Zestril (lisinopril) is an angiotensin-converting enzyme (ACE) inhibitor. It lowers blood pressure by blocking the conversion of angiotensin I to angiotensin II, a hormone that narrows blood vessels and promotes sodium and water retention. By reducing angiotensin II activity, Zestril relaxes arteries, decreases afterload, lowers blood pressure, and reduces strain on the heart and kidneys.
Clinically, Zestril is used to treat primary hypertension in adults and in children 6 years and older. It is also prescribed for heart failure with reduced ejection fraction to improve symptoms, reduce hospitalizations, and support survival. After an acute myocardial infarction (heart attack), Zestril helps improve outcomes by limiting adverse cardiac remodeling and supporting blood pressure control. In people with diabetes and chronic kidney disease (CKD), it may slow progression of kidney damage by lowering intraglomerular pressure and proteinuria when used as part of a comprehensive care plan.
Because high blood pressure often has no symptoms, Zestril’s benefits are measured over time through blood pressure readings, kidney labs, and risk reduction for stroke, heart attack, and heart failure. It is typically part of a broader regimen that includes lifestyle measures like sodium restriction, weight management, physical activity, and moderation of alcohol.
Your exact Zestril dosage should be individualized by a clinician based on blood pressure, kidney function, other medications, and treatment goals. The following are commonly referenced ranges, not personal medical advice:
Hypertension (adults): Typical starting dose is 10 mg once daily. If taking a diuretic, a lower starting dose of 5 mg once daily is often used to reduce the risk of first-dose hypotension. The maintenance range is generally 10–40 mg once daily. Maximum daily dose is often 40 mg. Many patients see good control between 20 and 40 mg daily.
Heart failure: Start 2.5–5 mg once daily and titrate upward (often to 20–40 mg daily) as tolerated based on blood pressure, kidney function, and potassium levels. Titration is usually gradual, with labs monitored after each change.
Post–myocardial infarction: A typical protocol is 5 mg as soon as clinically appropriate within 24 hours of the event, followed by 5 mg at 24 hours, then 10 mg daily thereafter as tolerated.
Pediatric hypertension (≥6 years): Weight-based dosing is commonly used; prescribers may start around 0.07 mg/kg once daily (up to a usual maximum of 0.61 mg/kg or 40 mg daily), with careful monitoring.
Renal dosing: In kidney impairment, starting doses may be lower and titration slower. Your clinician will consider estimated glomerular filtration rate (eGFR) or creatinine clearance. Zestril is largely renally excreted; accumulation can occur in significant renal impairment.
Administration tips: Take Zestril at the same time each day, with or without food. Avoid salt substitutes that contain potassium, unless advised otherwise. Hydration matters—excessive dehydration (from vomiting, diarrhea, heavy sweating, or diuretics) can increase the risk of low blood pressure or kidney issues when on ACE inhibitors.
Monitoring: After initiation or dose increases, clinicians often recheck blood pressure and labs (serum creatinine and potassium) within 1–2 weeks. Mild increases in creatinine can occur when starting an ACE inhibitor, but significant rises require evaluation. Regular follow-up ensures effective and safe dosing over time.
Zestril carries a boxed warning for fetal toxicity. Do not use during pregnancy. ACE inhibitors can harm or terminate a developing fetus, especially in the second and third trimesters. If pregnancy is planned or occurs, contact your prescriber promptly to transition to a safer alternative and stop Zestril under medical guidance.
Angioedema is a rare but serious reaction characterized by swelling of the face, lips, tongue, or throat, which can obstruct breathing. It can occur at any time during therapy, even after long-term use. If swelling or difficulty breathing occurs, seek emergency care and do not take further doses unless cleared by a clinician.
Cough is a well-known ACE inhibitor effect—typically dry, persistent, and nonproductive. If bothersome, discuss alternatives such as switching to an angiotensin receptor blocker (ARB), which is less likely to cause cough.
Hyperkalemia (high potassium) can develop, particularly in people with CKD, diabetes, or those using potassium supplements, potassium-sparing diuretics (e.g., spironolactone), or certain antibiotics (e.g., trimethoprim). Elevated potassium can impair heart rhythm; monitoring is essential.
