a sphygmomanometer (blood pressure monitor)

How do you keep your blood pressure under control? Managing blood pressure is an important pillar for maintaining good health and reducing the risk of strokes or heart disease. Regular exercise, a diet high in healthful vegetables and fruits and ways to relax and manage stress can help. But sometimes people need blood pressure medication to get hypertension into bounds. Lisinopril is a popular prescription pill for blood pressure, but what about lisinopril side effects?

ACE Inhibitors for Blood Pressure Control:

Blood pressure pills are perceived as generally safe medications. ACE (angiotensin converting enzyme) inhibitors in particular are considered highly effective with few adverse reactions. We calculate that at least 100 million prescriptions are filled for ACE inhibitors each year. Here is a list of commonly prescribed ACEi drugs:

  • Benazepril (Lotensin)

  • Captopril (Capoten)

  • Enalapril (Vasotec)

  • Fosinopril (Monopril)
Lisinopril (Prinivil, Zestril)

  • Moexipril (Univasc)

  • Perindopril (Aceon)

  • Quinapril (Accupril)

  • Ramipril (Altace)

  • Trandolapril (Mavik)

We have frequently written about an ACEi cough, which drives many patients crazy because it can keep them awake at night, cause incontinence and make them miserable. However, another reaction worries us even more. It is called angioedema and it can be life threatening. A Turkish patient died from angioedema triggered by lisinopril despite emergency treatment (Iranian Journal of Allergy, Asthma, and Immunology, Dec., 2015).

We received the following message from a visitor to this website.

“One night after taking lisinopril my lips began to swell as if I had a fever blister. Within two hours my face was extremely swollen and my throat began to feel like it was closing off my air passage. I went to the hospital and spent the night in the emergency room with an IV and other meds.

“The doctors identified that I had a reaction from the lisinopril. I still had some swelling a full 24 hours after the incident. I was told that I was lucky and that they were close to doing a tracheotomy.

“I had taken lisinopril for four years before the reaction. I would strongly advise alternative medications other than lisinopril, and recommend anyone who has been taking this for any length of time have a discussion with their physician.

“The final advice I have is that if you have a reaction seek medical attention immediately.” Gary

Angioedema and Other Lisinopril Side Effects:

Angioedema is a somewhat mysterious reaction to ACE inhibitor blood pressure pills. It can happen within the first few days or weeks of starting treatment, or, as in Gary’s case, show up after years of taking the medication. There is no way to predict what will trigger such a hazardous reaction. When it happens, however, it requires emergency medical attention. If your airways close, breathing becomes impossible. That is why they were considering an emergency tracheotomy in Gary’s case.

Angioedema doesn’t always affect the face, tongue and neck, though. We have heard from other visitors that ACE inhibitors can affect the belly. Here is one poignant story:

“I was put on lisinopril for high blood pressure in January. That month I experienced severe stomach cramping and vomiting. I was rolling on the floor in agony. The doctor said it was most likely the flu but started me on two different antibiotics in case it was bacterial.

“A few weeks later I had another attack with severe stomach cramping and vomiting. I went to the ER, where I was given IV pain meds. A CT scan showed small intestine inflammation partially blocking off my bowel. I was sent home but returned the next day with pain that was a 10 on a 10-point scale. The doctor said that all the tests had been done and there was nothing he could do. I was sent home with pain medication.

“A few weeks later I was admitted to the hospital with increased small intestine inflammation and another blockage. I vomited and dry-heaved for 12 hours. I was released four days later with no definitive diagnosis.

“I was told most likely I had Crohn’s disease, but a colonoscopy was negative for Crohn’s. I underwent extensive tests, including endoscopy, and all were negative. None of the doctors made a connection with the drug lisinopril.

“After two months of missing work, three more ER visits and untold suffering, I found several other people who reported similar symptoms connected to lisinopril. I stopped the medication and have not had another attack. If you look on PubMed you can see reports on lisinopril and intestinal angioedema, but doctors don’t think to connect this with lisinopril because it is not listed as a common side effect.” 

Taking ACE Inhibitors for Hypertension:

ACE inhibitors can be very effective medications for many people. As long as you don’t experience an unrelenting cough, breathing difficulties or severe abdominal discomfort, you may be home free. No medicine should ever be stopped without medical supervision.

