In the US, around 108 million of the adult population is reportedly hypertensive. This accounts for 45% of the adult population, and the cause for concern is the number of individuals who have the condition under control. Only 25% of the patients with hypertension have the condition under control. Different types of medications are presently used for managing the condition, including – diuretics. ACE inhibitors, alpha blockers, angiotensin II receptor blockers, combined alpha and beta blockers etc. ACE inhibitors are one among the popularly used medications and we will look at the side effects of Lisinopril, one of the commonly used ACE Inhibitors.
Drug overview and side effects of Lisinopril
In medical use for more than 3 decades, Lisinopril belongs to the category of ACE inhibitors and is used for treating conditions that are related to each other. Unlike most other ACE inhibitors the drug does not belong to the category of prodrugs. Tt is prescribed for treating hypertension, myocardial infarction and heart failure and works by preventing the angiotensin converting enzyme. Additionally, the drug also prevents the inhibition of renin angiotensin aldosterone. Before we look at the side effects of Lisinopril it is time to understand the mechanism of action of the drug.
Mechanism of action of Lisinopril
Used as a first line therapy, Lisinopril is known to have a wide therapeutic index – which effectively means that overdosage possibility is restricted. The medication is also known to have a long duration of action which makes it a better choice as long-term medication. The drug works by constricting coronary blood vessels, and as a result reduces vascular resistance. The action of the medication is classified as positively inotropic, which effectively means that it strengthens the heart-beat. The drug specifically prevents angiotensin I to convert to angiotensin II and this effectively prevents myocyte hypertrophy. Similarly, the action of the drug prevents smooth muscle cell proliferation. The combined effects of the drug, help to mange the symptoms and manifestations associated with the various conditions it treats. Let us now look at the side effects of Lisinopril.
Commonly reported side effects of Lisinopril
All medications have side effects and Lisinopril is no exception, and the side effects are typically attributed to the mechanism of action of the medication. Commonly reported side effects of Lisinopril include angioedema, hypotension and cough. The medication is known to cause a sudden swelling in the limbs, intestines and in the face. In rare instances, this swelling can actually end up as a fatal manifestation. Indications of this condition include pain in the abdomen and sudden onset of swelling. Patients with a history of angioedema are at heightened risk of the condition.
Similarly, the drug is also known to end up causing low blood pressure. This is typically experienced during the initial stages of taking the medication. Possible indications of hypotension include a light headed and dizzy feeling. The condition could aggravate if the patients are on diuretics or undergoing dialysis. Patients who are known to sweat profusely, or who do not consume enough fluids are also at risk of aggravating the condition. Additionally, individuals who either vomit or have bouts of diarrhea are also at risk of losing fluids and therefore aggravating the condition. Other side effects of Lisinopril include a cough that does not go away. In most cases, this condition will resolve once the individual stops the medication. Individuals on the4 medication are expected not to drive or operate equipment that require constant attention or high levels of alertness. Lowered blood pressure and pain in the chest are other possible side effects that may be experienced by the patient. When these conditions persist for a period beyond two weeks, it is advisable to seek medical attention.
Side effects of Lisinopril that are serious in nature
Side effects of Lisinopril can also be serious in nature and warrant urgent attention. For instance, individuals who experience severe allergic reactions need medical attention as this could be life endangering in nature. Patients who experience difficulty in swallowing food or drinking water need to be self-aware. Similarly, individuals who experience any difficulty in breathing should also seek appropriate medical attention. Other indications of side effects that are serious in nature include tiredness and abrupt increase in weight. This could mean that the drug has caused problems in the kidneys.
Other symptoms include a swelling in the limb extremities and difficulty in breathing. The drug could also result in causing liver complications in a section of people. For instance, individuals who observe the skin color turning yellow or if the whites of the eyes begin to turn yellow, need to seek medical attention as this could indicate liver problems. The drug is known to cause an elevation of liver enzymes, pain in the stomach and feelings of nausea/vomiting. An increase in potassium levels is considered as one among the side effects of Lisinopril that are regarded as serious. This could result in an impact on heart rhythm and the rate of heart beat. The risks could end up further aggravated when the individual has other comorbidities, such as diabetes or problems in the kidney.
Black box warning medication
Lisinopril belongs to the category of medication that come with a black box warning. Considered as the most serious warning of the US FDA, a black box warning effectively means that the contents of the medication are not to be taken by pregnant women and by women planning pregnancy. This also indicates that the medication could end up harming the baby in the womb or could also fatally harm the baby. Women on the medication who have not planned for pregnancy, but end up turning pregnant need to seek urgent medical advice on bringing down blood pressure levels.
Drug interactions of Lisinopril
In addition to the side effects of Lisinopril there are also possible drug interactions from the medication. This includes herbal supplements or vitamin supplements that patients may be consuming. For instance, the medication is known to interact with certain other drugs that are used for treating blood pressure. The interaction could result in a lowering of blood pressure, beyond the desired levels. There could also be other problems such as possible kidney failure. This medication has known side effects with ARB medications used for managing blood pressure. Similarly, the medication is also known to result in drug interactions when taken in combination with other ACE inhibitors and Renin inhibitors.
Individuals on diabetes medication are also expected to exercise caution as the medication can result in a lowering of blood sugar levels beyond the desired outcomes. This includes oral medications and insulin that are typically used for managing the condition. Other drug interactions that need mention include diuretics. Patients on water pills are at risk of ending up lowered blood pressure levels and are therefore advised to seek medical advice regarding the same. In addition to the side effects of Lisinopril mentioned earlier, patients on the medication also need to exercise caution while combining the medication with other potassium supplements and diuretics. The consequence of this combination is a spike in the potassium levels which could cause other serious manifestations.
The need for caution when taking other medications with Lisinopril
Patients on other medication such as mood stabilizer medications, would experience an increase in the effects of the medication when taken alongside Lisinopril. Similarly, patients on pain killers may experience impaired kidney functions due to the combination of Lisinopril and pain killers, including non-steroidal anti-inflammatory drugs. The side effects of Lisinopril extend to the drug interactions with medications that are used for suppressing the body’s rejection of transplanted organs. The combination of Lisinopril with these medications can end up with angioedema, which can in turn be serious in nature. The drug also interacts with alcohol, and individuals who consume alcohol alongside this medication may end up with lowered blood pressure levels.
Education: Doctor of Pharmacy (PharmD) from the University of Florida. Experience: 5 years as a pharmacist and medical writer, creating content on medication management and pharmaceutical news for healthcare blogs and patient education sites.
