Universal Drugstore logo

October 1 - Service Level Update – Please Read - More info

What is the Biggest Side Effect of Lisinopril?

Key Takeaways

  • The most talked about side effect of lisinopril is a persistent dry cough, affecting up to 35% of patients taking this medication.
  • The cough is more common in older adults, women, and non-smokers.
  • While annoying, the dry cough is generally harmless. It does often lead people to discontinue treatment.
  • Other serious side effects include low blood pressure, high potassium levels, and angioedema (swelling in different parts of your body, including the face, throat, and tongue).
  • Most side effects are mild and resolve on their own or can be managed by your healthcare provider.

If you’ve recently started taking lisinopril to treat high blood pressure or heart failure, it is important to know what side effects to expect. As one of the most commonly prescribed ACE inhibitors, it is generally well-tolerated. But like all medications, it can cause adverse effects. While there are several side effects of lisinopril to be aware of, the answer to what is the biggest side effect of lisinopril is clear. A persistent, dry cough is responsible for more people stopping treatment than any other side effect. Keep reading to understand why it happens and what can be done about it.

The Biggest Side Effect: Persistent Dry Cough

When it comes to the side effects of lisinopril, a dry cough is the one that most people know about. It isn’t a minor throat clearing. Instead it is more like this:

  • Dry and unproductive (no mucus).
  • Worse at night or when you are lying down.
  • May feel like a tickle or scratch in your throat.
  • Doesn’t respond well to typical cough medications.
  • Can develop anywhere from days to months after starting lisinopril treatment.

Studies show that up to 35% of patients ACE inhibitors like lisinopril experience this dry cough. It’s the leading cause of people stopping lisinopril treatment. The cough often continues as long as you’re taking lisinopril and many people find that it interferes with their sleep, work, and daily activities.

Research reveals interesting differences in how this side effect affects different populations. Black patients have significantly higher rates of cough-related discontinuation at 9.6% compared to 2.4% in other ethnic groups. This suggests that genetic factors may influence how likely you are to develop this troublesome side effects.

Why Lisinopril Causes This Troublesome Cough

Understanding how does lisinopril work helps explain why this cough occurs. Lisinopril belongs to a drug class called angiotensin converting enzyme (ACE) inhibitors. By blocking the ACE enzyme, it helps lower blood pressure by relaxing blood vessels.

Doing this also prevents the breakdown of a substance called bradykinin. When it accumulates in your body, it can irritate and inflame your respiratory tract, and make your cough reflex more sensitive. This cough is common in all other ACE inhibitors because they work the same way.

Who’s Most Likely to Experience the Dry Cough

Not everyone taking lisinopril develops a cough. Some risk factors include:

  • Previous cough with other ACE inhibitors
  • Older adults
  • Cough reflex sensitivity
  • Females
  • Being a non-smoker
  • Airway diseases like asthma or chronic obstructive pulmonary disease (COPD)

Other Common Side Effects of Lisinopril

While the dry cough may be the most known side effect, taking lisinopril can cause several other side effects that you should be aware of:

Low blood pressure (hypotension). This can make you feel dizzy, especially when standing up quickly. It may lead to fainting in severe cases. Hypotension is more common when starting treatment or when your dose is increased. This side effect often improves as your body adjusts to lisinopril.

Headaches. This is more common during when you first start taking lisinopri. They are usually mild and resolve within a few weeks of starting therapy.

High potassium levels (hyperkalemia). Lisinopril affects how your kidneys get rid of potassium. This is more likely to occur if you have kidney disease or take other medicines that increase your potassium levels. Hyperkalemia can cause muscle weakness, chest pain, or irregular heartbeat. Your healthcare provider should regularly monitoring this as well as your kidney function.

Gastrointestinal (GI) issues. Nausea and stomach pain are a relatively common side effect. Some patients may also experience diarrhea, indigestion, or abdominal or stomach pain. These are typically mild and go away on their own.

Fatigue and weakness. Unusual tiredness affects some patients, and it may be related to lower blood pressure. This often improves as your body adjusts to the medication.

Serious Side Effects That Require Immediate Attention

Most side effects of lisinopril are easily tolerated. However, if you experience any of these serious and potentially life threatening symptoms, call your doctor immediately:

Angioedema (serious allergic reaction). Symptoms include a sudden swelling of face, lips, tongue, or throat and trouble breathing. This is more common in people with a history of allergies. If you experience any facial swelling, seek immediate medical attention.

