The People's Perspective on Medicine

Lisinopril & Other Pril Pill Side Effects Stimulate Heated Debate

ACE inhibitor blood pressure "pril" pills like lisinopril or ramipril can cause life-threatening swelling in the mouth, throat or abdomen.

Some of the most commonly prescribed drugs in the world for high blood pressure are called ACE inhibitors. These compounds help blood vessels relax and dilate by blocking angiotensin converting enzyme (ACE). For millions of people they are extremely effective and cause no complications.

This class includes drugs such as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril and trandolapril. If your medicine ends in “pril” there is a good chance it is an ACE inhibitor. These compounds are also found in dozens of combination blood pressure medications that include diuretics.

Whenever someone is prescribed a pril pill, they must be warned of two potentially serious complications. First: the ACE inhibitor cough. Such medications are notorious for triggering a hard-to-treat cough that can be incredibly debilitating. We have heard from hundreds of people who were not warned of this side effect. Many received complicated and expensive workups for allergies, asthma and other respiratory problems, only to discover after months or even years that their blood pressure medicine was responsible for an uncontrollable cough.

The second problem is called angioedema. It is a kind of allergic reaction that leads to swelling of soft tissue. When it happens around the face and neck, breathing can become difficult. This is an extreme emergency requiring immediate medical attention. The reaction can occur suddenly, years after someone has taken such drugs safely.

Angioedema of the Abdomen

A less well recognized complication of ACE inhibitors is swelling of the intestines. As you might imagine, when this occurs it can be incredibly uncomfortable. If the bowels become obstructed, it can be life threatening. Sadly, drug-induced abdominal angioedema is frequently misdiagnosed for weeks or months.

We share this with you because it has led to a heated debate among visitors to this website. Some people believe that warning about the ACE inhibitor cough or angioedema will scare patients unnecessarily.

A.H.D. says:

“I’ve been taking lisinopril for 4 years and now your comments have me very worried. Shouldn’t you balance these reports with success stories?”

There is no doubt that many people can take medications like enalapril, lisinopril or ramipril without experiencing any symptoms. But then there is this from Christie:

“Five days after starting lisinopril I was admitted to the hospital. I had a SEVERE allergic reaction that is extremely rare and it took doctors 2 1/2 months to figure out what was going on. It took 5 hospital trips and 2 surgeries for them to figure out it was the lisinopril.”

“Everyone reacts to medications differently. My mom took lisinopril with no problems. My dad got the really bad cough and stopped it.

“My intestines were closing and I went through HELL while on the medication. I would not wish the pain I had on my worst enemy…it was THAT bad. Labor pains weren’t as bad as the pain I got. I was sick for almost 3 months and within weeks of stopping the medication I was back in the hospital because my blood levels were so out of whack the results came back ‘panic’….not low, but panic! I could have had a heart attack, seizure, or some other things happen….all because I was so sick and wasn’t able to eat properly while on this medicine.

“Please don’t make it sound like we’re all just overly sensitive or exaggerating because I definitely know I’m not!”

R.C. shared this scary story:

“Doctors may mention ordinary side effects but may fail to discuss long-range serious problems.

“My brother was on lisinopril for about two years. Four days ago, he woke up with an extremely swollen tongue. No shortness of breath, no swelling otherwise. By the time we got to the ER, he was barely able to breath, couldn’t talk well enough to be understood. He was rushed back in an emergency triage, stripped of his clothes and given a large dose of steroid. The doctor said that if he hadn’t awakened when he did he would probably have died.

“This reaction is listed well down on the list under rare reactions. The ER doctor and his cardiologist were very adamant that he never come into contact with it again, but the pharmacist wasn’t so convinced that lisinopril was the cause.”

