Lisinopril

What it is

Lisinopril is an ACE inhibitor. It blocks the enzyme that converts angiotensin I to angiotensin II, so blood vessels stay dilated and the kidney retains less salt and water; it also reduces the strain and remodelling that follow a failing heart. It is prescribed for high blood pressure and for heart failure.

Used for

• Hypertension
• Heart failure

What to know while taking it

Food does not matter and it is usually taken in the morning. Because it lowers aldosterone it holds potassium back, so spironolactone and potassium or magnesium aspartate supplements can push potassium too high, while ibuprofen and diclofenac blunt the blood-pressure effect and strain the kidneys alongside it. Potassium, sodium, creatinine and eGFR are checked after starting and after changes, and zinc stores can fall over time. A dry persistent cough is a recognised effect of the drug class, not an infection, and it is not used in pregnancy because of harm to the developing kidneys.

When to see a doctor

Swelling of the lips, tongue or throat, or difficulty breathing, is an emergency. Muscle weakness or an irregular heartbeat, a sharp fall in urine output, fainting, or a pregnancy discovered or planned while on it all mean see a doctor rather than adjusting anything alone.

Worth knowing

• Can raise potassium
• Dry cough is a known effect
• Not during pregnancy
• Caution with kidney disease

Markers to watch

• Potassium
• Creatinine
• eGFR
• Sodium

Nutrients affected

• potassium — raised by (Potassium)
• zinc — depleted by (Free T3, Testosterone, TSH)