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. Lisa

    While on vacation in Texas I woke one morning feeling quite full as if I had just finished a big meal. It was uncomfortable but not painful. As the day went on it worsened and was extremely painful. Finally my husband insisted we go to the ER. They took me in immediately and did a CT scan. They diagnosed the small intestinal blockage immediately and started pain meds and an NG tube to empty my stomach.

    I was admitted into the hospital and they told me it would resolve itself or they would need to do surgery. The next day’s x-ray showed that it was clear. I had been taking Lisinopril for at least 5 years with no noticeable side affects but during my stay (3 days) I was not allowed anything and eventually liquid. No Lisinopril. I was fine the next day. They told me I would need to follow up when I returned home. Luckily I live close to the Mayo Clinic in Rochester and at my appt. the Dr. reviewed scans from the hospital and did another CAT scan that day. During the appt. he diagnosed Lisinopril based on the type of symptoms I had. Not taking them in the hospital is what resolved the problem. I’ll be looking for an alternative blood pressure pill going forward!

  2. Peg
    Atlanta, GA

    My already fine thin hair began thinning more when I started taking Lisinopril. I also passed out recently at a conference with no prior dizziness nor any other symptoms. I was taken to ER where they said I must have had a dip in BP. I had not connected any of this with the medication until now reading your news. I had previously been on HCTZ for years with no noticeable problems but began having low sodium so was changed to Lisinopril. I just had my prescription refilled but began having doubts. I’m 73 and feel fine and happyy otherwise. P W

  3. Renee

    Renee I have taken Losartan, Propanolol and am now taking Lisinoprol. I’ve experienced body tingles, sensations of pins & needles, a constant headache & insomnia to boot! I’ve been on Atenelol for high blood pressure for 10 years & never had any side effects! The meds mentioned were added due to my BP increasing! Dr, said these meds have the least side effects! Don’t know what to do anymore!

  4. Monique

    On December 15, I had to be taken to the ER due to really bad stomach pains. The pains I felt was worse than labor pains, it felt like someone was stomping on my intestines with high heel shoes on. Once admitted, the doctors ran all of the test from colonoscopy upper GI, and different blood test. Everything the doctors was looking for came back negative. While in the hospital they kept giving me my blood pressure med, lisinopril. My lips became swollen while I was there and I was told it was because of the test I had done earlier. I replied no something is not right, but they continued to say I was ok, it’s because of the test.

    I suffered in pain for a week and 2 1/2 days while laying in the hospital. The Doctors could not find or figure out was going on and said we feel like it would be safe to send you home. They then released me from the hospital with instructions, a 2 week follow up appointment and another colonoscopy and also with an added blood pressure pill to go with the lisinopril. Once at home I continued taking my blood pressure pills according to Doctors directions and the pain, vomiting, diarrhea, the horrible coughing, continued. I began having chest pains and shortness of breath, I thought it was because I was trying to do too much to fast.

    On January 17 my upper lip started to swell and later that night it got worse, the next day I woke up I looked horrible; my face, upper lip and neck was swollen even more. I returned to the ER that’s when the ER Doctor said I was having an allergic reaction to the lisinopril, they began to give me steroids and other meds to stop what was going on and to keep my throat from swelling up as well. They then released me with a prescription for a 3 day steroid fix. I thank God he kept me because I could have died. Feeling safe enough to send me home almost cost my life.

  5. Shawn

    I have taken Lisinopril for 4 years after my BP was found to be high (155/90) at my checkup. It was a stressful time in my life and that may have contributed to the high BP, but the doctor said that I would need to be on BP meds for life.

    The symptoms came on quickly (dry cough) and then continued to compound. Muscle cramps, dizziness, etc. My BP did go down to normal but the medication altered other parts of my life. I always felt either dizzy or high (not in a good way!). Sometimes I would be at lunch with clients and feared that I would pass out at the table. I also started to get mild anxiety attacks – probably from fearing that I’d pass out or need medical attention in front of clients or family.

    Five months ago I started cutting my dose in 1/2 – went from two pills a day to one. In addition, I started exercising regularly and lost over 10 lbs. Even with this, I still had days where I just didn’t feel right. So I started to do research on natural HBP remedies. I started taking Cayenne Pepper capsules and garlic supplements. Also cut out all gluten (bread, pasta), soda, beer (ouch, I LOVE beer), sugar and other crap. Also went from 1 pill a day to a 1/2 pill per day.

    My prescription ran out a few days ago and I did not have it refilled. My current BP averages around 134/84. I can live with this. The last 5 days have been awesome – no dizziness, feeling out of it, etc. I feel like a normal person again. At 53 years of age I am looking forward to driving, skiing, biking, hiking and more importantly spending time with family (wife, kids and grandchildren) in a normal state of being.

    I think that obtaining this nirvana of 120/80 is insanity. Some of us run a little bit “hotter” than others; we may not live as long, but as long as our BP can be maintained at a reasonable level then we may live as well as others.

    My advice to others: unless your BP is so high that you are in imminent danger then I urge you to seek non-prescription solutions to your HBP.

  6. 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.

    • Deb
      New York

      I was recently put on Lisinopril, 5mg a day, along with another BP med that I have been on for a long time. The doctor wants to get my BP down lower than the 130s. I am encouraged by the info on alternative non-drug options. I am hoping that excersizing, adding garlic and cayenne pepper, and cutting back on sugar will allow me to reduce the dose and eventually eliminate the need for Lisinopril. It’s scary to read about the possible risks of taking it!

  7. 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.

  8. 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.

  9. 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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