The pharmacist clearly had not done her homework. The prescribing information that comes with lisinopril and most ACE inhibitors states quite clearly:

“Angioedema of the face, extremities, lips, tongue, glottis and/or larynx has been reported in patients treated with angiotensin converting enzyme inhibitors, including lisinopril. This may occur at any time during treatment. Lisinopril should be promptly discontinued and appropriate therapy and monitoring should be provided until complete and sustained resolution of signs and symptoms has occurred. Even in those instances where swelling of only the tongue is involved, without respiratory distress, patients may require prolonged observation since treatment with antihistamines and corticosteroids may not be sufficient. Very rarely, fatalities have been reported due to angioedema associated with laryngeal edema or tongue edema.”

Take Home Message

Just because a side effect is considered “rare” does not mean it can’t happen to you. And even if you have taken a medication safety for years does not mean you are home free. We are not trying to be alarmist, but we do want you to be aware of potentially life-threatening reactions. That way you can act appropriately if something strange begins to occur and not waste time wondering if a symptom deserves immediate medical attention.

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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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I took one pill of lisinopril and 12 hours later had a grand mal seizure! I found a number to call the FDA and asked about it, and they told me it’s rare but that side effect is, indeed, on a secondary side effect list. That was a month ago, and I’m still struggling to feel normal.

I have been taking lisinipril for about 7 years, I haven’t had any side effects up until now, very rapid heart beat as well
not in rhythm, tried changing diet, changed the vitamins I was taking,even stopped drinking coffee I’m in great shape, I stopped taking the bp med and 2 days later it cleared up, 1week after stopping I started taking it again, 2 days later my symptoms began once again, I stopped it again and symptoms disappeared again, I am now very certain it is caused by lisinipril
Time to switch.
Pay attention to what your body is telling you

I have taken lisinopril for 5 months and have stiff neck with pain, both shoulders painful,and painful muscles. What should I use for bp?

I had taken pril med for over 20 years and had a reaction to the med people DO NEED TO BE WARNED. It is scary not knowing why you are having a reaction.

Took lisinopril for 9 years. After 5 years I went for routine blood test and was hunted down by hospital and told to get there immediately because my potassium was deadly high. turned out to be a false positive but they took me off lisinopril.

About 3 years later, I was put back on under half the previous dosage. No problems until this week when i woke up with a hugely swollen lower lip. by afternoon the swelling subsided but that evening my upper lip started swelling and wouldnt stop. went to ER was given steroids benedryl and one other medication which reduced the swelling. Doctors suspect lisinopril again but are checking my other BP pills to see if they are the cause.

I was put on lisinopril in October of 2017 on February 4, 2018 I was hospitalized in ICU for angioedema of the face for taking lisinopril I was giving all kinds of steriod and they did not stop the swelling of my face. The hospital had call on ear, eyes, and nose specialist o come up some medication to stop the swelling of my face, Thank GOD what the specialist gave work and stop the swelling.

Wow. So honestly I don’t know where to begin. I’ve had so many symptoms. Weight gain, dry throat, and the cough has triggered asthma attacks. Swelling on both sides of my neck. Was sent to an ENT doctor. He scheduled me for a biopsy only to cancel as I was being prepped for surgery. Said the lumps were gone. They were just harder to spot when I’m lying down. I put myself on benadryl because I have these skin problems. The dermatologist says you’re just allergic to life. Not knowing what I’m reacting to scared me so. I have been taking 50mg of benadryl for months now. Still have hives. Lumps growing on both sides of my neck. Was told it was fat. Why would I be gaining weight in my neck? Am tired and have muscle pain, even bone pain. Chest pain that has sent me ER. And blood pressure goes from high to low all day, daily. Blood in urine for a year now. Almost feel like giving up. If it weren’t for having kids. Trying to come off the lisinopril, and that’s not fun. I’m laid up right now dizzy, jittery, headache just feel awful. I don’t know if I should take a pill or fight thru. BP is up and down from 140/43 20 minutes ago now it’s 167/101. What do I do?

