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What Are the Different Lisinopril Interactions?

By C.B. Fox
Updated Mar 03, 2024
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Though lisinopril can be safely used along with many other drugs, there are a few interactions that are known to be extremely unsafe for a patient. Lisinopril can interact with potassium, salt, non-steroidal anti-inflammatory drugs (NSAIDs), diuretics, and lithium. Many of these lisinopril interactions can threaten the life of the patient. Lisinopril interactions with vitamins, minerals, and other medications are relatively uncommon.

Potassium can interact dangerously with lisinopril in ways that patients should be alert for. In some patients, especially older male patients, lisinopril can cause hyperkalemia. In this condition, the kidneys retain potassium, resulting in unsafe levels of this element in the patient’s body. Patients who are taking potassium supplements will likely be asked to stop during a course of treatment with lisinopril. Potassium in the form of table salt substitute should also be avoided.

Similar lisinopril interactions occur with table salt. Many patients are prescribed a low-sodium diet while they are using this medication, which they need to follow carefully. Over time, a buildup of salt can lead to a loss of bone mass, making the bones more brittle and easier to fracture.

Lisinopril interactions with aspirin and other NSAIDs are also common. The use of NSAIDs can make lisinopril less effective by interfering with the drug’s ability to effectively control a patient’s blood pressure. NSAID’s can cause water retention, leading to an increase in the overall volume of blood in the patient’s body. The increased volume puts strain on the walls of the blood vessels, creating an increase in blood pressure.

Patients who use diuretic medications may experience adverse effects from lisinopril and diuretic interaction. Drugs in the diuretic class cause a reduction in the amount of water in the body by excreting more water through urine. Diuretics also cause water loss by reducing the absorption of sodium in the body, which causes water retention. It is also for this reason that diuretics may impact the function of lisinopril.

Lithium can also interact dangerously with lisinopril. A certain amount of sodium is required in the bloodstream to effectively take up and make use of lithium that is given as a medication. Patients who are taking lisinopril are often on a low sodium diet and frequently have lower sodium levels because the kidneys retain more salt while a patient is taking lisinopril. This can create a life threatening situation, in which a patient has high levels of lithium in the bloodstream that cannot be absorbed.

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Discussion Comments
By burcidi — On Jul 04, 2013

@ysmina-- I've heard the same thing. I'm going to ask my doctor about it at my next visit but I'm avoiding grapefruit and grapefruit juice for now.

Apparently, grapefruit can reduce lisinopril's effects. But I have no idea if it's true because I was put on lisinopril recently and I haven't had grapefruit yet.

I do know that I have to be careful with some drinks though, like natural sparkling water because it contains salt and potassium. It increases my blood pressure.

By ysmina — On Jul 04, 2013

I read that grapefruit shouldn't be eaten when on certain blood pressure medications. Does this also apply to lisinopril?

By fBoyle — On Jul 03, 2013

One other dangerous interaction is lisinopril and antihistamines. They don't do well together at all. It's a bummer because antihistamines are great for allergies and the common cold. I have a hard time finding medications to take when I'm sick. But I can't risk having dangerously high blood pressure so I manage.

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