Here are some other side effects to aware of.

 Lisinopril Side Effects:

  • Dry cough, uncontrollable cough, nausea, vomiting
  • Dizziness, excessively low blood pressure
  • Kidney function changes, BUN & creatinene elevations
  • Headache
  • Digestive distress, diarrhea, abdominal pain
  • Tiredness, fatigue, malaise
  • Excessive potassium levels (requires immediate medical attention!), irregular heart rhythms, chest pain
  • Elevated uric acid levels
  • Sensitivity to sunlight (photosensitivity), skin rash
  • Angioedema (swelling of face, lips, tongue, throat)
  • Angioedema (swelling in abdomen, severe abdominal pain)
  • Severe allergic reaction (anaphylaxis) requiring emergency treatment
  • Toxicity to liver or pancreas
  • Blood disorders
  • Potential birth defects if taken during early pregnancy
  • Sexual difficulties

In one case report, lisinopril caused hair loss (Journal of Pharmacy Practice, online June 6, 2016). Anyone who would like to learn more about non-drug approaches to controlling hypertension may find our Guide to Blood Pressure Treatment of interest. There is also information about other medications for dealing with blood pressure problems.

Share your own experiences below. Those who would like to learn more about ACE inhibitor cough will find this link of great interest.

Revised 9/28/16

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  1. Pam

    I am an African American 62 yr old female. I was taking 10mg of lisinopril for 2wks and did experience lower bp, however I had the persistent cough, stomach pain, dizziness and depression. Saw doctor yesterday and was taken off. Now going to try Losartan.

  2. Genevieve

    I’ve only been on Lisinopril 10 mg once a day, for only a week. The carvedilol 3.5 was not doing it’s job, and the BP was way up. First day taking the Lisinopril I had gut pain like I was in labor 10/10, and comparable to my pain I had with C. Difficile infection a year ago. I think it’s doing it’s job as my BP has come down, but heart rate is up a bit, but I feel like a bucket of crap.

    Heavy chest pain if feels like, sharp pains come and go. Yet the numbers are ok. I was told to take it easy, and I am, but it’s hard to even stand at times with the gut pain, headache, dizzy, and chest pain. Definitely going to check and see if there is an alternative after all I have read. I’m a white 50 yo female with long history of hypertension induced by stress.

  3. Cindy
    New York

    Just to balance out some of the comments: (Almost everyone responding has had problems – not that this is unusual, as people naturally have a tendency to identify complaints & worries, but mostly don’t bother to report when things are ok or not worrisome.)

    I have taken 20 mg Lisinopril for probably 10 to 15 years with none of the side effects described. When I get a cold with a cough, my cough lasts for weeks or months, but I can’t blame it on Lisinopril which I took before, during & after the cold, and the cough comes and goes, but it takes a while. I also take Bisoprolol HCTZ, but alone that wasn’t enough to get my blood pressure down. So I’ve been fine with this.

    However, my husband was put on Lisinopril 5mg to combat his “fatty liver”. He used to have asthma, but now just gets bronchitis about once a year. However, he coughs constantly – sometimes productive, sometimes not. He seems to be inclined to ignore it; I think it shouldn’t be as constant as it is and will wear him down. (and his resistance to whatever germs may be about. He has Parkinson’s Disease and is a type 2 diabetic). It seems like he’s always coughing, more or less, and I can’t remember if it changes when he’s been on or off Lisinopril.

    I think we should address this with his doctor, but could anyone suggest an alternative to combat fatty liver. His blood pressure is admirably perfect. Thanks.

  4. Beth
    San Diego

    I have been on Lisinopril for probably 7 years, maybe a little longer. I am on 5Mg daily. I haven’t had any problems and that dose doesn’t really take my pressure down a lot, but my doctor doesn’t want to give me more and I don’t want more. Sometimes my pressure is 150 or 160, but usually 130.

    I do have moments when I am a bit dizzy if I turn quickly. And sometimes I feel like I am loosing balance briefly and I have wondered if that was causing it. I am 79 now. So I need to be very careful not to fall.

    I will discuss this article and comments w/my doctor. Since it seems to be agreeing, I hate changing drugs, but would sure not want to have a sudden problem. I live alone.

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