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Lisinopril, also known as Privinil or Zestril, is a member of the class of drugs called angiotensin-converting enzyme (ACE) inhibitors. It comes in various dosage forms, such as 10 mg, 20 mg, 30 mg, 40 mg, 5 mg, and 2.5 mg oral tablets. Also available is the 1 mg/ml oral solution.

Your doctor may use Lisinopril alone or as a combo with other anti-hypertensive in people at least 6 years old. It is also employed in the treatment of congestive heart failure and helps to increase the chances of survival in people who have a heart attack.

How Does Lisinopril Work?

Angiotensin-converting enzymes (ACE) play dual roles. They convert inactive angiotensin I to active angiotensin II and cause degradation of bradykinin. ACEs narrow the blood vessels, causing high blood pressure and forcing the heart to work more than it should. Lisinopril, being an ACE inhibitor, prevents this from occurring by ensuring that the blood vessels maintain their width. Ultimately, blood flows without constrictions, and the pressure returns to normal. 

How to Use Lisinopril

You should utilize this drug precisely as your physician directs. However, it works well whether you have eaten or not. You should swallow the tablets whole with a glass of water, except you must break it to get a particular dose.

If using the liquid form, shake it vigorously before consuming it. Ensure you use the measuring device provided to get the accurate dose. You may need to monitor your blood pressure at intervals and report findings to your doctor as you use Lisinopril.

Lisinopril Dosing Information

Lisinopril dosage is dependent on your condition and the doctor’s assessment. Those with diabetes or kidney impairment may need dosage adjustments.

  • Hypertension in adults: While the initial dose is 5 to 10 mg once daily, the maintenance dose is 20 to 40 mg once daily. The maximum daily dose is 80 mg.
  • Myocardial infarction in adults: The initial dose is 5 mg to be taken within twenty-four hours of acute infarction onset. This is followed by another 5 mg after twenty-four hours and 10 mg after forty-eight hours. The maintenance dose is 10 mg daily and can last for 42 days.
  • Congestive heart failure in adults: While the initial dose is 2.5 mg once per day, the maintenance dose should be gradually increased as tolerated by the patient but should not exceed 40 mg once daily.

Precautions

Before taking this drug, read and understand the information in the enclosed leaflet within the pack. Ensure to discuss any concerns you have with your healthcare provider. Also, you should adhere to the following precautions before and while consuming Lisinopril:

  • Inform your doctor if you are allergic to Lisinopril and other ACE inhibitors like benazepril or any other allergies you may have. 
  • Avoid consuming this drug within 1 day and 12 hours before or after consuming drugs that contain sacubitril, for example, Entresto. Also, do not ingest Lisinopril with drugs that contain Aliskiren if you are diabetic.
  • To be sure you can safely consume this medication, inform the health personnel if you have:

○ Kidney diseases (or on dialysis)

○ Low blood pressure

○ Angioedema (severe allergic reaction characterized by swellings in the eyes, lips, hands, or feet)

○ Diabetes 

○ Low WBC count

○ Heart diseases, including any recent heart attack

○ Low salt intake diet

○ Liver diseases

○ Pain in the abdomen

  • Inform your doctor if you are pregnant or planning to get pregnant while using Lisinopril. This drug is known to cause damage to unborn children during the 2nd or 3rd trimester of pregnancy. So if you become pregnant while using Lisinopril, discontinue therapy immediately. 
  • The use of Lisinopril by breastfeeding mothers should be based on a doctor's assessment of the risks/benefits involved. 

Side Effects of Lisinopril

The common side effects that may occur as your body tries to get along with the drug include:

  • Dizziness
  • Headache
  • Diarrhea
  • Fatigue
  • Lightheadedness
  • Dry cough
  • Low blood pressure
  • Chest pains

If these symptoms get worse, inform your doctor immediately. Other side effects that you may experience are:

  • Low blood potassium
  • Irregular heartbeats
  • Tingly sensation 
  • Low WBC count that fever, sore throats, mouth sores, and sores on the skin may accompany 
  • Kidney problems (e.g., making less urine, shortness of breath, swellings on the feet and ankles) 
  • Loss of appetite
  • Pain on the right side of the stomach 
  • Jaundice
  • Dark-colored urine
  • Clay-like stool 
  • Swelling of face, lips, tongue, or throat

Missed Dose and Overdose 

If you miss a dose, take it as soon as you remember. Do not double-dose to make up for a missed dose. Also, if you suspect an overdose or poisoning, call the poison control center in your area. 

Interactions

Lisinopril interacts with several drugs, such as:

  • NSAIDS (Meloxicam, Aspirin, Naproxen, Diclofenac, Indomethacin)
  • Insulin and other diabetes medications
  • Diuretics (Spironolactone or Amiloride)
  • Drugs used for suppressing rejection after organ transplant (Everolimus or Sirolimus)
  • Other heart/blood pressure medications

The disease conditions which Lisinopril interacts with are:

  • Bone Marrow suppression
  • Renal impairment
  • Angioedema
  • Hemodialysis
  • Low blood pressure
  • Congestive heart failure (CHF)
  • Liver diseases
  • Hyperkalemia (High Blood Potassium) 

Storage

Lisinopril should be stored at room temperature, away from moisture and heat. It should be kept out of the reach of children and pets.