Lisinopril Warnings and Precautions
Understanding lisinopril warnings and precautions can help ensure a safe treatment process. For example, people with a history of angioedema or kidney disease should discuss this with their healthcare provider before taking the drug. It's also important to be aware of potential drug interactions and possible side effects with lisinopril. Warnings and precautions also extend to women who are breastfeeding or pregnant and people who are on dialysis.
Lisinopril: What Should I Tell My Healthcare Provider?You should talk with your healthcare provider prior to taking lisinopril (Zestril®) if you have:
- Heart disease, including congestive heart failure, aortic stenosis, or hypertrophic cardiomyopathy
- Liver disease, including cirrhosis
- Kidney disease or kidney failure
- Systemic lupus erythematosus (lupus or SLE)
- A personal or family history of angioedema, which is swelling under the skin
- Any allergies, including allergies to ACE inhibitors, foods, dyes, or preservatives.
Also let your healthcare provider know if you:
- Are pregnant or trying to become pregnant
- Are breastfeeding
- Are on dialysis
- Will be undergoing surgery or anesthesia.
Tell your healthcare provider about all medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Specific Lisinopril Warnings and PrecautionsWarnings and precautions to be aware of prior to taking lisinopril include the following:
- Lisinopril can interact with certain medications (see Lisinopril Drug Interactions).
- ACE inhibitors are more likely than other drugs to cause allergic reactions. For example, there have been reports of severe allergic reactions occurring in people on lisinopril during dialysis. There have also been reports of severe reactions in people getting bee or wasp venom to protect against stings. Discuss these risks with your healthcare provider. Also, seek emergency medical attention immediately if you notice:
- An unexplained rash
- Difficulty breathing
- Swelling of the face or throat.
- ACE inhibitors may cause swelling (angioedema) of the head and neck, including the tongue, lips, eyes, or throat. This occurs more frequently in African Americans. Seek emergency medical care immediately if you notice swelling in the head or neck area, or if you have wheezing or difficulty breathing or swallowing.
- In addition to head and neck angioedema, ACE inhibitors have been known to cause swelling in the intestines. This is known as intestinal angioedema. Symptoms may include, but are not limited to, abdominal pain (stomach pain), with or without vomiting. Seek medical attention immediately if you develop any of these symptoms.
- Lisinopril may cause extreme low blood pressure in some people. This is more likely to happen in people who are taking a diuretic, who are on dialysis, who have diarrhea or vomiting, or who sweat a lot. This is why it is important to drink fluids regularly while taking lisinopril. If you have any possible symptoms of extreme low blood pressure (such as dizziness, lightheadedness, or fainting), contact your healthcare provider and stop taking the medicine.
- Do not to drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how lisinopril affects you.
- People on lisinopril can be at an increased risk for infections. Talk to your healthcare provider if you develop any signs of infection, such as a sore throat or fever, while taking lisinopril.
- Lisinopril is a pregnancy Category D medicine, meaning that it can present health risks to your unborn child. If you become pregnant while taking lisinopril, contact your healthcare provider immediately (see Lisinopril and Pregnancy).
- ACE inhibitors, including lisinopril, are known to cause a cough. If the cough becomes bothersome, talk to your healthcare provider about alternate options for your condition (see Lisinopril Cough).
- While taking lisinopril, do not use potassium supplements or salt substitutes with potassium unless you have discussed this with your healthcare provider. In some people taking lisinopril, potassium in the blood can increase to dangerous levels.
- This medication may cause a decrease in kidney function, especially in people who are elderly, have kidney disease, have severe congestive heart failure (CHF), or are taking nonsteroidal anti-inflammatory drugs (NSAIDs) or diuretics (water pills). Your healthcare provider may choose to monitor your kidney function with a blood test while you are taking it. Contact your healthcare provider if you notice a decrease in urination or swelling in your hands, legs, ankles, or feet, which can be signs of kidney problems.
- If you have kidney disease or kidney failure, your body may metabolize the lisinopril differently than intended. Therefore, your healthcare provider will likely monitor your situation more closely.
- In clinical studies, ACE inhibitors, including lisinopril, have rarely been known to cause liver failure. Contact your healthcare provider immediately if you notice:
- Itchy or yellowing skin
- Abdominal pain (stomach pain)
- Flu-like symptoms.
- If you have diabetes, you should closely monitor your blood sugars, as lisinopril may cause a drop in blood sugars. This is more common during the first month of treatment.
- It is not known whether lisinopril passes through breast milk. Therefore, if you are taking lisinopril and nursing, ask your healthcare provider whether you should stop lisinopril or stop breastfeeding.