Side Effects of lisinopril: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Main Research Findings

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor widely used for the treatment of hypertension and heart failure. 14 , 10 Lisinopril works by dilating blood vessels and lowering blood pressure. 17 However, there are several known side effects associated with lisinopril. 7 This review summarizes the side effects of lisinopril based on information obtained from relevant studies.

Reasons for Side Effects

Side effects of lisinopril may be related to the accumulation of vasodilating substances such as bradykinin due to ACE inhibition. 14 Lisinopril may also affect the kidneys and liver. 9

Common Side Effects

Cough

The most common side effect of lisinopril is cough. 2 This is believed to be caused by the accumulation of bradykinin. 14 Cough usually disappears when lisinopril administration is stopped. 10

Angioedema

Lisinopril may cause angioedema. 8 This is swelling of tissues such as the face, lips, tongue, and throat. 20 Angioedema can cause difficulty breathing in severe cases. 8 Angioedema usually disappears when lisinopril administration is stopped. 20

Hyponatremia

Lisinopril may cause hyponatremia. 24 This is a condition where there is too little sodium in the blood. 24 Hyponatremia can cause symptoms such as headache, nausea, and fatigue. 24 Hyponatremia usually disappears when lisinopril administration is stopped. 24

Hyperkalemia

Lisinopril may cause hyperkalemia. 24 This is a condition where there is too much potassium in the blood. 24 Hyperkalemia can cause symptoms such as changes in heart rate, muscle weakness, and nausea. 24 Hyperkalemia usually disappears when lisinopril administration is stopped. 24

Kidney Injury

Lisinopril may affect the kidneys. 9 Lisinopril can reduce kidney function. 9 Symptoms of kidney injury include decreased urine output, swelling, and fatigue. 9 Kidney injury usually disappears when lisinopril administration is stopped. 9

Liver Injury

Lisinopril may affect the liver. 9 Lisinopril can reduce liver function. 9 Symptoms of liver injury include jaundice (yellowing of the skin and whites of the eyes), fatigue, and loss of appetite. 9 Liver injury usually disappears when lisinopril administration is stopped. 9

Side Effects Countermeasures

Cough

Cough caused by lisinopril often disappears when lisinopril administration is stopped. 10 Switching to a different ACE inhibitor may also be effective. 19

Angioedema

Angioedema caused by lisinopril usually disappears when lisinopril administration is stopped. 20 In severe cases, treatment with antihistamines or steroids may be necessary. 8

Hyponatremia

Hyponatremia caused by lisinopril usually disappears when lisinopril administration is stopped. 24 In severe cases, treatment such as intravenous fluids may be necessary. 24

Hyperkalemia

Hyperkalemia caused by lisinopril usually disappears when lisinopril administration is stopped. 24 In severe cases, treatment such as dialysis may be necessary. 24

Kidney Injury

Kidney injury caused by lisinopril usually disappears when lisinopril administration is stopped. 9 In severe cases, treatment such as kidney transplantation may be necessary. 9

Liver Injury

Liver injury caused by lisinopril usually disappears when lisinopril administration is stopped. 9 In severe cases, treatment such as liver transplantation may be necessary. 9

Comparison of Studies

Commonalities

Many studies have shown that lisinopril is effective in treating hypertension. 17 Studies have also shown that lisinopril can cause side effects such as cough, angioedema, hyponatremia, hyperkalemia, kidney injury, and liver injury. 2 , 8 , 24 , 9

Differences

The incidence of lisinopril side effects varies from study to study. 2 For example, the incidence of cough caused by lisinopril ranges from 0.2% to 15% depending on the study. 2 This is believed to be due to differences in study design and participant characteristics. 2 Also, the incidence of angioedema caused by lisinopril ranges from 0.1% to 0.7% depending on the study. 7 Overall, these results suggest that lisinopril is an effective drug for treating hypertension but can cause some side effects.

