Zestril Precautions and Warnings

Understanding Zestril precautions and warnings before taking the drug can help ensure a safe treatment process. Review with your healthcare provider potential drug interactions, people who should not take the drug (such as those with diabetes or liver disease), and serious side effects that can occur (such as allergic reactions). Zestril precautions and warnings also extend to women who may become pregnant or are nursing while taking it.

Zestril: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Zestril® (lisinopril) if you have:
Also let your healthcare provider know if you:
  • Are pregnant or trying to become pregnant
  • Are breastfeeding
  • Are on dialysis
  • Will be undergoing surgery or anesthesia.
Tell your healthcare provider about all medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Zestril Precautions and Warnings

Warnings and precautions to be aware of prior to taking Zestril include the following:
  • Zestril can interact with certain medications (see Zestril Drug Interactions).
  • ACE inhibitors are more likely than other drugs to cause allergic reactions. For example, there have been reports of severe allergic reactions occurring in people on Zestril during dialysis. There have also been reports of severe reactions in people getting bee or wasp venom to protect against stings. Discuss these risks with your healthcare provider. Also, seek emergency medical attention if you notice:
    • Hives
    • An unexplained rash
    • Difficulty breathing
    • Swelling of the face or throat.
  • ACE inhibitors may cause swelling (angioedema) of the head and neck, including the tongue, lips, eyes, or throat. This occurs more frequently in African Americans. Seek emergency medical care immediately if you notice swelling in the head or neck area, or if you have wheezing or difficulty breathing or swallowing.
  • In addition to head and neck angioedema, ACE inhibitors have been known to cause swelling in the intestines. This is known as intestinal angioedema. Symptoms may include, but are not limited to, abdominal pain (stomach pain), with or without vomiting. Seek medical attention immediately if you develop any of these symptoms.
  • Zestril may cause extreme low blood pressure in some people. This is more likely to happen in people who are taking a diuretic, who are on dialysis, who have diarrhea or vomiting, or who sweat a lot. This is why it is important to drink fluids regularly while taking Zestril. If you have any possible symptoms of extreme low blood pressure (such as dizziness, lightheadedness, or fainting), contact your healthcare provider and stop taking the medicine. 
  • Do not drive, operate any heavy machinery, or perform any other task that requires alertness before you know how Zestril affects you.
  • People on Zestril can be at an increased risk of infections. Talk to your healthcare provider if you develop any infections, such as a sore throat or fever, while taking Zestril.
  • Zestril is a pregnancy Category D medicine, meaning that it can present health risks to your unborn child. If you become pregnant while taking Zestril, contact your healthcare provider immediately (see Zestril and Pregnancy for more information).
  • ACE inhibitors, including Zestril, are known to cause a cough. If the cough becomes bothersome, talk to your healthcare provider about alternate options for your condition (see Zestril Cough).
  • While taking Zestril, do not use potassium supplements or salt substitutes with potassium unless you have discussed this with your healthcare provider. In some people taking Zestril, potassium in the blood can increase to dangerous levels.
  • ACE inhibitors, including Zestril, have been known to cause a decrease in kidney function, especially in certain groups, such as those with severe congestive heart failure. Let your healthcare provider know if you have symptoms such as a decrease in urine output, drowsiness, headache, or back pain. Your healthcare provider will also regularly check your kidney function with a simple blood test.
  • If you have kidney disease or kidney failure, your body may metabolize Zestril differently than intended. Therefore, your healthcare provider will likely monitor your situation more closely.
  • In clinical studies, ACE inhibitors, including Zestril, have rarely been known to cause liver failure. However, you should contact your healthcare provider immediately if you notice:
    • Nausea
    • Tiredness
    • Lethargy
    • Itchy or yellowing skin
    • Abdominal pain (stomach pain)
    • Flu-like symptoms.
  • If you have diabetes, you should closely monitor your blood sugars, as Zestril may cause a drop in blood sugars. This is more common during the first month of treatment.
  • It is not known whether Zestril passes through breast milk. Therefore, if you are taking Zestril and nursing, ask your healthcare provider whether you should stop Zestril or stop breastfeeding.
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Zestril (Lisinopril)

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