What is lisinopril (Prinivil, Zestril) used for?

Lisinopril is a prescription medicine that is used to treat hypertension (high blood pressure). It may also be used to treat congestive heart failure. Lisinopril is also given to reduce the risk of death after a heart attack.

How does lisinopril (Prinivil, Zestril) work?

Lisinopril is a long-acting ACE inhibitor. Inhibition of the angiotensin-converting enzyme (ACE) blocks the production of angiotensin, a potent vasoconstrictor. This allows the blood vessels to relax, thereby lowering blood pressure. For people with congestive heart failure, the amount of work that the heart has to do is reduced because lisinopril causes dilation of blood vessels.  

What is the dosage of lisinopril (Prinivil, Zestril)?

Lisinopril is available in oral tablet and liquid form. 

Common lisinopril doses include:

Oral tablet strength:  2.5 mg | 5 mg | 10 mg | 20 mg | 30 mg |  40 mg
Oral liquid strength: 1 mg/mL (milligram per 1 milliliter)

Adult dosing: 

Lisinopril is FDA-approved for three indications and the dosing varies based on the indication:

1. Hypertension (high blood pressure) in adults

   • Initial dose: 10 mg orally once a day; 5 mg orally once a day if the patient is already on a diuretic (water pill).

   • Maintenance / standard dose: 20 to 40 mg orally once a day

   • Maximum dose: 80 mg orally once a day - this dose has not been proven to provide additional benefits

2. Myocardial infarction (heart attack)

   • Initial dose: 5 mg orally within 24 hours of a heart attack, then 5 mg orally the next day

   • Maintenance dose: 10 mg orally once daily for at least 6 weeks

3. Congestive heart failure:

   • Initial dose: 2.5 to 5 mg orally once daily in combination with a diuretic (water pill) and digoxin.

   • Maintenance dose: initial dose should be increased gradually as tolerated to the maximum dose of 20 to 40 mg orally once daily.

Off-label dosage (not FDA-approved):

1. Diabetic nephropathy:

   • Initial dose: 10 mg orally once daily

   • Maintenance dose: 20 to 40 mg orally once daily 

Pediatric dosing (6 years or older):

1. For hypertension, lisinopril is dosed by weight, 0.07 mg/kg (up to 5 mg total) orally once daily, typically starting at a low dose. Maximum dose is 0.61 mg/kg per day or 40 mg/day.