Precautions for Application in Daily Life

Lisinopril is an effective drug for treating hypertension and heart failure, but it can cause some side effects. 17 It is important to talk to your doctor about these side effects before taking lisinopril. 17 It is also important to see your doctor regularly while taking lisinopril. 9

Limitations of Current Research

Research on the side effects of lisinopril is still ongoing. 9 In particular, there is not enough data on the effects of lisinopril when taken for a long time. 9 Also, the incidence of lisinopril side effects can vary greatly from person to person. 7 Therefore, further research on the side effects of lisinopril is needed. 7

Future Research Directions

Further research on the side effects of lisinopril is needed. 7 In particular, research on the effects of long-term lisinopril use, factors affecting the incidence of lisinopril side effects, and methods to reduce lisinopril side effects is important. 7

Conclusion

Lisinopril is an effective drug for treating hypertension and heart failure, but it can cause some side effects. 17 It is important to talk to your doctor about these side effects before taking lisinopril. 17 It is also important to see your doctor regularly while taking lisinopril. 9

Literature analysis of 26 papers
Positive Content
18
Neutral Content
0
Negative Content
8
Article Type
7
0
1
4
24
1.

Hypokalaemia and drinking green tea: a literature review and report of 2 cases.

Author: ChongSebastian Jen Kin, HowardKerry Antoinette, KnoxChloe

Hypokalaemia

This report describes a case of hypokalaemia associated with excessive green tea consumption in an Oriental couple. Reducing green tea consumption reversed the low potassium levels.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Wound healing, angiotensin-converting enzyme inhibition, and collagen-containing products: a case study.

Author: BuscemiCharles P, RomeoCarolAnn

Keloid prevention
Wound healing
Collagen deposition impairment

This study reviewed the effects of angiotensin-converting enzyme inhibitors (ACEIs) on wound healing. ACEIs may impair collagen deposition in cutaneous wounds, but have also been used to prevent or minimize keloid formation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

Clinical effects produced by a standardized herbal medicinal product of Hibiscus sabdariffa on patients with hypertension. A randomized, double-blind, lisinopril-controlled clinical trial.

Author: Herrera-ArellanoArmando, Miranda-SánchezJudith, Avila-CastroPedro, Herrera-AlvarezSara, Jiménez-FerrerJesús Enrique, ZamilpaAlejandro, Román-RamosRubén, Ponce-MonterHéctor, TortorielloJaime

ACE inhibition
Blood pressure reduction
Hypertension treatment
Dose-dependency
Serum sodium levels

Hibiscus sabdariffa L. (HsHMP) extract demonstrated significant antihypertensive effectiveness with a wide margin of tolerability and safety. It significantly reduced plasma ACE activity and demonstrated a tendency to reduce serum sodium concentrations without affecting potassium levels, supporting its potential as a natural antihypertensive agent.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Randomized Trial of Lisinopril Versus Carvedilol to Prevent Trastuzumab Cardiotoxicity in Patients With Breast Cancer.

Author: GuglinMaya, KrischerJeffrey, TamuraRoy, FinkAngelina, Bello-MatricariaLauren, McCaskill-StevensWorta, MunsterPamela N

Reduced cardiotoxicity
Reduced treatment interruptions

Lisinopril, an angiotensin-converting enzyme inhibitor, and carvedilol, a beta-blocker, were found to be effective in preventing trastuzumab-induced cardiotoxicity in patients with HER2-positive breast cancer who were receiving anthracyclines. A double-blind, placebo-controlled trial of 468 women showed that both lisinopril and carvedilol reduced the rate of cardiotoxicity and treatment interruptions compared to placebo. The study suggests that these drugs should be considered to minimize trastuzumab interruptions in patients receiving anthracyclines.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Underreported Risk of Lisinopril-Induced Angioedema in a Veteran Population.

Author: WhiteheadWhitley J, ReidJennifer Meyer

Lisinopril angioedema

The risk of lisinopril-induced angioedema (LIA) is likely underestimated. Underreporting analysis suggests a risk of 1.6% or 1 in 63 patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

8.

Unnecessary surgery for acute abdomen secondary to angiotensin-converting enzyme inhibitor use.

Author: de GraaffLaura C G, van EssenMartijn, SchipperEleonora M, BoomHenk, DuschekErik J J

Intestinal angioedema

This case report highlights the importance of considering angiotensin-converting enzyme inhibitor (ACE-i) use in the differential diagnosis of unexplained abdominal pain. Intestinal angioedema, a side effect of ACE-i, can mimic acute abdominal pain and lead to unnecessary surgery.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Prediction of clinically relevant safety signals of nephrotoxicity through plasma metabolite profiling.