Race and response: As monotherapy, ACE inhibitors may have a smaller blood pressure–lowering effect in Black patients compared with other groups. Combination therapy (e.g., adding a thiazide diuretic or calcium channel blocker) often optimizes control in all populations.
Surgery and anesthesia: Zestril can contribute to intraoperative hypotension. Your surgical and anesthesia team should know you take an ACE inhibitor; you may be advised to hold a dose before major procedures.
Lactation and pediatrics: Lisinopril passes into breast milk in low amounts; discuss risks and benefits if breastfeeding. Pediatric use is established for certain ages and conditions under specialist guidance.
Alcohol and heat: Alcohol can amplify blood pressure–lowering effects and dizziness. Excessive heat or saunas can increase the risk of lightheadedness; stand up slowly and stay hydrated.
Do not take Zestril if you have a history of ACE inhibitor–associated angioedema or hereditary/idiopathic angioedema. It is also contraindicated in pregnancy.
Avoid combining Zestril with aliskiren in patients with diabetes due to increased risks of kidney impairment, hyperkalemia, and hypotension. In general, dual renin–angiotensin–aldosterone system (RAAS) blockade (e.g., ACE inhibitor plus ARB) is discouraged unless specifically directed by a specialist for selected situations.
Severe bilateral renal artery stenosis or stenosis to a solitary kidney can make ACE inhibitors risky, as they may reduce kidney perfusion. Clinicians may avoid or use only with close monitoring in such cases.
Hypersensitivity to lisinopril or any component of the formulation is a clear contraindication.
Common side effects: dry cough, dizziness or lightheadedness (especially when starting or increasing the dose), headache, fatigue, and nausea. Many of these lessen as your body adapts. Taking the dose at bedtime may reduce daytime dizziness for some people.
Serious side effects: angioedema (facial or throat swelling), severe hypotension (fainting), kidney function changes (rising creatinine), and hyperkalemia (muscle weakness, palpitations, or abnormal heart rhythm). Rarely, liver problems can occur; seek care for jaundice, dark urine, or severe abdominal pain.
When to seek help: Call emergency services for swelling of the face or throat, difficulty breathing, fainting, or chest pain. Contact your clinician promptly for persistent cough, notable swelling in legs, rapid weight gain, or signs of high potassium (muscle weakness or irregular heartbeat).
Risk reduction: Start low and titrate as directed, monitor labs as scheduled, avoid high-potassium salt substitutes, and inform every healthcare provider of all medications and supplements you take.
Potassium-elevating agents: Combining Zestril with potassium supplements, salt substitutes, potassium-sparing diuretics (spironolactone, eplerenone, amiloride), or trimethoprim can raise potassium levels. Monitor closely or avoid combinations as advised.
Dual RAAS blockade: Avoid routine combination with ARBs (e.g., losartan) or direct renin inhibitors (aliskiren), particularly in diabetes. The risks of kidney impairment and hyperkalemia generally outweigh benefits.
NSAIDs: Regular use of nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen) may reduce antihypertensive effects and increase kidney risk, especially in dehydration or CKD. If NSAIDs are necessary, use the lowest effective dose and stay hydrated; monitor kidney function.
Diuretics and other antihypertensives: Thiazides and loop diuretics are commonly combined with Zestril to improve blood pressure control and heart failure outcomes. However, the first few doses can provoke low blood pressure; clinicians may lower diuretic doses temporarily or start Zestril cautiously.
Lithium: ACE inhibitors can increase lithium levels and risk toxicity. Combined use requires careful monitoring or alternative therapy.
Neprilysin inhibitors: Do not use Zestril within 36 hours of taking sacubitril/valsartan due to a heightened risk of angioedema.
Alcohol and sedatives: These can intensify dizziness. Use caution with activities requiring alertness until you know how Zestril affects you.
If you miss a dose of Zestril, take it as soon as you remember unless it is close to the time for your next dose. If it is near your next scheduled dose, skip the missed dose and resume your regular schedule. Do not double up to make up for a missed dose, as that can increase the risk of dizziness, low blood pressure, or other side effects.