Lisinopril nearly killed a friend of mine several years ago. It gave her a case of acute pancreatitis. No one suspected the lisinopril at first. She lost 20 pounds in three weeks (10 days in hospital, remainder at home), and food tasted bad to her and would not stay down. When I was looking up the three meds she was taking (Lisinopril, a thyroid medication, and something for acid reflux) to see if any of them were messing up her sense of taste and influencing her continued weight loss, a hunch had me look each medication up in connection with ‘acute pancreatitis’.

The lisinopril had hits all over the place, some of which dated back to articles published in medical journals in the early 1990s. I reported back to my friend that the lisinopril could cause acute pancreatitis, she relayed the info to the visiting nurse who came to check on her, the nurse informed her doctor, and they had her back to the hospital for more tests and a different blood pressure med. Food started staying down and she had regained a pound or two by the end of the week. The scary thing is that her doctor had increased her dose of the lisinopril while she was in the hospital because her blood pressure had spiked from the pain.

Thanks so much to theses folks at people’spharmacy.com for sharing factual information about medications.

Knowledge is not scary – it is empowering.

Lisinipril is made from venom of a South American Pit Viper. The body is of course, always trying to rid itself of this toxin, so, eventually it is no surprise one starts experiencing autoimmune disease symptoms as well as a plethora of other weird and scary health issues.

It is most unfortunate that FULL disclosure about medications is not required. The contraindications on the paperwork with your prescription is only the tip of the iceberg. It has taken me a year to research lisinipril and the other medications I was prescribed. I wended myself off my mess over this last year and have been off for a week now.

My clinic has very caring folks who unfortunately don’t have the time to go down the rabbit hole and research intensively all medications as well as interactions with other medicines – but I did.

I am allergic to sulfa drugs and lisinipril is a sulfa drug.

I was also prescribed hydrochlorothiazide. So those two medications constantly kept my body in a hyper state as one lowers aldosterone and one raises it. One lowers potassium levels, one raises it.

So for years I have been daily consuming a snake venom I am highly allergic to while my body has been in a state of confusion with drugs that battle each other.

Dr. John Bergman has a wonderful collection of helpful YouTube videos I refer you all to – particularly the one about blood pressure.

Did you ever ponder how it is decided what your blood pressure should be? The group of physicians who decide that decided quite a few years ago that it should be 150/95…not 120/80 or lower. Guess the memo wasn’t circulated properly.

Take a deep breath. Pray and ask God for discernment. Make a nice cup of herbal tea and start researching your meds. Then act as your own advocate and make wise choices.

Run from any health care professional who intimidates you or is not willing to help you on your own journey to help yourself.

I care about each of you reading this. Your body talks to you. It is not your enemy but your wise friend. Listen to it, please…

I think this bp medicine may kill me! Every one I take has terrible side effects. Extreme coughing and allergy symptoms, swollen joints, pain…and I know it’s from the meds bkus if I skip a dose or two, I am immediately relieved of all the discomfort. What’s a person to do? Dr said I would be kicked out of his practice if I didn’t take bp meds. I want him to re-calibrate his bp cuff and have his nurse take the bp measurements more carefully.

Jody, thank you for the information and your insights as I was just put on lisinipril. I have problems with meds because of my acid reflux. I was on cozaar, but asked got a switch. I am so shocked by what i’m reading that I may go back to cozaar until I can get myself off of all my b/p meds. Thank you for caring enough to share.

Took Lisinopril for 6 years and had angioedema in the face, throat, and neck. Was in the ICU for 3 days, even receiving blood plasma with other antihistamines. Was discharged, and 7 days later, after stopping Lisinopril, had more swelling and was readmitted to ICU for same treatment.

SoI would say it takes some time for the effects of Lisinopril to clear the system. Cannot take any “pails” ever. The only wanting was on the pill bottle–similar warnings to what many meds have. Ask questions about any medications your doctor prescribes!

I’m on Ramapril 2.5 and have been for 3 years. For the past 6 months I have had severe shoulder and upper arm pain, sleeplessness, heartburn and general depression. I am wondering if this can be caused by the medication. Anyone able to help me with this? Thanks.

