to drink, do so in moderation and only after discussing it with your healthcare provider.
No, Lisinopril is not safe during pregnancy and carries a Black Box Warning from the FDA. Taking this medication during the second and third trimesters can cause severe injury or death to the developing fetus, including kidney failure and skull deformities. While the risk in the first trimester is less clearly defined, it is still generally avoided. If you are planning to become pregnant or discover that you are pregnant while taking Lisinopril, you must contact your doctor immediately to switch to a safer alternative. Women of childbearing age should use reliable birth control while on this medication.
Lisinopril begins to lower blood pressure within about one hour of taking the first dose, with the strongest effect occurring about 6 to 7 hours later. However, it may take several weeks of consistent daily use to see the full benefits of the medication on your blood pressure readings. For patients with heart failure, it may take even longer—sometimes weeks or months—to notice a significant improvement in symptoms like shortness of breath or exercise tolerance. It is important to keep taking the medication even if you do not feel an immediate difference, as hypertension often has no symptoms.
You should never stop taking Lisinopril suddenly without first consulting your healthcare provider. While stopping Lisinopril does not usually cause a dangerous 'rebound' spike in blood pressure like some other medications, your blood pressure will likely return to its previous high levels. This increases your long-term risk of heart attack, stroke, and kidney damage. If you need to stop the medication due to side effects, your doctor will usually help you taper off the dose or transition you directly to a different class of blood pressure medication to ensure your heart remains protected.
If you miss a dose of Lisinopril, you should take it as soon as you remember. However, if it is nearly time for your next scheduled dose, you should skip the missed dose and simply take the next one at your regular time. Never take two doses at once to make up for a missed one, as this can cause your blood pressure to drop dangerously low. To help you remember your medication, try taking it at the same time every day, such as right after you brush your teeth in the morning. Consistency is key to managing blood pressure effectively.
Lisinopril does not typically cause weight gain as a direct side effect. In fact, for patients with heart failure, it may actually help reduce weight that is caused by fluid retention. However, if you notice rapid weight gain (such as 3 to 5 pounds in a single week) along with swelling in your ankles or feet, this could be a sign that your heart failure is worsening or that your kidneys are not functioning correctly. You should report any sudden changes in weight or significant swelling to your doctor immediately, as this requires a medical evaluation rather than a change in diet.
Lisinopril can be taken with many other medications, but there are several important exceptions. You should be especially careful with potassium supplements, salt substitutes, and other medications that can raise potassium levels, such as spironolactone. Taking these with Lisinopril can lead to dangerously high potassium in the blood. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can also reduce the effectiveness of Lisinopril and potentially harm your kidneys. Always provide your doctor and pharmacist with a full list of all prescription drugs, over-the-counter medicines, and herbal supplements you are taking.
Yes, Lisinopril is widely available as a generic medication and is typically very affordable. The generic version is bioequivalent to the original brand-name drugs, Prinivil and Zestril, meaning it has the same active ingredient, strength, and effectiveness. Because it is a generic, it is covered by almost all insurance plans and is often included in low-cost generic programs at major pharmacies. Whether you take the brand-name or the generic version, the clinical effects and potential side effects remain the same, so you can feel confident in the generic's quality.
Other drugs with the same active ingredient (Lisinopril)
> Warning: Stop taking Lisinopril and call your doctor or emergency services immediately if you experience any of the following:
Prolonged use of Lisinopril is generally considered safe and is often necessary for the management of chronic conditions. However, long-term monitoring is required for:
Fetal Toxicity: Lisinopril carries a strict FDA Black Box Warning regarding its use during pregnancy. When pregnancy is detected, Lisinopril should be discontinued as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus, particularly during the second and third trimesters. Risks include skull hypoplasia (underdeveloped skull), anuria (lack of urine), renal failure, and limb contractures in the newborn.
Report any unusual symptoms or side effects to your healthcare provider promptly to ensure your treatment remains safe and effective.
To ensure safety, your healthcare provider will require periodic laboratory tests, including:
Lisinopril can cause dizziness, especially during the first few days of treatment or when the dose is increased. Do not drive, operate heavy machinery, or engage in dangerous activities until you know how this medication affects you.
Alcohol can enhance the blood-pressure-lowering effect of Lisinopril, which may lead to severe dizziness, lightheadedness, or fainting. It is generally advised to limit alcohol consumption while taking this medication.
Do not stop taking Lisinopril abruptly. While it does not typically cause a 'rebound' effect like some other blood pressure medications (e.g., beta-blockers), your blood pressure will likely return to hypertensive levels, increasing your risk of cardiovascular events. Always consult your doctor before tapering or stopping the medication.
> Important: Discuss all your medical conditions, especially kidney disease, diabetes, and allergies, with your healthcare provider before starting Lisinopril.
Lisinopril does not typically interfere with common laboratory tests, but it will affect the results of the Renin-Angiotensin System assessment. It may also cause a false-positive result in some urine ketone tests.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. A complete medication review is the best way to prevent dangerous drug interactions.
Conditions requiring careful risk-benefit analysis and intensive monitoring include:
There is a high degree of cross-sensitivity among ACE inhibitors. If a patient has had a serious allergic reaction to another drug ending in '-pril', they should generally not be prescribed Lisinopril. However, there is no cross-sensitivity between ACE inhibitors and other classes of blood pressure medications like Calcium Channel Blockers or Beta-Blockers.
> Important: Your healthcare provider will evaluate your complete medical history, including any previous allergic reactions, before prescribing Lisinopril.
Clinical studies have not identified overall differences in safety or effectiveness between elderly (65 years and older) and younger patients. However, elderly patients are more likely to have decreased renal function and may be taking multiple other medications (polypharmacy). This increases the risk of drug interactions and side effects like dizziness and falls. Dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range.
As Lisinopril is cleared by the kidneys, its half-life increases significantly in patients with renal failure. For patients with a CrCl between 10 and 30 mL/min, the starting dose should be reduced to 5 mg. For those with a CrCl < 10 mL/min or those on dialysis, the starting dose is 2.5 mg. These patients require frequent monitoring of serum creatinine and potassium levels.
Unlike most other ACE inhibitors, Lisinopril is not a prodrug and does not require activation by the liver. Therefore, its pharmacokinetics are not significantly altered in patients with stable hepatic cirrhosis. However, these patients should still be monitored for general safety and potential fluid balance changes.
> Important: Special populations require individualized medical assessment and more frequent monitoring to ensure the safe use of Lisinopril.
| Parameter | Value |
|---|---|
| Bioavailability | ~25% (range 6-60%) |
| Protein Binding | 0% (only binds to ACE) |
| Half-life | ~12 hours (accumulation half-life) |
| Tmax | ~7 hours |
| Metabolism | None (Excreted unchanged) |
| Excretion | Renal 100% |
Lisinopril is classified as an Angiotensin-Converting Enzyme Inhibitor [EPC]. It belongs to the same therapeutic family as Enalapril, Ramipril, and Captopril. Within the broader category of antihypertensives, it is considered a first-line agent for the treatment of hypertension and heart failure, particularly in patients with diabetes or chronic kidney disease.