2 Before you take
Do not take Lisinopril tablets and tell your doctor if you
- are allergic (hypersensitive) to lisinopril, other ACE inhibitors (such as captopril, ramipril) or any of the other ingredients in Lisinopril tablets (see section 6).
- have previously had allergic reactions with swollen legs, arms, face, mucous membranes and tongue with ACE inhibitors.
- or any of your family have experienced allergic symptoms, which may be unrelated to the use of medicines.
- are more than 3 months pregnant. (It is also better to avoid Lisinopril tablets in early
pregnancy – see pregnancy section.)
Check with your doctor or pharmacist before taking Lisinopril tablets if you:
- are dehydrated due to sickness and diarrhoea, use of diuretics (water tablets), on a low salt diet or have severe renin-dependent hypertension.
- have reduced blood flow to the heart (ischaemic heart disease) or disease of the blood vessels in the brain (cerebrovascular disease).
- have any of the following heart diseases: heart failure, narrowing (stenosis) of the opening of the aortic or mitral valve or enlarged heart (hypertrophic cardiomyopathy).
- have had a heart attack and have low blood pressure or are in cardiogenic shock.
- have reduced kidney function, narrowing of the arteries supplying the kidneys or renovascular hypertension (high blood pressure due to a blockage in a blood vessel in the kidney).
- are having dialysis or have had a kidney transplant.
- are receiving treatment to lessen your reactions to bee or wasp stings or for so called LDL apheresis.
- have had surgery on your airways.
- have problems with your immune system due to some illness or medicines such as scleroderma, lupus erythematosus, allopurinol, procainamide or drugs to suppress the immune system (especially if you also have impaired kidney function). You should tell your doctor if you have any sign of infection.
- have diabetes.
- are Afro-Caribbean. If you are taking Lisinopril tablets as the only treatment for your high blood pressure, you may have a reduced response to this medicine. This may mean that you may need a higher dose than usually recommended.
Take special care with Lisinopril tablets
You must tell your doctor if you think you are (or might become) pregnant. Lisinopril tablets are not recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as they may
cause serious harm to your baby if used at that stage (see pregnancy section).
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
Diuretics (water tablets) - cause a large drop in blood pressure.
Potassium-sparing diuretics (e.g. spironolactone, triamterene or amiloride), potassium supplements, potassium salts or any other medicines that can increase levels of potassium in the blood such as heparin. Frequent monitoring of the potassium levels in the blood is necessary.
Anaesthetics - the blood pressure lowering effect of Lisinopril tablets is enhanced when
taken with these medicines. Therefore, it is important that the doctor/hospital is informed about your treatment with Lisinopril tablets.
Lithium (used to treat depression) - when taken with Lisinopril tablets an increase of lithium levels may occur. Frequent monitoring of lithium levels in blood is necessary.
Non-steroidal anti-inflammatory drugs (NSAIDs - pain killer and anti-inflammatory medicine) including aspirin (doses of 3g a day) - may reduce the blood pressure lowering effect of Lisinopril tablets. These medicines also cause an increase in potassium levels in blood and reduce kidneys function.
Allopurinol (used to treat gout), medicines used to suppress the immune system or procainamide (used to treat heart rhythm disorders).
- Tricyclic antidepressants, muscle relaxants or antipsychotics – may further reduce your blood pressure.
Sympathomimetics (used in asthma) - may reduce the blood pressure lowering effect of Lisinopril tablets.
Antidiabetics (tablets and insulin)- when taken with Lisinopril tablets blood glucose may be reduced further, particularly during the first weeks of treatment with Lisinopril tablets and in patients with reduced kidney function.
- Other blood pressure lowering medicines e.g. fosinopril - cause an increase in the blood pressure lowering effect when taken together with Lisinopril tablets.
Glyceryl trinitrate, other nitrates or vasodilators e.g. hydralazine - may lower
your blood pressure further.
Gold – may cause flushing, dizziness, blood pressure to drop too much or feeling sick.
Pregnancy and breast-feeding
You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Lisinopril tablets before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Lisinopril tablets. Lisinopril tablets are not recommended in early pregnancy, and must not be taken when more than 3 months pregnant, as they may cause serious harm to your baby if used after the third month of pregnancy.
