Meta Information
ID:lisinopril
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Lisinopril can cause significant injury and even death to a developing fetus, particularly during the second and third trimesters. This is a boxed warning from the FDA.
Actionable advice:
Lisinopril is absolutely contraindicated during pregnancy; stop taking it immediately and contact your doctor if you become pregnant.
Target id:
/condition/history-of-angioedema
Target name:
History of Angioedema
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Patients with a history of angioedema (hereditary, idiopathic, or related to previous ACE inhibitor use) are at a very high risk of a recurrence, which can be life-threatening.
Actionable advice:
Do not take lisinopril if you have any history of angioedema.
Target id:
/intervention/sacubitril-valsartan
Target name:
Sacubitril/Valsartan (Entresto)
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
36
Hours after target:
36
Description:
Taking lisinopril and sacubitril (a neprilysin inhibitor) close together dramatically increases the risk of angioedema, a serious and potentially fatal swelling of the face, lips, and airway.
Actionable advice:
Do not take lisinopril within 36 hours (before or after) of taking sacubitril/valsartan.
Target id:
/class/potassium-sparing-diuretics
Target name:
Potassium-Sparing Diuretics
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Both lisinopril and potassium-sparing diuretics (e.g., spironolactone, amiloride) reduce the body's excretion of potassium, leading to a high risk of dangerous hyperkalemia (excessively high blood potassium).
Actionable advice:
Avoid using these medications together unless under strict medical supervision with frequent potassium monitoring.
Target id:
/intervention/potassium
Target name:
Potassium Supplements
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Lisinopril causes the body to retain potassium. Taking potassium supplements at the same time can easily lead to dangerously high potassium levels (hyperkalemia), which can affect heart rhythm.
Actionable advice:
Avoid all potassium supplements unless specifically prescribed and closely monitored by your doctor.
Target id:
/dietary/potassium-salt-substitutes
Target name:
Potassium-Containing Salt Substitutes
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Many salt substitutes replace sodium with potassium chloride. Using these products while taking lisinopril can cause dangerously high blood potassium levels (hyperkalemia).
Actionable advice:
Do not use salt substitutes that contain potassium; check the ingredient label carefully.
Target id:
/class/arbs
Target name:
Angiotensin II Receptor Blockers (ARBs)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Combining an ACE inhibitor (lisinopril) with an ARB (e.g., telmisartan, losartan) is known as dual RAAS blockade. This combination significantly increases the risk of low blood pressure, high potassium, and kidney failure without providing additional benefits.
Actionable advice:
Never take lisinopril together with an ARB.
Target id:
/intervention/aliskiren
Target name:
Aliskiren
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
The combination of lisinopril and aliskiren (a direct renin inhibitor) is contraindicated in patients with diabetes or renal impairment due to a high risk of hypotension, hyperkalemia, and acute kidney injury.
Actionable advice:
Do not take lisinopril with aliskiren, especially if you have diabetes or kidney disease.
Target id:
/intervention/lithium
Target name:
Lithium
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Lisinopril reduces the kidneys' ability to clear lithium from the body. This can lead to a toxic buildup of lithium, causing serious side effects.
Actionable advice:
Avoid this combination; if it is medically necessary, lithium levels must be monitored extremely closely.
Target id:
/biomarker/serum-potassium
Target name:
Serum Potassium Level
Severity:
major
Interaction type:
requirement
Nature:
absolute
Description:
Because lisinopril can cause potassium retention, it is essential to monitor blood potassium levels to prevent hyperkalemia, which can lead to serious cardiac arrhythmias.
Actionable advice:
Ensure your serum potassium is checked before starting and periodically during therapy as directed by your doctor.
Target id:
/biomarker/creatinine
Target name:
Serum Creatinine
Severity:
major
Interaction type:
requirement
Nature:
absolute
Description:
Lisinopril can affect kidney function, particularly when starting therapy or in at-risk individuals. Monitoring creatinine (and eGFR) is crucial to ensure renal safety.
Actionable advice:
Ensure your kidney function is checked before starting and periodically during therapy as directed by your doctor.
Target id:
/class/nsaids
Target name:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
NSAIDs (e.g., ibuprofen, naproxen) can reduce the blood pressure-lowering effect of lisinopril and, when used together, increase the risk of kidney damage, especially in the elderly or dehydrated individuals.
Actionable advice:
Avoid chronic use of NSAIDs; for occasional pain relief, consider acetaminophen as a safer alternative.
