💊 Lisinopril (Lisinopril)
Lisinopril is an oral ACE inhibitor used to treat high blood pressure, as adjunct therapy in heart failure, and in acute myocardial infarction. It must not be used during pregnancy. The dose is always set by your doctor or pharmacist.
In Arabic: ليسينوبريل
🏷️ Brand names & manufacturers
Packages shown are US-market (DailyMed). Brands available in Palestine are in the price section below.
Lisinopril🏭 Aurobindo Pharma Limited
Lisinopril🏭 Exelan Pharmaceuticals Inc.
Lisinopril🏭 NCS HealthCare of KY, LLC dba Vangard Labs✅ What it is used for
- Treatment of hypertension in adults and children 6 years of age and older
- Adjunct therapy for heart failure
- Treatment of acute myocardial infarction
🧪 Active ingredient
The active ingredient is lisinopril, a long-acting ACE inhibitor. It reduces angiotensin II (a vasoconstrictor) and aldosterone secretion, which lowers blood pressure.
🌿 Benefits
- Lowers blood pressure, reducing the risk of stroke and heart attack
- Helps in the management of heart failure
- Reduces mortality after acute myocardial infarction
📝 How to use
- Taken by mouth.
- The dose is set by your doctor or pharmacist based on your condition, blood pressure response and kidney function; do not change it yourself.
- If blood pressure is not controlled with lisinopril alone, your doctor may add a diuretic and may then adjust the lisinopril dose.
- After a heart attack, treatment continues for at least six weeks as directed by your doctor.
💊 Dosage forms
- Tablets: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, 40 mg
⚠️ Common side effects
- Headache
- Dizziness
- Cough
- Low blood pressure
- Chest pain
- Fatigue and weakness
- Constipation or diarrhea
- Dry mouth
🚨 Serious — seek medical help
- Angioedema: swelling of the face, lips, tongue, throat or limbs and difficulty breathing; stop the drug and seek emergency care immediately
- Jaundice (yellow skin/eyes) or signs of liver failure
- High blood potassium (hyperkalemia)
- Worsening kidney function
- Severe skin reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis
- Rare blood disorders such as leukopenia/neutropenia and thrombocytopenia
⛔ Do not use if
- History of angioedema, or hereditary or idiopathic angioedema
- Hypersensitivity to lisinopril or other ACE inhibitors
- Co-administration with aliskiren in patients with diabetes
- Combination with a neprilysin inhibitor (e.g., sacubitril); do not give within 36 hours of switching to or from sacubitril/valsartan
❗ Warnings & precautions
- Boxed warning: fetal toxicity; discontinue as soon as pregnancy is detected
- Angioedema can occur at any time during treatment; risk is higher in Black patients and with mTOR inhibitors
- Monitor renal function periodically
- Hypotension risk is higher in patients with other heart or renal diseases; monitor blood pressure after initiation
- Monitor serum potassium periodically
- Monitor for jaundice or signs of liver failure
- Antihypertensive effect is smaller in Black patients than in non-Black patients
🔄 Drug interactions
- Diuretics: may cause excessive blood pressure drop; potassium-sparing diuretics (spironolactone, amiloride, triamterene) increase the risk of hyperkalemia
- Antidiabetics (insulin, oral agents): may increase glucose-lowering effect with risk of hypoglycemia
- NSAIDs including COX-2 inhibitors: may worsen renal function and reduce antihypertensive effect
- Dual blockade of the renin-angiotensin system: increased risk of renal impairment, hypotension and hyperkalemia
- Lithium: symptoms of lithium toxicity
- Gold: nitritoid reactions have been reported
- mTOR inhibitors (temsirolimus, sirolimus, everolimus) and neprilysin inhibitors: increased risk of angioedema
🤰 Pregnancy
Lisinopril can cause fetal harm, particularly in the second and third trimesters (reduced fetal renal function, oligohydramnios, fetal lung hypoplasia, skeletal deformations, and death). When pregnancy is detected, it should be discontinued as soon as possible after consulting your doctor.
