Prinivil, Zestril (lisinopril)

How does this medication work? What will it do for me?

Lisinopril belongs to a class of medications called angiotensin converting enzyme (ACE) inhibitors. It is used to treat high blood pressure and congestive heart failure. It works by relaxing blood vessels and helping the heart to pump blood that carries oxygen to the different parts of the body more efficiently. It is also used immediately after a heart attack in order to reduce the risk of having another heart attack.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

5 mg
Each white, oval-shaped, compressed tablet, with code "MSD 19" on one side and scored on the other, contains 5 mg of lisinopril. Nonmedicinal ingredients: calcium phosphate, cornstarch, magnesium stearate, and mannitol. The splitting of Prinivil tablets is not advised.
10 mg
Each light yellow, oval-shaped, compressed tablet, engraved "MSD 106" on one side and scored on the other, contains 10 mg of lisinopril. Nonmedicinal ingredients: calcium phosphate, cornstarch, iron oxide, magnesium stearate, and mannitol. The splitting of Prinivil tablets is not advised.
20 mg
Each peach, oval-shaped, compressed tablet, engraved "MSD 207" on one side and scored on the other, contains 20 mg of lisinopril. Nonmedicinal ingredients: calcium phosphate, cornstarch, iron oxide, magnesium stearate, and mannitol. The splitting of Prinivil tablets is not advised.

How should I use this medication?

The recommended adult dose of lisinopril ranges from 2.5 mg to 40 mg daily, depending on the condition being treated. It is taken in one daily dose with or without food.
People who take other medications that lower blood pressure (e.g., diuretics) or people who have kidney disease may need lower doses. It may take up to 2 weeks to see the full effects of the medication.
The dose of lisinopril for children is determined by the child's body weight. Children who weigh 20 to 50 kilograms should start with 2.5 mg once daily. This may be gradually increased to a daily dose of 20 mg. Children who weigh more than 50 kilograms should start with 5 mg taken once daily. This may be gradually increased to a daily dose of 40 mg.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take lisinopril if you:

• are allergic to lisinopril or any ingredients of the medication
• are allergic to another ACE inhibitor (e.g., captopril, enalapril, quinapril, ramipril)
• are pregnant or intend to become pregnant
• has a history of angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell) after taking any ACE inhibitors (e.g., captopril, enalapril, fosinopril, ramipril)
• have been diagnosed with hereditary angioedema
• are taking aliskiren, and
• have diabetes
• have kidney disease
• are taking a medication in the class of angiotensin receptor blockers (e.g., irbesartan, losartan, valsartan)
• are taking another angiotensin converting enzyme inhibitor (e.g., captopril, lisinopril, ramipril)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• changes to sexual performance
• cough (dry, persistent)
• diarrhea
• drowsiness
• dry mouth
• mild dizziness
• hair loss
• headache
• heartburn
• nausea
• runny nose
• signs of low blood pressure (e.g., dizziness or lightheadedness)
• taste changes
• trouble sleeping
• unusual tiredness/fatigue

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:

• chest pain
• confusion
• hallucinations (seeing or hearing things that aren’t there)
• increased frequency of infections or flu-like symptoms
• itching
• numbness or tingling in the fingers or toes
• rapid heartbeat
• signs of anemia (low red blood cells; e.g., dizziness,  pale skin, unusual tiredness or weakness, shortness of breath)
• signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood,  bleeding gums, cuts that don’t stop bleeding)
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of kidney problems (e.g., decreased urine production, blood in the urine, swelling, fatigue, abdominal pain)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• signs of too much potassium in the body (e.g., confusion; irregular heartbeat; nervousness; numbness or tingling in hands, feet, or lips; shortness of breath or difficulty breathing; weakness or heaviness of legs)
• wheezing

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of angioedema (e.g., swelling of face, mouth, hands, or feet)
• signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
• signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
• trouble in swallowing or breathing (sudden)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.