Target id:
/class/diuretics
Target name:
Diuretics (Water Pills)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Initiating lisinopril in a patient already taking a diuretic can cause a sharp, excessive drop in blood pressure (first-dose hypotension), leading to significant dizziness or fainting.
Actionable advice:
Your doctor may advise stopping the diuretic for a few days before starting lisinopril or initiating it at a very low dose.
Target id:
/class/mtor-inhibitors
Target name:
mTOR Inhibitors (e.g., Rapamycin/Sirolimus)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Taking an ACE inhibitor like lisinopril with an mTOR inhibitor may increase the risk of developing angioedema, a serious swelling reaction.
Actionable advice:
Use this combination with caution and be vigilant for signs of angioedema (swelling of the face, lips, or tongue).
Target id:
/class/dpp4-inhibitors
Target name:
DPP-4 Inhibitors (e.g., Sitagliptin)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Concomitant use of a DPP-4 inhibitor (a type of diabetes medication) with an ACE inhibitor may increase the risk of developing angioedema.
Actionable advice:
If taking these together, be aware of the signs of angioedema (swelling of the face, lips, or tongue) and seek medical help if they occur.
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications (e.g., Insulin, Metformin)
Severity:
moderate
Interaction type:
synergistic
Nature:
absolute
Description:
Lisinopril can improve insulin sensitivity, which may enhance the glucose-lowering effect of diabetes medications and increase the risk of hypoglycemia (low blood sugar).
Actionable advice:
Monitor your blood glucose levels closely, especially during the first few weeks of taking lisinopril.
Target id:
/condition/renal-impairment
Target name:
Renal Impairment (Kidney Disease)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Since lisinopril is cleared by the kidneys, impaired renal function increases the risk of drug accumulation, hyperkalemia, and further kidney damage. Lower starting doses are required.
Actionable advice:
Your dose must be adjusted based on your kidney function; close monitoring is essential.
Target id:
/condition/dehydration
Target name:
Dehydration
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Being dehydrated (e.g., from vomiting, diarrhea, or excessive sweating) significantly increases the risk of a severe drop in blood pressure (hypotension) and acute kidney injury when taking lisinopril.
Actionable advice:
Ensure you maintain adequate fluid intake, and consult a doctor if you become severely dehydrated.
Target id:
/dietary/alcohol-acute
Target name:
Alcohol
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Alcohol can potentiate the blood pressure-lowering effects of lisinopril, leading to increased dizziness, lightheadedness, or fainting.
Actionable advice:
Limit alcohol intake and be cautious when rising from a sitting or lying position.
Target id:
/class/antihypertensives
Target name:
Other Antihypertensive Medications
Severity:
moderate
Interaction type:
synergistic
Nature:
absolute
Description:
Using lisinopril with other blood pressure-lowering drugs (e.g., beta-blockers, calcium channel blockers) has an additive effect. This is often intentional but requires monitoring to avoid hypotension.
Actionable advice:
Monitor your blood pressure regularly, especially when adding a new medication, and report any symptoms of dizziness.
Target id:
/intervention/trimethoprim
Target name:
Trimethoprim (Antibiotic)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
The antibiotic trimethoprim can increase serum potassium levels, and its use with lisinopril significantly elevates the risk of developing hyperkalemia.
Actionable advice:
If this combination is necessary, use with caution and ensure potassium levels are monitored.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
It is not definitively known if lisinopril is excreted in human milk. Due to the potential for serious adverse reactions in a nursing infant, a decision should be made whether to discontinue nursing or the drug.
Actionable advice:
Discuss treatment options with your doctor, as an alternative medication may be preferred while breastfeeding.
Target id:
/dietary/potassium-rich-foods
Target name:
High-Potassium Foods
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Description:
While normal dietary intake is generally safe, excessive consumption of high-potassium foods (e.g., bananas, oranges, potatoes, spinach) can contribute to elevated potassium levels, especially in those with kidney disease.
Actionable advice:
Consume high-potassium foods in moderation and avoid excessive, consistent intake.
Target id:
/intervention/gold-sodium-thiomalate
Target name:
Injectable Gold (for Arthritis)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Description:
Rarely, patients on ACE inhibitors have experienced nitritoid reactions (symptoms include facial flushing, nausea, vomiting, and hypotension) during or shortly after injections of gold.
Actionable advice:
Be aware of this potential reaction if you receive injectable gold therapy.