Lisinopril

Lisinopril is a blood pressure lowering medication, also called an antihypertensive. Lisinopril is part of a group of medications called ACE inhibitors. ACE stands for angiotensin converting enzyme, an enzyme that controls your blood pressure.

ACE inhibitors are commonly used to treat high blood pressure. They are the first type of blood pressure tablets your doctor may start you on if you have been diagnosed with high blood pressure.

You often will not have any symptoms of high blood pressure, which is also called hypertension. If you leave it untreated it can lead to serious health problems, like stroke or heart attacks.

Your doctor or nurse may notice high blood pressure at a routine health check. You will not be started on treatment immediately, but your doctor may want to monitor your blood pressure over the next few weeks.

The ideal blood pressure is around 120/80mmHg, but you may have a slightly different reading as everyone is different. If you have other health conditions, like diabetes, this can also change the ideal blood pressure for you.

Lisinopril is normally taken once daily. You can take lisinopril with or without food and with a glass of water. It’s better to take lisinopril in the morning as your blood pressure is naturally higher then.

You’ll usually be started on a low dose of lisinopril such as 2.5mg or 5mg daily. Your doctor will adjust the dose of lisinopril depending on how your blood pressure responds. Always follow your doctor’s advice on the most suitable dose of lisinopril for you.

Lisinopril is an ACE inhibitor. Angiotensin converting enzyme (ACE) works to make angiotensin II. Angiotensin II is a molecule that causes your blood vessels to constrict. This increases your blood pressure.

Sometimes, your body needs to raise its blood pressure, but if it does not get lower naturally then it will remain high. This is where you may need treatment.

Lisinopril works by stopping the ACE enzyme from making angiotensin II. This stops your blood pressure from getting higher and is maintained at a healthy range.

Your blood vessels are flexible as they are constantly being constricted and dilated. As you get older, your blood vessels get less flexible. This means you’re more prone to high blood pressure when you get older than 65. If you have a family history of high blood pressure or heart disease, you may be at a higher risk of getting it too.

Lisinopril is effective in managing blood pressure. You may see some improvement in your blood pressure within a week, but it can take 3 to 4 weeks for your body to adjust completely. If you’ve recently started to take lisinopril, your doctor will routinely check your blood pressure. This is to make sure you are responding to the medication.

If your blood pressure is still too high or you’re experiencing side effects, they can adjust the dose for you.

You may get some possible side effects when you first start taking lisinopril. Many of these side effects will go away once you get used to taking the tablets.

The common side effects of lisinopril are:

• a dry cough
• being sick
• headaches
• feeling lightheaded
• diarrhoea

If these side effects are persistent, speak to your doctor. You may need a lower dose or a different high blood pressure medication.

The uncommon side effects of lisinopril are:

• feeling sick
• difficulty sleeping
• erectile dysfunction for men
• feeling tired or sleepy
• indigestion

If you have an allergic reaction after taking lisinopril, contact 999 immediately. Symptoms of an allergic reaction include:

• swelling of the face (angioedema)
• difficulty breathing or shortness of breath

For more information on side effects, read the patient information leaflet that comes in your pack.

You can take lisinopril if you need treatment for high blood pressure.

Certain people must not take lisinopril otherwise they might feel unwell. This includes if you are:

• allergic to lisinopril or any of its ingredients
• allergic to ACE inhibitors or anyone in your family is allergic
• pregnant or think you might be pregnant
• breastfeeding

Speak to your doctor if you:

• have any narrowing of your arteries (also called stenosis)
• have thickening of your heart muscle
• are often dizzy, light-headed or have a tendency to faint
• have kidney problems including having dialysis
• have liver problems
• take medicines used after organ transplant like tacrolimus or sirolimus

If you are from an Afro-Caribbean background, you may be started on a different type of blood pressure tablet. Calcium channel blockers, like amlodipine, are better to manage your blood pressure in this case.

Your doctor will check your blood pressure and kidney function when starting treatment and a few weeks later. Once you are stable on lisinopril, you’ll need yearly blood pressure checks and blood tests.

Lisinopril can interact with other medications or over the counter products you are taking. Tell your doctor or pharmacist if you are taking any other medications as they’ll let you know if lisinopril is suitable for you.

Lisinopril may interact with:

• lithium tablets used to treat bipolar disorder
• certain painkillers called non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
• vildagliptin used to treat diabetes
• decongestants including those sold over the counter
• medicines that increase the potassium in your blood like spironolactone or heparin
• allopurinol used to treat gout

You should not take lisinopril if you are taking:

• aliskiren to lower your blood pressure
• sacubitril/valsartan to treat heart failure (also called Entresto)

Some medicines will have the side effect of lowering your blood pressure. If you take these with lisinopril, your blood pressure can get too low and make you feel dizzy. These include:

• diuretics (water tablets) like furosemide
• nitrate medications like isosorbide mononitrate
• certain antidepressants called tricyclic antidepressants, such as amitriptyline
• other blood pressure lowering medication

This does not mean you cannot take lisinopril, but your doctor should be aware when adjusting your blood pressure treatment.

There are many different medications available to treat blood pressure.

There are a few other medications like lisinopril, including ramipril, perindopril and enalapril.

If you get a persistent dry cough when taking lisinopril, your doctor may prescribe an alternative medication. ARBs (angiotensin receptor blockers) work in a similar way to ACE inhibitors and are often used to manage blood pressure. These include candesartan and losartan.

Other blood pressure treatments include diuretics, like indapamide, and beta blockers, like atenolol.

Keeping a healthy and balanced diet and getting regular exercise is a good way of managing your blood pressure. If you are overweight, you may benefit from a weight loss plan to bring your blood pressure down.

Certain foods that are high in salt can increase your blood pressure. Drinking too much caffeine or alcohol can also have this effect.

Remember to take into account lifestyle factors that may be affecting your blood pressure, like stress.