Lisinopril

Medically Reviewed by HaVy Ngo, Pharm.D.

Last Reviewed: Apr 06, 2022

Warnings


What are the risks of taking lisinopril (Prinivil, Zestril)?


Do not take lisinopril or any ACE inhibitor if you are pregnant or actively trying to conceive.

Lisinopril (Zestril, Prinivil) can cause harm to the unborn child especially if taken during the second and third trimester. Inform your doctor immediately and stop taking the medicine right away if you become pregnant


Other risks of lisinopril use include:
  • Worsening kidney function: Your doctor will do lab tests to check kidney function before starting lisinopril.

  • High potassium (hyperkalemia): Lisinopril can increase potassium levels in the body, which can cause irregular heartbeats that can be fatal.

  • Liver failure: Rarely, lisinopril can cause blockage of the bile duct leading to liver injury and even liver failure.


Speak to your doctor or pharmacist about other treatment options if you are at high risk for the above complications.


What should I tell my doctor before starting lisinopril (Prinivil, Zestril)?

Your health care professional should know if you have any of these conditions:

  • diabetes
  • heart or blood vessel disease
  • kidney disease
  • low blood pressure
  • previous episodes of angioedema (tongue/face/lips swelling with difficulty breathing, difficulty swallowing, hoarseness, or tightening of the throat)
  • a previous allergic reaction or unusual reaction to lisinopril or other ACE inhibitors as well as allergies to foods, preservatives, dyes, or insect venom
  • pregnant, breastfeeding, or planning a pregnancy
  • being allergic to other ACE inhibitors, such as benazepril, captopril, enalapril, fosinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril
  • having taken medication that contains sacubitril within 36 hours

What precautions should I take while on lisinopril (Prinivil, Zestril)?

  • Check your blood pressure as instructed. Ask your doctor about your goal blood pressure and when to contact them regarding an out-of-range blood pressure reading.
  • Visit your doctor or health care professional for regular checkups. 
  • Do not self-treat with over-the-counter (OTC) medicines for pain, coughs, and colds while using lisinopril. Some ingredients in these medicines can increase blood pressure. Get medical advice from your doctor or pharmacist before using any OTC remedies.
  • Pregnant women and those who are actively trying to conceive should inform the prescribing physician.
  • Inform your doctor if you get severe diarrhea, nausea, and vomiting. Dehydration can increase the risk of kidney injury while taking lisinopril
  • Avoid salt substitutes unless advised otherwise by your doctor or health care professional.
  • Lisinopril can cause drowsiness or dizziness. Do not drive, operate heavy machinery, or do anything that requires you to be mentally alert until you know how lisinopril affects you.
  • Reduce or limit alcohol intake while taking lisinopril

What drugs can interact with lisinopril (Prinivil, Zestril)?

The list below may not describe all possible drug interactions with lisinopril. Be sure to give your health care provider a complete list of all your medications, including prescription drugs, and over-the-counter products. Also tell them if you smoke, consume alcohol, or use recreational drugs, as they may interact with lisinopril. 

Do not take lisinopril with the following medicines:

  • Medication that contains aliskiren, such as Amturnide, Tekturna, Tekamlo
  • Medication that contains sacubitril, such as Entresto—the wash-out period is 36 hours, meaning do not take lisinopril 36 hours before or after taking sacubitril-containing medicine
  • Angiotensin receptor blockers (ARBs such as losartan, valsartan)—ACE inhibitors that are taken in combination with ARB increase the risk of kidney failure, low blood pressure, and high levels of serum potassium

There can also be interactions between lisinopril and the following medicines:


  • certain diabetes medicines
  • potassium supplements
  • organ transplant rejection medication such as tacrolimus, sirolimus, everolimus, and temsirolimus


  • NSAIDs (non-steroidal anti-inflammatory drugs like naproxen,ibuprofen, naproxen, celecoxib, and diclofenac) 
  • diuretics (water pills)
  • gold compounds
  • lithium