Lisinopril, Oral

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KEY POINTS

• This medicine is taken by mouth to treat and control high blood pressure or heart failure, or to improve heart function after a heart attack. Take it exactly as directed.
• You may get infections more easily when you are taking this medicine.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: ACE inhibitor

Generic and brand names: lisinopril, oral; Prinivil; Qbrelis; Zestril

What is this medicine used for?

This medicine is called an ACE inhibitor. It is taken by mouth to treat and control:

• High blood pressure
• Heart failure

It may be given to improve heart function after a heart attack.

You may take this medicine alone or with other medicines.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before you start taking this medicine, tell your healthcare provider about any other medicines you are taking, including nonprescription products.

Tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Angioedema
• Diabetes
• Heart valve problems
• Liver or kidney problems
• Lupus, scleroderma, or other connective tissue disease
• Problems with low blood levels of sodium or high blood levels of potassium.

Tell your healthcare provider if you have been on a low-sodium diet.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are receiving this medicine.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Take it regularly every day even if you feel better. Do not stop taking this medicine unless your healthcare provider approves. You may need to take this medicine for a long time to control your blood pressure. If your provider has also prescribed another medicine, take it regularly. Follow your healthcare provider's instructions about diet and exercise.

Check with your healthcare provider before using this medicine in children under age 6.

Take this medicine with a glass of water. If you have trouble swallowing the medicine, talk with your healthcare provider.

If you have the oral solution, use the measuring spoon, cup, dropper, or oral syringe that comes with the medicine, or ask your pharmacist for one. Do not use a kitchen spoon because the dose may not be correct.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: dizziness, lightheadedness, fainting, weakness.

What should I watch out for?

This medicine may make you lightheaded or dizzy. Do not drive or operate machinery unless you are fully alert.

This medicine may cause a sudden drop in blood pressure, especially when you first start taking it. You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help. If you feel dizzy or faint while you are standing, lie down for a while and then get up slowly.

This medicine may make your skin more sensitive to the sun, which may lead to painful sunburns. Avoid long exposure to the sun. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors. If you develop a severe sunburn, contact your healthcare provider.

A persistent dry cough is common with this medicine. If the cough changes or becomes bothersome, talk to your healthcare provider. Do not take nonprescription cough medicines. The cough will go away after the medicine is stopped.

Ask your healthcare provider if you can use a salt substitute that contain potassium or a potassium supplement while you are taking this medicine. Do not use salt substitutes or supplements that contain potassium unless your provider approves. Talk to your provider before you take a potassium-sparing diuretic such as amiloride, spironolactone (Aldactone), or triamterene (Dyrenium).

Severe vomiting or diarrhea, or heavy sweating can cause you to become dehydrated. Drink plenty of water while you are receiving this medicine.

Be careful when exercising. This medicine may make you feel lightheaded, dizzy, or faint, especially in hot weather.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Your healthcare provider will want to see you regularly to check your blood pressure and to adjust your dosage, if necessary. You may need to have blood tests regularly to see how this medicine affects you. Keep all appointments.

You may get infections more easily when you are taking this medicine. If you have any sign of infection, such as a sore throat or fever, contact your healthcare provider.

If you have diabetes: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives, itching, tightness in your chest, trouble breathing); chest pain; irregular or fast heartbeat; swelling of your face, lips, tongue, or throat; severe dizziness or fainting; trouble swallowing; severe stomach pain.

Serious (Report these to your healthcare provider right away.): Mouth sores; any signs of infection such as sore throat or fever; any unexplained swelling; unusual sweating, vomiting, or diarrhea; stomach pain; problems with urination; yellowing of the skin or eyes; dark urine; light colored bowel movements; persistent cough; skin blisters or peeling; unusual bruising or bleeding.

Other: Headache, dizziness, lightheadedness, tiredness, drowsiness, weakness, nausea, mild vomiting, mild diarrhea, back pain, muscle pain, dry cough, change in sense of taste.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Aliskiren (Tekturna) and aliskiren/hydrochlorothiazide (Tekturna HCT)
• Allopurinol (Aloprim, Zyloprim)
• Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), and terazosin
• Amifostine (Ethyol)
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antacids that contain aluminum, calcium, or magnesium, such as Gaviscon, Maalox, Mylanta, Phillips' Chewable Tablets, Rolaids, or TUMS (Take antacids at least 2 hours before or 2 hours after you take this medicine.)
• Antipsychotic medicines such as chlorpromazine, clozapine (Clozaril, FazaClo), haloperidol (Haldol), olanzapine (Zyprexa), and thioridazine
• Aspirin and other salicylates
• Blood pressure medicines such as hydralazine, methyldopa, minoxidil, and reserpine
• Diabetes medicines such as alogliptin (Nesina), canagliflozin (Invokana), glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Glynase), insulin, linagliptin (Tradjenta), metformin (Fortamet, Glucophage, Riomet), pioglitazone (Actos), pramlintide (Symlin), repaglinide (Prandin), rosiglitazone (Avandia), saxagliptin (Onglyza), and sitagliptin (Januvia)
• Digoxin (Lanoxin)
• Diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), chlorthalidone, eplerenone (Inspra), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• Erectile dysfunction medicines such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn)
• Everolimus (Afinitor, Zortress)
• Gold sodium thiomalate (Myochrysine)
• Guanfacine (Intuniv, Tenex)
• Immunosuppressants such as azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral, Sandimmune), mycophenolate (CellCept, Myfortic), sirolimus (Rapamune), tacrolimus (Astagraf, Prograf, Protopic), and temsirolimus (Torisel)
• Iron supplements or multivitamins that contain iron, and iron medicines such as ferric carboxymaltose (Injectafer), ferric gluconate (Ferrlecit), ferumoxytol (Feraheme), and iron sucrose (Venofer)
• Lanthanum (Fosrenol)
• Lithium (Lithobid)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate)
• Medicines to treat or prevent blood clots such as dalteparin (Fragmin), enoxaparin (Lovenox), and heparin
• Methylphenidate (Concerta, Daytrana, Metadate, Ritalin)
• Natural remedies such as alfalfa, arginine, black cohosh, cats claw, cayenne, dandelion, devils claw, dong quai, ephedra, fish oil, garlic, ginger, ginseng, goldenseal, gotu kola, hawthorn, horny goat weed, kava, kelp, ma huang, natural licorice, nettle, noni juice, shepherd's purse, and yohimbe
• Nesiritide (Natrecor)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), hydrocodone/ibuprofen (Vicoprofen), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Potassium supplements or salt substitutes that contain potassium
• Pregabalin (Lyrica)
• Rituximab (Rituxan)
• Sacubitril/valsartan (Entresto)
• Sulfamethoxazole/trimethoprim (Bactrim, Septra) or trimethoprim (Primsol)
• Tizanidine (Zanaflex)
• Tolvaptan (Samsca)

Do not drink alcohol while taking this medicine unless your healthcare provider approves.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.