Symptoms of overdose may include pronounced dizziness, fainting, very low blood pressure, and kidney impairment. If an overdose is suspected, seek emergency medical attention or contact Poison Control (in the U.S., 1-800-222-1222) immediately. Do not attempt to self-treat. Supportive care may include intravenous fluids and monitoring of blood pressure, kidney function, and electrolytes.
Store Zestril tablets at room temperature—typically 68–77°F (20–25°C)—in a dry place, away from direct light and moisture. Keep tablets in their original container with the lid tightly closed. Do not store in the bathroom. Keep out of reach of children and pets. Dispose of expired or unused medication responsibly through community take-back programs or as directed by your pharmacist.
Across public patient discussions online, several recurring themes appear when people talk about Zestril (lisinopril):
Many report effective blood pressure reduction within days to a few weeks, with additional improvements as the dose is titrated. Some describe a dry, tickly cough that develops weeks into therapy; others note that switching to an ARB helped if the cough persisted. Dizziness or lightheadedness, especially upon standing, is frequently mentioned early on, particularly in those starting while on a diuretic or after dehydration; taking the dose at night and rising slowly has helped some users.
Patients with heart failure often discuss better exercise tolerance over time and fewer swelling episodes when Zestril is combined with diuretics and other guideline-directed therapies. Others stress the importance of lab monitoring—sharing that their clinicians checked potassium and creatinine after starting or increasing doses, with a few recounting transient lab changes that resolved after dose adjustments.
Several posts highlight practical tips: watch out for high-potassium salt substitutes, stay hydrated, and avoid NSAIDs unless recommended by a clinician. A smaller group emphasizes hypersensitivity concerns, noting that any lip or tongue swelling warrants urgent care due to angioedema risk. Overall sentiment trends positive for blood pressure control and heart protection, balanced by the need to watch for cough, dizziness, and lab changes.
I’m not able to reproduce or attribute individual WebMD user reviews here. In aggregate, consumer feedback on reputable health sites commonly reflects a few consistent points about Zestril:
Effectiveness: Many users report reliable blood pressure control and improvements in heart failure symptoms when Zestril is part of a comprehensive plan. Some note that benefits became more noticeable after dose titration and adherence for several weeks.
Tolerability: A dry cough is the most frequently cited annoyance. Dizziness, especially early in treatment, is another recurring comment. People also mention the convenience of once-daily dosing and that taking it at the same time each day supports steady control.
Safety watch-outs: Users often mention being advised to monitor potassium and kidney function, avoid potassium-heavy salt substitutes, and be cautious with NSAIDs. Reports of angioedema are rare but taken very seriously by the community and clinicians alike.
As with any consumer reviews, experiences vary widely. Your personal response depends on individual factors like age, kidney function, diet, coexisting conditions, and other medications. Clinician guidance and follow-up remain essential for safe use.
In the United States, Zestril (lisinopril) is a prescription medication. By law, it should be dispensed only with a valid prescription from a licensed clinician after an appropriate medical evaluation. This protects patients by ensuring the medication is indicated, dosed correctly, and monitored for safety—especially regarding kidney function and potassium levels. Beware of websites or marketplaces that claim you can buy Zestril without prescription; such offers may be illegal, unsafe, or involve counterfeit products.
Northeast Ohio Applied Health offers a legal and structured solution for accessing care: it connects patients with licensed healthcare professionals who can evaluate blood pressure, medical history, and concurrent medications via an appropriate clinical pathway (often including telehealth). When clinically appropriate, a prescription for Zestril can be issued and filled through legitimate pharmacies. This approach ensures you are not bypassing safety safeguards while avoiding the risks of “no-Rx” sellers.
What to expect in a compliant pathway: an initial assessment (including blood pressure readings and medical history), consideration of alternatives if you are pregnant or planning pregnancy, review of kidney function and electrolytes, counseling on side effects and interactions, and a follow-up plan to check blood pressure and labs after starting or changing the dose. These steps are part of safe, evidence-based care for hypertension, heart failure, and post–heart attack treatment.
If you need treatment or refills, work with licensed clinicians. Northeast Ohio Applied Health can streamline that process while staying fully compliant with U.S. regulations—helping you obtain Zestril only when it is safe and appropriate for your situation.
