Side Effects of Zestril (lisinopril)

Zestril (lisinopril) is an ACE inhibitor used to treat high blood pressure, heart failure, and prevent kidney failure due to high blood pressure and diabetes.

ACE is important because it produces angiotensin II, which narrows arteries and raises blood pressure.

Zestril lowers blood pressure by reducing the production of angiotensin II, relaxing arterial muscles and enlarging arteries.

Lowering blood pressure reduces the workload on the heart and increases blood and oxygen flow, especially in people with congestive heart failure.

In the kidneys, angiotensin II narrows arteries and damages them. Zestril reduces this damage by enlarging and lowering the blood pressure in the arteries going to the kidney.

Common side effects of Zestril include dizziness, nonproductive cough, nausea, headaches, anxiety, insomnia, drowsiness, nasal congestion, and sexual dysfunction.

Serious side effects of Zestril include a decrease in red blood cells, white blood cells, and platelets.

Zestril should be stopped if there are symptoms of an allergic reaction, such as swelling of the face, lips, tongue, or throat. Severe allergic reactions and hives may occur.

Drug interactions of Zestril include potassium supplements or diuretics and lithium, which can increase potassium levels, as well as aspirin and other nonsteroidal anti-inflammatory drugs which may reduce the effects of Zestril.

Combining injectable gold sodium aurothiomalate with ACE inhibitors like Zestril may cause nitritoid reactions.

Zestril should not be taken during pregnancy as it can be harmful to the fetus. It is unknown if Zestril is excreted in breast milk, so consult your doctor before breastfeeding.

What are the important side effects of Zestril (lisinopril)?

The first doses of lisinopril can cause dizziness.

This drug can also cause a nonproductive cough, which resolves when the drug is discontinued.

Lisinopril should be stopped if there are symptoms of an allergic reaction, including swelling of the face, lips, tongue, or throat. Severe allergic reactions and hives may occur.

Rarely, lisinopril may cause a decrease in red blood cells, white blood cells, and platelets.

Why does lisinopril cause a cough?

Like all ACE inhibitors, lisinopril can cause a nonproductive cough that resolves when the drug is discontinued.

Zestril (lisinopril) side effects list for healthcare professionals

Clinical Trials Experience

Adverse reaction rates observed in clinical studies cannot be directly compared between drugs and may not reflect real-world rates.

Hypertension

In clinical trials, 5.7% of patients on Zestril discontinued due to adverse reactions. The most commonly observed adverse reactions with Zestril alone were headache, dizziness, and cough.

Heart Failure

In patients with heart failure, 11% discontinued Zestril due to adverse reactions. The most commonly observed adverse reactions with Zestril were hypotension and chest pain.

In a two-dose ATLAS trial, adverse reactions more commonly occurred in the high dose group and included dizziness, hypotension, increased creatinine, hyperkalemia, and syncope.

Acute Myocardial Infarction

Patients treated with Zestril had a higher incidence of hypotension and renal dysfunction compared to those not taking Zestril.

Other clinical adverse reactions occurring in 1% or higher of patients with hypertension or heart failure treated with Zestril in controlled trials include fatigue, orthostatic effects, bone marrow depression, hemolytic anemia, leukopenia/neutropenia, thrombocytopenia, diabetes mellitus, inappropriate antidiuretic hormone secretion, urticaria, alopecia, photosensitivity, and more.

Clinical Laboratory Test Findings

Hyperkalemia occurred in 2.2% and 4.8% of Zestril-treated patients with hypertension and heart failure, respectively. Minor increases in blood urea nitrogen and serum creatinine were observed in about 2% of hypertensive patients treated with Zestril, mainly in those receiving concomitant diuretics.

In patients with acute myocardial infarction, Zestril treatment was associated with a higher incidence of renal dysfunction.

Small decreases in hemoglobin and hematocrit occurred frequently in patients treated with Zestril, but were rarely of clinical importance. Less than 0.1% of patients discontinued therapy due to anemia.

Post-marketing Experience

Other adverse reactions reported after approval include hyponatremia, hypoglycemia, mood alterations, mental confusion, hallucinations, and more.