Author: MattesW B, KampH G, FabianE, HeroldM, KrennrichG, LooserR, MellertW, ProkoudineA, StraussV, van RavenzwaayB, WalkT, NaraokaH, OmuraK, Schuppe-KoistinenI, NadanacivaS, BushE D, MoellerN, Ruiz-NoppingerP, PiccoliS P

MetaMap Tox for drug safety
Drug-induced kidney injury

This study demonstrated that metabolite profiling coupled with the MetaMap Tox metabolomics database can be a powerful adjunct to standard safety assessment for predicting a wide variety of adverse events, including DIKI.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Efficacy of lisinopril in migraine prophylaxis--an open label study.

Author: Schuh-HoferS, FlachU, MeiselA, IsraelH, ReuterU, ArnoldG

Migraine prevention
Cough

This study investigated the efficacy of a low dose of lisinopril (5mg daily) in migraine prevention. The study found that low-dose lisinopril was effective in reducing migraine attack frequency and intake of acute migraine drugs. However, the study was limited by the small sample size and the fact that some patients discontinued treatment due to intolerable cough.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Bioequivalence evaluation and food effect assessment of Lisinopril/amlodipine tablets in healthy Chinese subjects under fasting and fed conditions.

Author: LiTing, LiuYan-Ping, LiuShu-Qin, ShiPing, JiangXin, TaoYe, GaoXiao-Meng, MaYa-Ping, CaoYu

Lisinopril/amlodipine combination

This study compared the pharmacokinetic parameters and bioequivalence of two Lisinopril/amlodipine tablets in healthy Chinese subjects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Long-term dual blockade with candesartan and lisinopril in hypertensive patients with diabetes: the CALM II study.

Author: AndersenNiels H, PoulsenPer L, KnudsenSøren T, PoulsenSteen H, EiskjaerHans, HansenKlavs W, HellebergKjeld, MogensenCarl E

Reduce blood pressure

There was no significant difference between lisinopril 40 mg once daily and lisinopril 20 mg in combination with candesartan 16 mg once daily in reducing systolic blood pressure in hypertensive patients with diabetes.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Effectiveness and safety of diltiazem or lisinopril in treatment of hypertension after heart transplantation. Results of a prospective, randomized multicenter trail.

Author: BrozenaS C, JohnsonM R, VenturaH, HobbsR, MillerL, OlivariM T, ClemsonB, BourgeR, QuiggR, MillsR M, NaftelD

Effective hypertension treatment
Adverse events

Both diltiazem and lisinopril were safe for the treatment of hypertension after heart transplantation, but neither drug achieved control in a majority of patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

An international randomised placebo-controlled trial of a four-component combination pill ("polypill") in people with raised cardiovascular risk.

Author: , RodgersAnthony, PatelAnushka, BerwangerOtavio, BotsMichiel, GrimmRichard, GrobbeeDiederick E, JacksonRod, NealBruce, NeatonJim, PoulterNeil, RafterNatasha, RajuP Krishnam, ReddySrinath, ThomSimon, Vander HoornStephen, WebsterRuth

Reduced cardiovascular disease

There is a need for placebo-controlled studies to evaluate the efficacy and tolerability of combination cardiovascular medications containing aspirin, blood pressure lowering agents, and cholesterol lowering agents.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

WITHDRAWN: Angiotensin converting enzyme inhibitors in normotensive diabetic patients with microalbuminuria.

Author: LovellH G

Albumin excretion reduction
No link to renal failure

Inhibition of angiotensin converting enzyme can arrest or reduce the albumin excretion rate in microalbuminuric normotensive diabetics. However, given the drop in blood pressure in patients on angiotensin converting enzyme inhibitors, it is not certain that the reduction of albumin excretion rate is due to a separate renal effect.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

19.

Usefulness of patch tests for diagnosing selective allergy to captopril.

