High blood pressure has been called one of the “silent killers.” It can produce serious health issues without significant symptoms until there is major physical damage.

High blood pressure adds to the workload of the heart. Over time, it can result in damage to the blood vessels in the brain, heart, and kidneys. It can lead to increased potential for heart attack, stroke, or even kidney failure.

Medications developed to control high blood pressure can help to significantly reduce the risks of developing these issues. 

Lisinopril (brand names: Zestril and Prinivil) belongs to a class of medications commonly referred to as ACE inhibitors (angiotensin-converting enzyme inhibitors) to reduce high blood pressure (hypertension).

Lisinopril is also used in conjunction with other medications to improve survival after a heart attack or to treat congestive heart failure. Physicians may also use it for some off-label uses.

Mechanism of Action

ACE inhibitors slow down the activity of the enzyme ACE, which decreases the production of a substance called angiotensin II. This relaxes the blood vessels, causing them to dilate, thereby reducing blood pressure.

By lowering blood pressure, the flow of blood is increased. Oxygen and nutrients are delivered to the organs in the body, reducing the risk of long-term injuries and tissue damage.

It may take several weeks of using the medication to fully lower blood pressure to a normal level.


Lisinopril is not listed as a controlled substance by the U.S. Drug Enforcement Administration; however, it does require a prescription from a physician to legally obtain it due to some of its side effects and potential interactions with other medications.

Some Cautions Regarding Lisinopril Use

Some issues might result in untoward reactions with lisinopril. People with the following conditions should exercise caution:

  • A prior allergic reaction to another ACE inhibitor
  • A history of kidney disease
  • Significant liver issues or liver disease (cirrhosis)
  • Diabetes
  • Rheumatoid arthritis
  • Lupus
  • Other rare conditions, such as Marfan syndrome (a connective tissue disorder) or Sjogren’s syndrome (a disorder of the immune system)
  • Pregnancy

Certain conditions can lead to dangerously low blood pressure when a person takes lisinopril, such as being on a low-salt diet, using diuretics, or having chronic issues with diarrhea. These conditions might also rule out use of the medication.

Does Lisinopril Abuse Happen?

ACE inhibitors are not considered to be significant potential drugs of abuse. Although artificially producing extremely low blood pressure by taking high amounts of the medication or combining it with other medications may produce feelings of sedation or lightheadedness, the drug is not the type of medication that produces psychoactive effects.

Even though there is very little information about cases of lisinopril abuse, people who chronically abuse drugs often combine numerous types of drugs to achieve unique psychoactive experiences.

While there are not extensive records or case studies regarding abuse of lisinopril, it certainly could be abused by individuals who are attempting to achieve some type of unique psychoactive effect by combining it with some other medication, illicit drug, or alcohol. However, this does not appear to be a common practice.

Drinking Alcohol with Lisinopril

Alcohol use can lead to a decrease in blood pressure. Someone may experience significantly decreased blood pressure if they drink alcohol while taking lisinopril.

The recommendations on the drug’s label suggest that lisinopril should not be used in conjunction with alcohol. Drinking alcohol in conjunction with lisinopril may increase the potential for side effects associated with the drug.

Lisinopril & Dehydration

Consuming diuretic substances like caffeine, alcohol, and others may increase the risk of dehydration while taking lisinopril.

Individuals should discuss all other medications, dietary practices, and any other substances they consume, like alcohol or caffeine products, with their physician before getting a prescription for any drug.

The instructions that lisinopril provides suggest that individuals drink plenty of water when using the drug. Any situation that results in significant fluid loss should be reported to the prescribing physician.

General Side Effects

Some of the most common side effects associated with using lisinopril include:

  • Feeling dizzy, lightheaded, or as if you might faint when suddenly getting up from a sitting or lying position (postural hypotension)
  • Fatigue or weakness
  • Decrease in urine output or cloudy urine
  • Sweating, blurred vision, or confusion
  • Nausea
  • Coughing
  • Flu-like symptoms, such as fever, chills, muscle aches, and sweating
  • Mood changes

Individuals experiencing any of these side effects, particularly nausea, should immediately discuss the situation with their physician.

Other potential side effects can occur, including allergic reactions that would consist of anxiety, swelling of the lips or face, hives or rash, difficulty breathing, or stomach pain. If there are any signs of an allergic reaction, immediately stop taking the medication.

Rare but Serious Side Effects

Individuals who take lisinopril and become severely nauseous with vomiting or diarrhea should immediately contact their physician, as they may become dehydrated or develop low blood pressure. A sore throat, fever, and/or chills could be a sign that the medication has affected a person’s white blood cell count, and this could lead to a risk to develop infections.

In some people, lisinopril may produce hyperkalemia, or high potassium levels in the blood. The signs of hyperkalemia include stomach pain, confusion, irregular heartbeat, nausea, numbness in the hands or feet, heaviness in the extremities, and difficulty breathing. Hyperkalemia can result in irregular heartbeat rhythms, which can be potentially serious.

Loss of appetite, fatigue, dark urine, nausea, upper stomach pain, and a yellow tint to the skin or eyes may suggest that the medication is causing a serious issue with the liver.

Overdose Potential

People can take too much of an ACE inhibitor. Signs of taking too much lisinopril include a significant drop in blood pressure as well as feeling weak, faint, and/or extremely dizzy. These symptoms can lead to an increased potential for accidents or other mishaps. 

Very often, overdoses on lisinopril occur in conjunction with other prescription medications to address hypertension, which can complicate the situation.

Chronically taking too much lisinopril can lead to long-term problems with hypotension (low blood pressure) that may later lead to organ damage and even renal failure. Dizziness, lethargy, mild confusion, and other effects warrant an immediate call to the prescribing physician.

Interactions with Other Medications

Lisinopril can have interactions with more than 600 different medications.

Many of these interactions can produce moderate-to-severe effects, depending on the person, the amount of the medication they are using, and other factors. This is one of the reasons why lisinopril can only be obtained legally with a prescription from a physician.

As mentioned above, when an individual is being considered for a prescription of lisinopril, they should discuss their use of other medications, including over-the-counter medications and all prescription medications, with their physician. Individuals using illicit drugs should reveal this practice to their physician before taking lisinopril.

Discontinuing Lisinopril

When using any prescribed medication, individuals should never suddenly stop using the medication unless they are instructed to do so by their physician.

The use of most prescription medications and even many over-the-counter medications for periods of more than a few weeks will often produce changes in the system that can lead to issues with withdrawal symptoms if suddenly stopped. The abrupt discontinuation of lisinopril may lead to a rapid increase in blood pressure (rebound hypertension), which can be potentially serious.

Sometimes, people are under the mistaken impression that if they develop any level of physical dependence on a medication, they are addicted to it. Developing physical dependence on drugs used for medical reasons while under the supervision of a physician is not addiction.

If an individual is experiencing side effects or potential allergic reactions to the drug, they can stop using the medication, but should immediately contact their physician. Otherwise, if a person who has been taking lisinopril wishes to stop using the medication, they should discuss this with their physician.

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