[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [ACE inhibitors](https://durgical.com/en/pharmacology/classes/ace-inhibitors/) › Lisinopril

[Pharmacology](https://durgical.com/en/pharmacology/) · [ACE inhibitors](https://durgical.com/en/pharmacology/classes/ace-inhibitors/)

# Lisinopril

A long-acting ACE inhibitor that is active as taken and cleared unchanged by the kidneys. Used for high blood pressure, heart failure and after a heart attack.

Updated 2026-11-01

- Class: [ACE inhibitors](https://durgical.com/en/pharmacology/classes/ace-inhibitors/)
- Enzyme: Angiotensin-converting enzyme (ACE)
- ATC code: C09AA03

✂**Angiotensin-converting enzyme (ACE)**Lisinopril

ⓘ The figure shows lisinopril bound to the zinc active site of human testicular ACE (the C-domain form).

**Target in 3D:** Angiotensin-converting enzyme (ACE). PDB structure 1O86 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/1O86) · Drag to rotate · pinch to zoom

## Mechanism of action

Lisinopril, a lysine analogue of enalaprilat, binds the zinc in the ACE active site. Angiotensin II and aldosterone fall, arterioles dilate and sodium retention lessens; bradykinin builds up, adding vasodilation, cough and angioedema. It needs no activation in the liver and is not metabolised.

- Lisinopril binds the zinc in the ACE active site
- Less angiotensin II and aldosterone; bradykinin builds up
- Arterioles dilate and blood pressure falls

## Pharmacokinetics

**Absorption**
Food does not change absorption

**Metabolism**
Not a prodrug and not metabolised

**Elimination**
Excreted unchanged by the kidneys

**Half-life**
Effective half-life about 12 hours with repeated doses

## Indications

- High blood pressure [Arterial hypertension →](https://durgical.com/en/conditions/arterial-hypertension/)
- Heart failure [Heart failure →](https://durgical.com/en/conditions/heart-failure/)
- Stable patients after acute myocardial infarction [Myocardial Infarction (Heart Attack) →](https://durgical.com/en/conditions/myocardial-infarction/)

## Adverse effects

### Common

- Dry cough
- Dizziness and hypotension
- Headache
- Hyperkalaemia
- Rise in creatinine

### Serious (rare, important)

- Angioedema, including intestinal angioedema
- Acute kidney injury
- Fetal toxicity

## Contraindications

- Pregnancy
- Previous angioedema with an ACE inhibitor, or hereditary or idiopathic angioedema
- Use with sacubitril/valsartan or within 36 hours of it
- Use with aliskiren in people with diabetes

## Key interactions

**Potassium-sparing diuretics, potassium supplements or salt substitutes**
Hyperkalaemia

**NSAIDs**
Weaker effect and kidney injury

**Lithium**
Lithium toxicity

**Diuretics**
Marked hypotension when starting in volume-depleted patients

## What is monitored

- Blood pressure
- Potassium and creatinine
- Signs of angioedema

## Administration and safety

- Given by mouth once a day, with or without food
- Several «-pril» names look alike: the name is checked on every order

## Nursing care

- Check blood pressure, especially after the first dose and in patients on diuretics
- Check potassium and creatinine within the first weeks
- Teach the patient that face, lip or tongue swelling is an emergency
- Ask women of childbearing age about pregnancy plans

## Pregnancy and breastfeeding

Contraindicated: drugs acting on the renin-angiotensin system can injure and kill the developing fetus; it is stopped as soon as pregnancy is detected.

## Memory aid

LISinopril is the Lysine-carrying, Lazy-liver ACE inhibitor: no activation, no metabolism, straight out by the kidney.

## Test yourself

Think of the answer, then tap the question to see it.

## How does lisinopril differ from enalapril in its activation?

Lisinopril is active as taken; enalapril is a prodrug that must be hydrolysed to enalaprilat.

## How is lisinopril eliminated?

Unchanged by the kidneys, so its dosing depends on kidney function.

## How long after stopping sacubitril/valsartan can lisinopril be started?

At least 36 hours, because the combination with a neprilysin inhibitor greatly raises the risk of angioedema.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/lisinopril/)

## Related drugs

- [Enalapril](https://durgical.com/en/pharmacology/enalapril/)
- [Captopril](https://durgical.com/en/pharmacology/captopril/)
- [Ramipril](https://durgical.com/en/pharmacology/ramipril/)

## Related conditions

- [Arterial hypertension](https://durgical.com/en/conditions/arterial-hypertension/)
- [Heart failure](https://durgical.com/en/conditions/heart-failure/)
- [Myocardial Infarction (Heart Attack)](https://durgical.com/en/conditions/myocardial-infarction/)

[← Back to the class: ACE inhibitors](https://durgical.com/en/pharmacology/classes/ace-inhibitors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - LISINOPRIL tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=34ebeea1-6812-4697-84c4-b2ae4f39e55f) (DailyMed (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=C09AA03) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 30 (McGraw Hill, 2023).

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Representative model, for educational purposes only.

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