Zestril is the brand name for lisinopril, an ACE inhibitor. It lowers blood pressure and eases strain on the heart by blocking the angiotensin-converting enzyme, which reduces production of angiotensin II, relaxes blood vessels, decreases aldosterone, and helps the kidneys excrete salt and water.
Zestril (lisinopril) treats high blood pressure, heart failure, and helps improve survival after a heart attack. It’s also used to protect kidney function in some patients with diabetes and protein in the urine, under clinician guidance.
You may see some blood pressure reduction within a few hours of the first dose, but full effect typically develops over 1 to 2 weeks, with maximum benefit by 4 weeks as the dose is adjusted.
Take Zestril once daily at the same time each day, with or without food. Be consistent. If it makes you dizzy at first, taking it at bedtime can help. Drink adequate fluids unless your clinician has restricted them.
For high blood pressure, common starting doses are 5 to 10 mg once daily, titrated up to 20 to 40 mg daily as needed. For heart failure, lower starting doses (2.5 to 5 mg daily) are used and increased gradually. Dosing is individualized based on response, kidney function, and other medicines.
Common effects include dry cough, dizziness or lightheadedness (especially after the first doses), headache, fatigue, and sometimes mild increases in blood creatinine or potassium. Many people tolerate it well.
Seek immediate care for swelling of the face, lips, tongue, or throat (angioedema), fainting, severe dizziness, very low urine output, chest pain, or signs of high potassium such as muscle weakness or abnormal heartbeats. Angioedema can occur anytime, even after long-term use.
Do not take Zestril during pregnancy or if you have a history of ACE inhibitor–related angioedema, hereditary angioedema, or known hypersensitivity. It’s generally avoided in bilateral renal artery stenosis and used cautiously with severe kidney disease or very low blood pressure.
Zestril is contraindicated in pregnancy because it can harm the developing fetus, especially in the second and third trimesters. If pregnancy occurs, stop Zestril and contact your clinician immediately. For breastfeeding, limited data suggest low levels in milk; alternatives with more safety data are often preferred, especially for newborns or preterm infants.
ACE inhibitors can cause a small, expected rise in creatinine when therapy begins; clinicians monitor to ensure it stays within a safe range. Zestril can raise potassium, especially in people with kidney disease or those using potassium supplements, salt substitutes, or potassium-sparing diuretics.
Key interactions include potassium supplements and salt substitutes, potassium-sparing diuretics (spironolactone, eplerenone, amiloride), ARBs and aliskiren (especially in diabetes), lithium (levels can rise), and NSAIDs (may blunt effect and strain kidneys). Diuretics can enhance the first-dose drop in blood pressure. Always review your medication list with your clinician.
Alcohol can enhance blood pressure–lowering effects and increase dizziness or fainting, particularly when starting or increasing the dose. If you drink, do so in moderation and be cautious when standing up.
Take it when you remember unless it’s close to your next dose. Do not double up. Resume your regular schedule. Consistent daily use is important for blood pressure control.
Yes, a persistent dry cough occurs in a minority of users due to bradykinin buildup. It’s harmless but bothersome. If it affects quality of life and lasts more than a week or two, talk to your clinician; switching to a different class (such as an ARB) often resolves it.
After a heart attack, Zestril is started early in appropriate patients to improve survival and reduce remodeling. In heart failure with reduced ejection fraction, it reduces hospitalizations and mortality by easing the heart’s workload and lowering neurohormonal stress. Dosing begins low and is titrated to target as tolerated.
Yes. Your clinician typically checks kidney function (creatinine, eGFR) and potassium before starting, 1 to 2 weeks after initiation or dose changes, and periodically thereafter, especially if you have kidney disease, diabetes, or are on interacting drugs.
Often yes. ACE inhibitors like Zestril can slow kidney disease progression and reduce protein in the urine in many patients with diabetes or CKD. Monitoring is essential to balance benefits with risks like rising potassium or creatinine.
Zestril is a brand of lisinopril. Generic lisinopril is widely available, bioequivalent, and typically far less expensive. Most patients do just as well on the generic.
ACE inhibitors may be less effective as single-agent therapy for blood pressure in some Black patients, and the risk of angioedema is higher. Combination therapy (for example with a thiazide diuretic or calcium channel blocker) often improves blood pressure control.
