Zestril (lisinopril) is a prescription drug used to treat certain heart-related conditions. Zestril can cause side effects that range from mild to serious. Examples include headache, dizziness, and cough.

Specifically, Zestril is prescribed to:

Zestril comes as an oral tablet and contains the active ingredient lisinopril. (An active ingredient is what makes a drug work.)

Keep reading to learn about the common, mild, and serious side effects Zestril can cause. For a general overview of the drug, including details about its uses, see this article.

* For this purpose, Zestril may be used alone or together with other blood pressure medications.
† For this purpose, Zestril is used as an add-on treatment with other heart failure drugs.

Below are just a few of the more common side effects reported by people taking Zestril in studies. Side effects can vary depending on what condition the drug is being used to treat.

More common side effects in people taking Zestril for high blood pressure include:

  • dry cough
  • dizziness
  • headache

A more common side effect in people taking Zestril for heart failure was chest pain.

The most common side effect in people taking Zestril for heart attack was low blood pressure.

Mild side effects have been reported with Zestril. These include:

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop taking Zestril unless your doctor recommends it.

Zestril may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

* To learn more about this side effect, see the “Side effects explained” section below.

Serious side effects have been reported with Zestril. These include:

If you develop serious side effects while taking Zestril, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.
† To learn more about this side effect, see “Pregnancy and breastfeeding with Zestril” in the “Warnings” section below.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Zestril, visit MedWatch.

Get answers to some frequently asked questions about Zestril’s side effects.

How do side effects of Zestril in women compare with those in men?

Most side effects of Zestril are the same for males and females.* However, in the drug’s studies, erectile dysfunction (ED) was reported in males and fetal harm was reported in females.

For males with ED, it’s best to talk with your doctor since there are treatments available for this condition.

For females, it’s recommended to use birth control while taking Zestril. (See “Pregnancy and breastfeeding with Zestril” in the “Warnings” section below.)

* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Does Zestril cause long-term side effects?

It may. Long-term side effects include those that may start at any time you’re taking a drug, even if you’ve taken it for a long time. They also include side effects that may not go away, even after you stop taking the drug.

Examples of long-term side effects reported in Zestril’s studies include:

  • dry cough
  • low kidney function
  • bone marrow and blood cell problems (rare)
  • liver problems or liver failure (rare)

Dry cough was a common side effect reported in studies of Zestril and is likely to last until the medication is stopped. Dry cough is typically worse in people with a viral lung infection, environmental allergies, or a lung condition.

Low kidney function and bone marrow and blood cell problems from Zestril are usually reversible by stopping the drug. But there’s a slight possibility Zestril could cause liver damage, leading to ongoing liver problems.

Your doctor will likely order occasional blood tests for you. These are to check for liver-, kidney-, and blood-related problems. It’s important to keep appointments for regular checkups and blood tests to help prevent long-term side effects.

Talk with your doctor or pharmacist if you’re concerned about possible long-term side effects with Zestril.

Can Zestril 10 mg cause more side effects than Zestril 5 mg?

It’s possible. As with most medications, the same side effects can occur with any dosage of Zestril. But higher drug doses have a greater chance of causing side effects than lower doses. Starting at the lowest possible dose is a good way to help manage side effects.

Studies showed that dizziness, low blood pressure, and low kidney function occurred more often with higher doses of Zestril than with lower doses.

Other factors that can increase your risk of side effects include:

  • your age
  • your kidney function
  • your liver function
  • other medications you take
  • other medical conditions you have

Talk with your doctor or pharmacist if you have questions about your dose of Zestril and side effects it may cause.

Learn more about some of the side effects Zestril may cause.

High blood potassium

High blood potassium was a common side effect reported in studies of Zestril and may cause symptoms such as:

  • nausea and vomiting
  • irregular or pounding heartbeat
  • a tingling feeling (“pins and needles”)
  • chest pain
  • shortness of breath
  • tiredness or weakness
  • muscle pain or cramps

Factors that can increase the risk of high blood potassium when taking this drug include:

What might help

Drinking plenty of water (especially during hot weather) and eating potassium-containing foods in moderation can help keep your blood potassium level normal.

If your potassium blood level gets too high, it can lead to heart attack. If you have symptoms of high blood potassium, especially pounding or irregular heartbeat, during Zestril treatment, call your doctor at once. They may want to check your potassium level right away. Call 911 or your local emergency number immediately if any symptoms seem life threatening.