Tell your doctor if you are breast-feeding or about to start breast-feeding. Lisinopril tablets are not recommended for mothers who are breast-feeding, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your baby is newborn, or was born prematurely.
Driving and using machines
Use of Lisinopril tablets may cause side effects such as dizziness, tiredness or confusion which may affect your ability to drive or operate machinery. Make sure you are not affected before driving or operating machinery.
Your doctor may want to carry out tests to monitor your kidney function and the amount of potassium in your blood.
You should inform your doctor that you take Lisinopril tablets if you are having an operation or an anaesthetic.
4 Possible side effects
Like all medicines, Lisinopril tablets can cause side effects, although not everybody gets them.
Stop taking Lisinopril tablets and contact your doctor immediately if you develop:
- yellowing of the skin or whites of the eyes (jaundice).
- an increase in liver enzymes (seen in a blood test).
- symptoms of an allergy (hypersensitivity): swelling of the face, lips, tongue, throat, hands or feet, difficulty breathing or swallowing.
Tell your doctor if you notice any of the following side effects or they get worse:
Common side effects
(occur in less than in 1 out of 10 patients)
Dizziness, low blood pressure (causing dizziness especially on standing), cough, diarrhoea, being sick, headache, impaired kidney function.
Uncommon side effects
(occur in less than in 1 out of 100 patients)
Changes in mood, ‘pins and needles’ or tingling, spinning sensation, taste disturbance, sleep disorder, heart attack or stroke possibly as a result of excessive low blood pressure in high risk patients, palpitations, a racing heart beat, condition causing pain, numbness, coldness and blueness of the fingers (Raynaud’s phenomenon), running nose, feeling sick, stomach pain, indigestion, reduced sexual potency in men, tiredness, weakness or loss of strength, increases in blood urea, creatinine and potassium levels, rash, itching.
Rare side effects
(occur in less than in 1 out of 1,000 patients)
Decreases in haemoglobin and haematocrit, mental confusion, dry mouth, pale or red irregular raised patches with severe itching (hives), hair loss, psoriasis (itchy scaly pink patches on the elbows, knees, scalp and other parts of the body), high levels of urea and other waste products in the blood due to kidney failure, acute kidney failure, enlarged breasts in men, increases in blood levels of bilirubin, decreases in blood levels of sodium, syndrome of inappropriate antidiuretic hormone secretion (SIADH).
Very rare side effects
(occur in less than 1 out of 10,000 patients, including isolated reports)
Reduced production of blood cells by the bone marrow, lymph node disease – enlargement of lymph nodes, autoimmune disease, changes in the numbers and types of your blood cells (anaemia, thrombocytopenia, eosinophilia, leucocytosis, leucopenia, neutropenia, agranulocytosis, haemolytic anaemia). If you notice increased bruising, nosebleeds, sore throats, infections, excessive tiredness, breathlessness on exertion or abnormal paleness of the skin, you should tell your doctor who may want you to have a blood test, low blood sugar levels, narrowing of the airways, sinusitis, inflammation or infection of the lungs due to an allergy (allergic alveolitis or eosinophilic pneumonia), inflammation of the liver (hepatitis) or pancreas, swelling of the intestines (intestinal angioedema), liver failure, an abnormally low or non production of urine, sweating, serious blistering skin disease (pemphigus), severe rash involving reddening, peeling and swelling of the skin that resembles severe burns (toxic epidermal necrolysis), severe form of skin rash with flushing, fever, blisters or ulcers (Stevens-Johnson Syndrome), widespread skin rash – circular, irregular red patches on the skin of the hands and arms (erythema multiforme), ‘symptom complex’ which may include one or more of the following: fever, blood vessel inflammation, muscle pain (myalgia), joint pain (arthralgia) or inflammation (arthritis), blood changes (such as positive antinuclear antibodies, elevated red blood cell sedimentation rate), sensitivity to sunlight or artificial light (e.g. sun beds), rash or other skin reactions.
Frequency unknown: fainting, depression.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
This leaflet was last revised in May 2012.