Occasional short-term use of acetaminophen is generally preferred. Frequent NSAID use (ibuprofen, naproxen) can reduce blood pressure control and strain kidneys when combined with ACE inhibitors, especially with diuretics. Discuss regular pain management with your clinician.
Any consistent time works. Morning is common, but if you experience dizziness, bedtime may be better. Stick to the same time daily to maintain steady levels.
Zestril and Prinivil are both brand names for lisinopril. They contain the same active ingredient and work the same way. There is no meaningful difference in efficacy or side effects; availability and cost often drive the choice, and generic lisinopril is typically used.
Both are ACE inhibitors with comparable blood pressure and heart failure benefits. Enalapril is a prodrug converted to enalaprilat; it’s often dosed twice daily for heart failure, while lisinopril is typically once daily. Choice depends on dosing preference, prior response, and cost.
Both lower blood pressure and reduce cardiovascular risk. Ramipril is a prodrug and may be dosed once or twice daily. Large outcome trials exist for several ACE inhibitors; no consistent head-to-head advantage has been shown. Tolerability and patient factors guide selection.
Both have evidence for slowing kidney disease in proteinuric states. Lisinopril and benazepril are effective options; the key is achieving adequate blood pressure and proteinuria reduction, with regular monitoring of creatinine and potassium. No clear superiority is established.
Both are effective ACE inhibitors. Quinapril is a prodrug; some patients use it once daily for hypertension and twice daily for heart failure. Lisinopril’s once-daily dosing is convenient. Side effect profiles are similar, including risk of cough and hyperkalemia.
Yes. Fosinopril has dual hepatic and renal elimination, which can be advantageous in patients with renal impairment, potentially requiring fewer dose adjustments. Lisinopril is primarily renally cleared. Clinicians choose based on kidney and liver function, dosing, and experience.
Captopril is short-acting and usually taken two to three times daily, which can affect adherence. It also has a higher incidence of rash and taste disturbances compared with many ACE inhibitors. Lisinopril’s once-daily dosing improves convenience for most patients.
Both are used after myocardial infarction in appropriate patients. Trandolapril and lisinopril have outcome data supporting post-MI use. Selection typically hinges on clinician familiarity, dosing frequency, patient tolerance, and formulary coverage rather than clear efficacy differences.
Both effectively lower blood pressure and have cardiovascular outcome data. Perindopril is a prodrug with a long-acting profile and is often used once daily. No consistent head-to-head superiority has been demonstrated; adherence and side effect tolerance matter most.
Generic lisinopril is bioequivalent to Zestril and is the standard choice due to cost-effectiveness, with similar efficacy and safety. Most patients do well with the generic; brand use is uncommon unless insurance or availability dictates.
Cough is a class effect linked to bradykinin and can occur with any ACE inhibitor. Individual susceptibility varies. Switching within the class may or may not help; switching to an ARB typically resolves cough but involves a different medication class.
Clinical trials show multiple ACE inhibitors improve heart failure outcomes. No clear class-internal winner consistently emerges. More important are reaching guideline-directed target doses, monitoring labs, and combining with other heart failure therapies.
Several, including lisinopril, ramipril, perindopril, trandolapril, and quinapril, can be dosed once daily for hypertension. Captopril is notably shorter-acting. The practical difference is often adherence rather than potency when dosed appropriately.
Generic lisinopril is among the most affordable. Most ACE inhibitors are available generically at low cost, but prices vary by pharmacy, insurance, and dose. Savings programs and 90-day supplies can reduce out-of-pocket costs.
Yes, under clinician guidance. Dose conversions are approximate (for example, lisinopril 20 mg daily is often considered roughly similar to enalapril 10 mg twice daily or ramipril 5 mg twice daily), but individual response varies. Labs should be rechecked after switches.
All share class effects: cough, dizziness, hyperkalemia, rare angioedema. Some, like captopril, have higher rates of rash and taste changes. Pharmacokinetic differences (prodrug status, clearance) influence dosing and use in kidney or liver disease more than side effect rates.
Fosinopril’s dual elimination can be advantageous in advanced kidney disease. Otherwise, ACE inhibitors, including lisinopril, are commonly used with careful monitoring. Starting low, titrating slowly, and checking creatinine and potassium are key across the class.