Low kidney function

Low kidney function is a common side effect reported in studies of Zestril. Low kidney function may cause symptoms such as:

  • swelling in your hands, ankles, or feet
  • nausea and vomiting
  • fatigue
  • shortness of breath
  • weakness
  • muscle cramps
  • anemia (low level of red blood cells)
  • itchiness
  • production of too much or too little urine
  • seizure

Factors that can increase the risk of low kidney function when taking this drug include:

What might help

Drink plenty of water and avoid taking NSAIDs such as ibuprofen and naproxen. Ask your pharmacist to review your medication list. They can identify harmful drug combinations and recommend medication changes to your doctor.

If you have symptoms of low kidney function during Zestril treatment, talk with your doctor right away. They’ll likely recommend lab work and an urgent medical visit. If the symptoms of low kidney function become severe, immediately call 911 or your local emergency number.

Allergic reaction

Like most drugs, Zestril can cause an allergic reaction in some people. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • angioedema (swelling under your skin — usually in your eyelids, lips, hands, or feet)
  • anaphylaxis (swelling of your mouth, tongue, or throat, which can make it hard to breathe)

It’s important to note that Zestril may cause angioedema and anaphylaxis reactions that aren’t related to a drug allergy. These reactions could affect your head, neck, or abdomen. Symptoms may include swelling of your head or neck, difficulty breathing, nausea or vomiting, and abdominal pain.

Certain factors may increase your risk of these reactions with Zestril, including:

* Zestril is an ACE inhibitor.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an oral antihistamine, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Zestril, they’ll decide whether you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Zestril, they may have you switch to a different treatment.

Keeping track of side effects

During your Zestril treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Zestril affects you. They can then use this information to adjust your treatment plan if needed.

Below is important information you should consider before taking Zestril.

Boxed warning: Risks if used during pregnancy

Zestril has a boxed warning for risks to a fetus if the drug is taken during pregnancy. A boxed warning is the most serious warning from the FDA. To learn more, see the “Pregnancy and breastfeeding with Zestril” section below.

Other warnings

Zestril can sometimes cause harmful effects in people with certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Zestril is a good treatment option for you.

Talk with your doctor about your health history before starting this drug. Be sure to tell them if any of the following factors apply to you:

  • low kidney function or factors that increase this risk, such as dehydration or infection
  • high blood potassium or factors that increase this risk, such as a high potassium diet or unmanaged high blood sugar
  • liver failure
  • low blood pressure
  • African ancestry
  • certain dialysis treatments
  • use of other medications, over-the-counter drugs, vitamins, herbs, or supplements
  • previous allergic or angioedema reaction to Zestril or to drugs that are similar
  • pregnancy
  • breastfeeding

Alcohol and Zestril

There are no known interactions between alcohol and Zestril. But it’s important to note that drinking alcohol while taking Zestril can increase the likelihood of their shared side effects. Examples include headache and dizziness.

Drinking alcohol may also increase your blood pressure, making it more difficult for Zestril to manage this condition.

If you have questions about consuming alcohol during Zestril treatment, talk with your doctor or pharmacist.

Pregnancy and breastfeeding with Zestril

Zestril is typically not prescribed for someone who is pregnant or breastfeeding. Keep reading to learn more.

Pregnancy

Zestril is not safe to take during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor about your treatment options. If you’re able to become pregnant, your doctor may recommend using a form of birth control before and during Zestril treatment.

Risk of use during pregnancy

Zestril has a boxed warning for the risk of fetal harm. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.

Taking Zestril during pregnancy, especially in the second and third trimesters, can harm a fetus. Types of fetal harm can include:

  • kidney damage
  • lung problems
  • bone deformities
  • death

If you find out you’re pregnant while taking Zestril, call your doctor right away. They can prescribe a medication to replace Zestril that’s safe to take during pregnancy.

Breastfeeding

Zestril is not safe to take while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor about your treatment options.

Like most drugs, Zestril can cause a number of side effects that range from mild to serious. But most are temporary and go away after a few days to weeks. If you have questions about side effects Zestril can cause, talk with your doctor.

Examples of questions to help get you started include:

  • Will Zestril make me too tired to drive?
  • When should I reach out to you about side effects I might have from Zestril?
  • Do certain foods have the potential to cause side effects with Zestril?

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.