How long does it take lisinopril to work?

If you have high blood pressure and need medication to manage it, you’re not alone. Nearly half of all adults in the United States live with this condition—also known as hypertension—according to the U.S. Centers for Disease Control and Prevention (CDC). Four in five adults with hypertension are prescribed blood pressure medication to manage it. ACE inhibitors, such as lisinopril, are some of the most common prescriptions used to manage hypertension.

Lisinopril—also sold under the brand names Qbrelis, Zestril, and Prinivil—helps your blood vessels relax so blood and oxygen can flow freely to your heart. Lisinopril blocks an enzyme called ACE, which stops the body from making too much angiotensin II. Angiotensin II makes blood vessels narrow and tells the body to hold onto salt and water, both of which can raise blood pressure. Excessive angiotensin II often leads to high blood pressure.

Lisinopril can prevent stroke and heart attack and is sometimes prescribed to help people with heart failure or those recovering from a heart attack. Thankfully, this medication works quickly—within a few hours of your first dose. However, certain factors can affect how fast it will lower your blood pressure.

How long does it take for lisinopril to work? 

Lisinopril should start working to lower your blood pressure within a few hours of taking your first dose, according to Erika Gray, Pharm.D., co-founder of ToolBox Genomics. However, it may take a few weeks for the drug to reach its full benefit.

Unlike antibiotics, when you are sick, you likely won’t feel a difference when lisinopril is doing its job. “If your blood pressure medication is working, you should not feel any different,” says Janet O’Mahony, MD, an internist with Mercy Personal Physicians Downtown in Baltimore, Maryland. “The only way to know for sure is to check your blood pressure in the doctor’s office or at home.” Your prescribing provider will likely schedule an appointment to measure your blood pressure within the first six to eight weeks of starting the medication to determine if your dose needs to be adjusted, says Alex Foxman, MD, president and founder of Mobile Physician Associates.

Common side effects of lisinopril include headache, dizziness, and a persistent dry cough. For people with heart failure, the side effects may also include low blood pressure or chest pain. Rare but more serious side effects include severe stomach pain or signs of an allergic reaction—such as swelling of the face, lips, throat, or tongue; trouble breathing or swallowing; hoarseness; itching; rash; or shortness of breath usually associated with persistent dry cough. If you have these more serious reactions, seek immediate medical advice. “Do not wait,” says Dr. O’Mahony. “Call your doctor right away.”

Your healthcare provider can switch your medication if you experience an adverse reaction. “Fortunately, blood pressure medications are well tolerated and don’t cause a lot of side effects,” says Dr. O’Mahony. “This is important because you are going to be on this medication for a long time.”

What can affect how long lisinopril takes to work?

There are a few factors that affect how long lisinopril will take to get your blood pressure under control:

• Time of day: Recent research suggests that lisinopril may be more effective when taken at night.
• Consistency: Adherence to the prescribed treatment regimen is essential for lisinopril to work effectively. Taking the medication consistently as directed by your healthcare provider, without missing doses, can help ensure optimal blood pressure control
• Underlying conditions: The presence of underlying medical conditions, such as kidney disease, heart failure, or diabetes, can affect how long it takes for lisinopril to work. In some cases, individuals with certain medical conditions may require higher doses or longer periods of treatment to achieve optimal blood pressure control.
• Diet: You can take lisinopril with or without food. However, what you eat matters. You should eat a well-balanced, heart-healthy diet. That means
  • Limiting high-sodium foods: These can make you retain fluid and raise your blood pressure.
  • Cutting back on high-potassium foods: Lisinopril increases the potassium in your blood. That doesn’t mean you can’t eat high-potassium foods at all, but you should limit them. Foods on the caution list include bananas, potatoes, tomatoes, oranges, dark leafy greens, squash, and salt substitutes.
  • Reducing alcohol consumption: Alcohol can actually increase the blood-pressure-lowering effect of lisinopril, which means that your blood pressure might drop a lot lower than you expected. As a result, you might start feeling dizzy or lightheaded. Experts suggest cutting back on your alcohol consumption if you realize that you’re feeling lightheaded or dizzy while drinking and taking lisinopril.
• Lifestyle changes: Finally, you can help lower your blood pressure naturally by quitting smoking, exercising regularly, and trying to reduce your stress levels.
• Certain medications: can affect how lisinopril works, so you should always inform your provider about all prescription medications, over-the-counter medications, and supplements you are taking. For example, high doses of anti-inflammatory meds like ibuprofen or aspirin can interact with lisinopril. Diuretics, nitrates, antidepressants, steroids, and some other prescription drugs can also affect how lisinopril works.

What is the standard lisinopril dosage?

Lisinopril treats high blood pressure, heart failure, and heart attack. The dosage varies based on the condition.

• Blood pressure: The standard dose of lisinopril to lower blood pressure in adults ranges from 2.5 mg to 40 mg per day. Most people start out with a daily dose of 10 mg. However, if they have stage 2 high blood pressure (greater than 160/100), their provider might recommend a starting dose of 20 mg, notes Dr. Gray.
• Heart failure: For this condition, you can expect to start with a 5 mg dose per day.
• Heart attack: The standard dose is 5 mg right after the heart attack, followed by another 5 mg 24 hours later, and 10 mg after 48 hours. Then, you would take 10 mg of lisinopril daily afterward.

Lisinopril is available in two forms: tablets, which range from 2.5 mg to 40 mg, and an oral solution of 1 mg/mL.

Who should avoid taking lisinopril?

Lisinopril is generally well-tolerated, with minimal side effects. However, some people should not take this particular medication. That includes people who have medical conditions such as:

• Hyperkalemia, or high potassium levels in the bloodstream
• Angioedema, a type of allergic reaction that causes swelling under the skin
• Renal failure with previous lisinopril use
• Bilateral renal artery stenosis (a condition in which blood vessels bringing blood to your kidneys are narrowed or squeezed) can reduce blood flow to your kidneys, affecting their ability to work properly, and causing high blood pressure or other kidney problems.

People with diabetes and kidney disease also need to be careful not to combine Tekturna (aliskiren) with lisinopril. Taking these two medications together increases the risk of serious kidney problems, as well as low blood pressure and high potassium levels.

Pregnant people should also not take lisinopril. The manufacturer of Zestril cautions that taking lisinopril could harm a developing fetus during the second and third trimesters. It’s unknown how much lisinopril passes into breastmilk, so discuss it with a healthcare professional if you plan to breastfeed.

The bottom line: Lisinopril works quickly

Lisinopril is commonly prescribed to treat high blood pressure, heart failure, and heart attack. It begins working within a few hours but takes several weeks to reach its full effect. It’s unlikely you’ll be able to feel that it’s working without taking a blood pressure reading in the doctor’s office, pharmacy, or at home using a blood pressure measuring device. While side effects are uncommon, you should seek immediate medical attention if you experience severe abdominal pain or signs of an allergic reaction.