Severe allergic reactions. In addition to angioedema, some patients develop widespread allergic reactions. Symptoms may include rash (hives), difficulty breathing, and swelling of the face, tongue, or throat. This reactions can be life threatening and needs emergency treatment.

Dangerously low blood pressure. While lower blood pressure is the goal of treatment, dropping it to low can be dangerous. This is more likely to happen when starting lisinopril or if you are taking other drugs to lower your blood pressure. Symptoms include severe dizziness, fainting, or falls.

Kidney function problems. Sympoms can include decreased urination, swelling, or unusual tiredness. Regular blood tests should be performed to monitor for kidney problems.

Liver issues. Though rare, serious liver problems can occur. Watch for yellowing of your skin or eyes (jaundice), severe stomach pain, or dark urine. Any signs of severe liver disease require immediate medical attention.

Extremely high potassium levels (hyperkalemia). This can affect your heart rhythm and be very dangerous. Symptoms include muscle weakness, tingling, irregular heartbeat, or general feeling of discomfort.

Managing the Dry Cough and Other Side Effects

If you’re experiencing a persistent dry cough or other side effects while taking lisinopril here are some suggestions to deal with them:

Dry cough:

  • Switch medications: Your healthcare provider may recommend an angiotensin receptor blocker (ARB) instead of lisinopril. These medications work similarly to lower high blood pressure but don’t affect bradykinin levels.
  • Cough suppressants: While not typically effective, some patients may find relief with over-the-counter cough medications.
  • Timing adjustments: Taking lisinopril at bedtime may reduce daytime coughing.
  • Drink plenty of water: Staying well-hydrated can help soothe throat irritation.

Low blood pressure and dizziness:

  • Get up slowly from lying or sitting position.
  • Stay hydrated, especially in hot weather or when exercising.
  • Avoid drinking alcohol, which can worsen low blood pressure.

Managing potassium levels:

  • Follow dietary restrictions on high-potassium foods if recommended.
  • Avoid salt substitutes that contain potassium.
  • Be careful with potassium supplements unless prescribed by your doctor.
  • Keep regular appointments for blood tests to monitor your potassium levels.

Stomach side effects:

  • Take lisinopril tablets with food if stomach pain occurs.
  • Stay hydrated to prevent dehydration if you are having diarrhea.
  • Report severe or continuing nausea to your healthcare provider.

You should work closely with your licensed healthcare professional if you are experiencing bothersome side effects. Many of these improve with time, but persistent problems may require medication adjustments or alternatives.

Frequently Asked Questions

Will the dry cough go away if I continue taking lisinopril?

Unfortunately, the dry cough caused by lisinopril rarely goes away on its own while taking lisinopril. Most people who develop this cough will need to switch to an different medication like an ARB to resolve the issue.

Can I take cough medicine while on lisinopril?

You can try over-the-counter cough suppressants, but they’re not typically very effective for ACE inhibitor-induced cough. Always check with your healthcare provider before adding new medications, as some cough medicines may interact with lisinopril or affect blood pressure. Avoiding drug interactions is important for your safety.

Are there alternatives to lisinopril that don’t cause cough?

Yes, angiotensin receptor blockers (ARBs) work similarly to ACE inhibitors to treat high blood pressure and heart failure but don’t typically cause the dry cough. Examples include losartan, valsartan, and olmesartan. These medications work differently and avoid the bradykinin accumulation that causes coughing. Your doctor can determine if switching to an ARB is appropriate for your condition.

How long does it take for the cough to disappear after stopping lisinopril?

Most patients notice improvement in their cough within 1 to 4 weeks after stopping lisinopril. The timing depends on how long you’ve been taking the medication and other individual factors. In some cases, it may take several months for the cough to completely resolve. This is why it’s important not to restart ACE inhibitors if you’ve had this side effect.

Is the lisinopril cough dangerous to my health?

The dry cough itself is generally not dangerous and doesn’t cause permanent damage to your lungs or respiratory system. However, it can significantly impact your quality of life, sleep, and daily activities. The bigger concern is that the persistent cough may lead people to stop taking their blood pressure medication, which can be dangerous for heart health. This is why finding an alternative medication that you can tolerate long-term is so important.

Sources