Author: GaigP, San Miguel-MoncinM M, BartraJ, BonetA, García-OrtegaP

Anaphylactoid reactions
Angio-edema
Cutaneous adverse reaction
Exfoliative dermatitis
Maculopapular eruptions
Pityriasis rosea-like rash
Toxic erythema

A case of a cutaneous immune adverse reaction to captopril with tolerance to enalapril and lisinopril demonstrated both by patch tests and double-blind challenge tests is reported for the first time. Patch tests are useful and safe in the diagnostic work-up of allergic drug reactions and in studies of cross-sensitivity among ACE inhibitors.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

A Rare Cause of Abdominal Pain: Intestinal Angioedema.

Author: FerreiraTania Araujo, AlvesMarta Rebocho, OliveiraAna Maria Pinheiro, SilvaFilipa Sofia Santos, PereiraClaudia

angioedema
angiotensin inhibitors

This case report describes a 28-year-old woman who experienced abdominal pain, nausea, vomiting, and watery stool after taking lisinopril for two months. The symptoms stopped after drug withdrawal. This case highlights the importance of considering angioedema as a possible diagnosis in patients with non-specific symptoms who are taking angiotensin-converting enzyme inhibitors.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

21.

A Case Report of Hypertensive Emergency and Intracranial Hemorrhage Due to Intracavernosal Phenylephrine.

Author: PalagiriRaga Deepak Reddy, ChatterjeeKshitij, JillellaAnusha, HammondDrayton A

Priapism resolution
Hypertensive emergency
Intracranial hemorrhage

Phenylephrine, a drug used to treat priapism, can cause dangerous increases in blood pressure.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

22.

Hibiscus sabdariffa L. in the treatment of hypertension and hyperlipidemia: a comprehensive review of animal and human studies.

Author: HopkinsAllison L, LammMarnie G, FunkJanet L, RitenbaughCheryl

Hyperlipidemia treatment
Hypertension treatment
Low toxicity
Hepatic toxicity (high dose)

Hibiscus sabdariffa L. (HS) extracts show promise in treating hypertension and hyperlipidemia, with a low degree of toxicity and evidence of effectiveness in both animal and human studies. The mechanisms of action are believed to involve antioxidant properties of anthocyanins, polyphenols, and hibiscus acid.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

Genetic variants associated with angiotensin-converting enzyme inhibitor-induced cough: a genome-wide association study in a Swedish population.

Author: HallbergPär, PerssonMatilda, AxelssonTomas, CavalliMarco, NorlingPia, JohanssonHans-Erik, YueQun-Ying, MagnussonPatrik Ke, WadeliusClaes, ErikssonNiclas, WadeliusMia

Angiotensin-converting enzyme inhibitor cough

A genome-wide association study on angiotensin-converting enzyme inhibitor-induced cough identified nearly genome-wide significant associations in several genes, suggesting that the cough may be associated with genes independent of bradykinin pathways.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

An Unexpected Case of Lisinopril-Associated Severe Hyponatremia.

Author: JiangYiran, CaiWenjing, MasquelinMeghane E, GordonKaitlin

Hyponatremia

ACE inhibitors, like lisinopril, are commonly used to treat high blood pressure. While angioedema and high potassium are well-known side effects, low sodium levels (hyponatremia) are rarely reported. This report describes a patient who developed severe hyponatremia while taking lisinopril, highlighting the importance of monitoring for this potential side effect.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

25.

Effect of angiotensin-converting enzyme inhibitor therapy in mitral regurgitation with normal left ventricular function.

Author: MarcotteF, HonosG N, WallingA D, BeauvaisD, BlaisM J, DaoustC, LisbonaA, McCansJ L

Reduced MR severity
Angina
Atrial fibrillation
Intolerance to lisinopril

Lisinopril, an angiotensin-converting enzyme inhibitor, was found to reduce the severity of chronic moderate mitral regurgitation in asymptomatic patients with normal left ventricular function.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

26.

ANICHKOV study: the effect of combined hypotensive and lipid-lowering therapy on cardiovascular complications in patients of high and very high risk.

Author: SergienkoI V, AnshelesA A, DrapkinaО М, GornyakovaN B, ZubarevaM Yu, ShepelR N, KuharchukV V, BoytsovS A

Cardiovascular risk reduction

Lisinopril/amlodipine/rosuvastatin FC (Ekvamer®) demonstrated promising results for reducing cardiovascular risk in patients with elevated cholesterol levels and concomitant hypertension.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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