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ACE Inhibitors Like Lisinopril and Hand Tremors

Lisinopril is the go-to treatment for hypertension. Cough is a relatively common side effect. We never made a connection with lisinopril and hand tremors.

The most prescribed blood pressure medicine in the U.S. is the ACE inhibitor lisinopril. At last count, more than 20 million Americans swallow this BP pill daily. We always thought we knew about lisinopril side effects such as cough, digestive upset, high potassium levels, sensitivity to sunlight, dizziness, headache, fatigue and swelling of the mouth, throat or abdomen (angioedema). A link between lisinopril and hand tremors was not on our radar scope until we received a question about it a few months ago. Since then, we have received many other reports about lisinopril and hand tremors.

Lisinopril and Hand Tremors:

Q. I recently started taking care of my own health issues. I had hand tremors that made the mouse run laps around the computer screen. After researching all my prescription medicines, I quit taking lisinopril for hypertension.

After a month being off it, the tremors are gone. They had been so bad that another nurse friend noticed it when we were out for dinner. I have many hobbies and could not imagine not being able to knit, crochet, sew or embroider again.

A. Your story took us by surprise. We have been interested in ACE inhibitors like lisinopril for decades. This blood pressure pill works well for most people, with relatively few side effects.

Some develop an uncontrollable cough, though. A few others experience something called angioedema, which can be life threatening.

In this condition, the tissues of the face, especially the lips, tongue and throat, swell and may block the ability to breathe. Angioedema can also occur in the abdomen, causing intestinal blockage. To learn more about angioedema and how serious it can be, check out this link.

Lisinopril Side Effects Can Be Lethal
Blood pressure pills like Lisinopril are perceived as generally safe medications, but mysterious lisinopril side effects called angioedema can be life threatening.

Lisinopril and Hand Tremors:

Hand tremors are not a life-threatening complication. We doubt that most health professionals are aware that it might be linked to lisinopril. We were certainly ignorant of this potential adverse reaction.

Tremor is listed in the prescribing information, but it appears to be quite rare. You are the first person who has told us about experiencing this complication.

We trust you are in touch with your doctor about other ways to control your blood pressure. We offer more information about lisinopril, other medications and nondrug approaches in our eGuide to Blood Pressure Solutions. This online resource is available in the Health eGuides section of this website.

There is a powerful lesson to be learned from this alert reader’s realization that there was a connection between lisinopril and hand tremors. Because a shaky hand is not considered a) important, b) common or c) drug related, it is easily ignored. We have learned a great deal from the readers who visit this web site. We never would have considered withdrawal itching associated with cetirizine (Zyrtec) without reader input. 

More Readers Report an Association between Lisinopril and Hand Tremors:

Q. After I read on your website that lisinopril could cause hand tremors, I asked my doctor to change my blood pressure medication. I had been on HCTZ/lisinopril for at least ten years. She said she hadn’t heard of any connection between the two and suggested I see a neurologist. I said let’s try changing my medication first.

She increased my HCTZ to 25 mg. I took no other medication. Within three days, my hand tremors were essentially gone. I was able to polish my own fingernails. Thank you for bringing this information forward.

A. A dry cough is the most common complication of ACE inhibitors like lisinopril. We’re not surprised that your doctor was unaware of tremor as a side effect. Most electronic drug databases that physicians rely on don’t list this adverse reaction.

We too were unaware of it until a reader reported hand tremor associated with lisinopril. When we checked the FDA-approved prescribing information, we found that tremor is a recognized reaction, though it is considered rare.

Lisa shares this poignant story about lisinopril and hand tremors:

“I have essential tremor (thanks, Dad). By the end of my father’s life, his tremor had progressed to the point that it prevented him from signing his name, tightening a screw, eating neatly, and doing almost anything that mattered to him.

“I’ve seen my tremor steadily progress throughout my life, as well. When I began taking metoprolol, though, my tremor regressed. I’d say it was knocked back thirty years or more, and it definitely was the metoprolol at work. That was a lovely thing. I’m an artist and had feared what my future would look like.

“Then I was switched from metoprolol to lisinopril. My tremor came back with a vengeance. It is now so bad that I have trouble writing and typing, buttoning a button–any task that requires careful hand control. Drawing and painting are a joke. Now, I even have begun to have tremor in my neck and jaw (think Katherine Hepburn).

“I asked to switch back to metoprolol. Instead, my doctor wanted me to add the metoprolol back and continue taking lisinopril. I was delighted and looked forward to the improvement I expected to follow. But it didn’t.

“Now I’m thinking, maybe it’s the lisinopril…”

Helen solved her problem with lisinopril and hand tremors without even realizing it:

“I took lisinopril for several years and changed because of a persistent cough. I also was beginning to have tremors but did not then connect them. Now I realize I have had none since stopping the lisinopril.”

Share Your Lisinopril Experience:

Have you ever suffered ACE inhibitor side effects? What about lisinopril and hand tremors? Please add your story in the comment section below. Never stop any medicine without discussing it with the health professional who prescribed it!

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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