🍼 Breastfeeding
The label advises not to breastfeed while using this medicine.
🧒 Children
Antihypertensive effects and safety are established in children aged 6 to 16 years. Safety and effectiveness are not established in children under 6 years or with glomerular filtration rate < 30 mL/min/1.73 m². The doctor determines the dose based on the child's weight.
👴 Older adults
No dosage adjustment is necessary in elderly patients, but greater sensitivity in some older individuals cannot be ruled out; renal dysfunction led to discontinuation more often in patients aged 75 and older.
🌡️ Storage
Store at controlled room temperature (20° to 25°C / 68° to 77°F). Protect from moisture, freezing and excessive heat. Dispense in a tight container.
⏰ Missed dose
The label does not give instructions on missed doses; ask your doctor or pharmacist and do not double the dose on your own.
🆘 Overdose
The most likely manifestation of overdose is hypotension, usually treated with intravenous normal saline. Lisinopril can be removed by hemodialysis. Seek emergency medical help immediately.
💰 Price & brands in your area
Local prices are currently available for Palestine; more countries are coming. Ask your pharmacist for local price and alternatives.
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Mechanism of action
Lisinopril inhibits ACE, which converts angiotensin I to the vasoconstrictor angiotensin II, leading to decreased angiotensin II, decreased aldosterone secretion and possibly a small rise in serum potassium. ACE is identical to kininase, which degrades bradykinin. It is antihypertensive even in low-renin hypertension.
Labeled dosing
Hypertension (adults): initial 10 mg once daily; usual range 20-40 mg once daily, titrated to blood pressure response; 5 mg if on diuretics. Heart failure: start 5 mg once daily (2.5 mg if serum sodium < 130 mEq/L), up to a maximum of 40 mg once daily. Acute MI: 5 mg within 24 hours, 5 mg after 24 hours, 10 mg after 48 hours, then 10 mg once daily for at least six weeks. Renal impairment: halve the initial dose if CrCl 10-30 mL/min; 2.5 mg if CrCl < 10 mL/min or on hemodialysis. Dosing is determined by the doctor/pharmacist.
- Pediatric patients ≥6 years: start 0.07 mg/kg (up to 5 mg) once daily, maximum 0.61 mg/kg (up to 40 mg)
- Initiate 2.5 mg in post-MI patients with low systolic BP (≤120 and >100 mmHg) during the first 3 days
- Not recommended in children < 6 years
- Doses up to 80 mg have been used without apparent additional effect
- Removable by hemodialysis
🎓 Key points for students
- ACE inhibition lowers angiotensin II and aldosterone and increases plasma renin activity
- Same enzyme as kininase (bradykinin degradation), which relates to cough and angioedema
- Common adverse effects: headache, dizziness, cough; hypotension in heart failure and MI
- Pregnancy is a contraindicated setting (boxed warning) due to fetal toxicity
- Contraindicated with aliskiren in diabetes and with sacubitril
- Monitor creatinine, potassium and blood pressure
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What is lisinopril used for?
It is used to treat high blood pressure, as adjunct therapy in heart failure, and in acute myocardial infarction.
Can lisinopril be used during pregnancy?
No. It can harm the fetus and should be stopped as soon as pregnancy is detected, after consulting your doctor.
What are the most common side effects?
Headache, dizziness and cough; low blood pressure may also occur.
When should I seek emergency help?
If you have swelling of the face, lips, tongue or throat, or difficulty breathing, as this may be angioedema.
Can I take NSAID painkillers with lisinopril?
NSAIDs may worsen kidney function and reduce lisinopril's blood-pressure-lowering effect, so ask your doctor or pharmacist first.
⚕️ For education only — not a substitute for advice from your doctor or pharmacist. Do not start or stop any medicine without advice. Source: official FDA drug label via openFDA (2023-08), simplified. Updated: 2026-11-10.