Medical Hex

Lisinopril (Zestril) Side Effects

1. Overview

Lisinopril (Prinivil, Zestril) is an antihypertensive agent that belongs to a class of drugs known as angiotensin-converting enzyme inhibitors (ACE-inhibitors). Lisinopril is used in the treatment of high blood pressure, kidney disease and heart failure.

Generic name Lisinopril
Brand name Prinivil, Zestril
Drug class Angiotensin-converting enzyme inhibitors
Drug group Antihypertensive
Black box warnings Pregnancy

It acts by preventing the conversion of angiotensin I to angiotensin II (a potent vasoconstrictor), and thus, decreases blood pressure.

Lisinopril can cause various adverse reactions, most commonly rash and persistent dry cough. To minimize these effects a reduction of dosage may necessary.

2. Common Lisinopril side effects

- Rash

- Persistent dry cough

- Headache

- Dizziness

- Postural hypotension

3. Less Common side effects

- Hyperkalemia (high potassium level in the blood)

- Nephrotoxicity

- Chest discomfort

- Upper respiratory infection

- Fatigue

- Abdominal pain

- Vomiting

- Nausea

- Diarrhea

- Hallucination

- Changes in mood

4. Rare side effects

- Angioedema

- Liver failure

- Palpitations (a suddenly noticeable heartbeat)

- Tachycardia

- Insomnia

- Paresthesia (prickling sensation)

- Muscle cramps

- Gynecomastia (abnormal enlargement of breasts in males)

- Bone marrow depression

- Autoimmune disorders

- Mouth ulcers

- Sore throat

- Fever

- Breathing difficulty

5. Overdose symptoms

- Excessive hypotension (occur in patients with heart failure)

- Swelling of face and lips (Angioedema)

- Hyperkalemia

- Agranulocytosis and neutropenia (may be noted in patients with collagen vascular disease)

- Nephrotic syndrome (might be noted in patients with a history of renal disease)


1. Kizior, R.J. and Hodgson, B.B. (2018). Saunders nursing drug handbook 2019. Philadelphia: Saunders.

2. British Medical Association (2015). British Medical Association new guide to medicine & drugs. London: Dorling Kindersley.

3. Joint formulary committee, BNF 80 (The British National Formulary), 80th Revised edition, Pharmaceutical Press, London, United Kingdom, [2020].

4. Kolesar, J.M. (2016). Mcgraw-hill’s 2018/2019 top 300 pharmacy drug cards.

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