My wife is in the ICU at this moment because of an allergic reaction to lisinopril. She has been in there since Friday Aug. 4, 2017. I am scared to see her in the state she is in. This medicine should be taken off the market. I don’t just say that because it harmed my wife, but after doing research to what it has done to many.

I had been taking lisinopril 20/25 for just about 3 weeks as of yesterday. Ended up in the ER last night due to angioedema on my lip and left hand. The night before I was in the ER for chest pains, rapid heart rate, and breathlessness. I have a hunch those symptoms will go away in a bit now that I am no longer taking lisinopril. I could have been saved all the worry about my chest pain and shortness of breath if my doctor had not blown off those symptoms after the first week. Hopefully my cough will disappear also. This was a very bad drug for me and I am glad the ER doctor knew exactly what was going on. My Dad has been on lisinopril for years and he is fine. There needs to be better warnings about this drug!!

I’m wondering if lisinopril could have an effect on GERD (acid reflux). Since it has a relaxing effect on blood vessels, could it also have a relaxing effect on the lower esophageal sphincter (LES)?

My wife was taking BP medications for many years and recently diagnosed with Barret’s esophagus after an endoscopy. The we came to find out it was 5 years of a BP med that loosens the LES and caused stomach acid to come back up into esophagus which caused the problem. Then was diagnosed NEXIUM for the ACID REFLUX. Another bad news drug.

Boy was I surprised to find that my hiatal hernia was likely CAUSED by lisinipril. Yes and yes…the failure of the esophageal sphincter to close is surely related to lisinipril. Following is the plethora of tummy issues.

Choose wisely for yourself.

Wean gradually off meds if you choose to be off. You still will have a rebound effect when stopping. However by being informed about it all it’s a lot less troubling.

The body will reset itself when we give it half a chance.

Blessings to you in your journey.

On my first trip to the ER while on lisinopril, for chest pains, shortness of breath, after testing for heart issues, they said it could be acid reflux. I have never had heart burn or acid reflux, but maybe it can affect GERD. I bet I do not have to take any acid reflux meds anymore though, since I don’t think that’s what it really was. Best wishes to you!

I’m wondering if lisinopril could have an effect on GERD. Since it has a relaxing effect on blood vessels, could it also have a relaxing effect on the lower esophageal sphincter (LES)?

I have been feeling funny in the head and don’t really understand if this is from the medicine. I take 10mg and just started this a couple of days ago

Wow I’ve been taken lisinipril for six months I’ve experienced some fatigue,coughing and allergies and some swelling around my knees when I scip a day or 2

I became violent when in lisinopril. My friends Joe also became violent with lisinopril. He quit the med, I was switched to enalapril. My enalapril dose was increased from 5 to 10 mg and this is causing crazy dreams. May have to ask the pharmacist for a better substitution and then talk with my cardiologist.

I’ve taken it (lisinopril) for years and have had AR too many times to count.. I carry a EPI PEN. I was told not to eat shrimp. Now I want to change my BP pill. Thanks for the information that Kaiser never gave me.

Has any one heard of lisinopril causing mental problems? I am getting ready to file for a divorce. My husband is 59 yrs old and took lisinopril for 10+ yrs. Hes had many side effects including an irregular heartbeat, the cough, stomach problems, non stop sleeping, ED, and so forth. Sadly he has changed mentally as well. He was the nicest guy you knew until he began taking that drug. Now he exhibits passive/aggressive behaviors and has for a very long time. They have gotten so bad I refuse to deal with them any longer. He quit taking this a few months ago but no change. Of course he sees nothing wrong. I cant take another day of this. My life has been shot down and I believe the cause is lisinopril. Please anybody, help me!! The pain and suffering have been unbelievable. I have been reduced to a worthless human being by a man that used to be loved by many. Theres no hope for us im sure. But maybe this will help someone else. Also hes slowly attempting to enter in to the physical abuse zone. The mental abuse cannot be described. Can anyone help?

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