How long does lisinopril stay in your system?

In this article:

• How long does lisinopril stay in your system?
• What affects the duration?
• How long do the side effects last?
• Missed doses and discontinuation
• Alternatives
• FAQs

In this article

• How long does lisinopril stay in your system?
• What affects the duration?
• How long do the side effects last?
• Missed doses and discontinuation
• Alternatives
• FAQs

Lisinopril is a widely prescribed angiotensin-converting enzyme inhibitor (ACE inhibitor) used to treat high blood pressure in adults and children 6 and older, although there is limited data to support its use in even younger children. Sold under the brand names Zestril and Prinivil, it’s also FDA approved to treat heart failure and reduce the risk of further heart damage after a heart attack. In some cases, health care providers prescribe it off-label to help manage kidney complications related to diabetes, including diabetic nephropathy and proteinuria.

The medication begins lowering blood pressure within about an hour of a dose and is generally well-tolerated. But even after you swallow a tablet, lisinopril doesn’t leave your body right away. A single dose can remain in your system for roughly two to three days before it’s fully eliminated.

If you’re taking lisinopril, consistency matters. Taking it exactly as prescribed helps maintain steady levels in your body and keeps your blood pressure controlled. And if you’re thinking about stopping the medication or notice side effects that don’t improve, talk with your health care provider before making any changes.

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How long does lisinopril stay in your system?

Lisinopril stays in your body for roughly 60 hours, or about two to three days. “To determine how long any prescription drug stays in one’s body, pharmaceutical companies perform half-life studies,” says Erika Gray, Pharm.D., Founder & Chief Medical Officer at ToolBox Genomics. A half-life is how long it takes for half of a drug to be eliminated from the body, and a drug is considered fully eliminated from the body after about 5 half-lives. The half-life of lisinopril is approximately 12 hours. 

Lisinopril works by blocking the action of angiotensin-converting enzyme. This prevents angiotensin I from being converted into angiotensin II. Angiotensin II constricts your blood vessels, so decreasing the amount present in your body works to relax blood vessels (the opposite of vasoconstriction), lowering your blood pressure. 

The peak effects of lisinopril typically occur about six hours after taking your daily pill and are dose-dependent, according to Dr. Gray. However, as the dose increases, there is a plateau in the dose-response effect, typically at 20 mg to 40 mg daily.

Healthcare providers don’t usually check for lisinopril in routine blood work, and tests that measure the drug itself aren’t common. In some cases, specialized lab tests can detect how much of the medication is in your blood within about a day of taking it. But because lisinopril leaves the body fairly quickly through urine, those tests aren’t very helpful after a few days. While you’re taking lisinopril, your doctor may still order blood tests to monitor how your body is responding, such as kidney function and potassium levels.

Factors that influence how long lisinopril stays in your system

There are two main factors that can influence how long lisinopril stays in your system, including: 

Kidney function

“Decrease in kidney function decreases elimination of lisinopril, leading to longer exposure within the body,” says Taylor Clark, Pharm.D., a clinical assistant professor of pharmacy practice at Binghamton University, State University of New York. Also, with kidney problems, the risk of certain serious side effects, such as hyperkalemia (elevated potassium), increases. 

Age

Age can influence how long lisinopril stays in your system because age can influence kidney function. Kidney function declines with age, so older adults may experience reduced clearance and a longer half-life of this medication compared to younger people.

Dr. Clark says healthcare providers often reduce the dose of lisinopril if someone’s kidney function drops below a certain level. This is based on a number called the estimated glomerular filtration rate (eGFR), which indicates how well the kidneys filter waste from the blood. If that number falls below 30, a smaller dose is usually recommended. If it drops below 10, a different medication may be a safer option.

How long does it take for side effects to go away after stopping lisinopril?

Since peak lisinopril effects typically occur around six to seven hours after taking your dose, the risk of certain adverse events, such as hypotension and dizziness, is highest at this time, according to Dr. Clark. “These common side effects typically go away as the medication is eliminated from the body,” she says. 

However, other adverse effects may take longer to resolve. Elevated potassium levels typically normalize within 48 hours of discontinuation, assuming lisinopril was the cause of the elevation, she adds. Lisinopril-associated cough typically resolves within one to four weeks of discontinuing the drug, but in some, it may persist for several months. 

What to do if you miss a dose or are considering stopping

If you miss a dose of lisinopril, go ahead and take it as soon as you remember. However, if it’s close to your next dose, skip the missed dose and take the next dose at the scheduled time, then continue with the regular dosing schedule as instructed by your healthcare provider. Avoid taking a double dose (or two doses at close intervals) to make up for a missed dose. 

You should never stop taking lisinopril without discussing it with your provider first. A study reported some minor adverse effects from stopping antihypertensive medications such as lisinopril, including headache, joint pain, and palpitations. Abruptly stopping your medication on your own can also cause worsening of your symptoms or rebound hypertension.

If you believe you are experiencing adverse effects from lisinopril, contact your healthcare team as soon as possible. They will direct you on how to safely discontinue lisinopril. This may involve tapering the medication over a period of time to avoid withdrawal symptoms or switching to another medication.

Lisinopril alternatives

There are alternative treatment options to lisinopril. Dr. Clark explains that what your doctor may recommend will depend on the indication and adverse effects that occurred with treatment. 

Lisinopril alternatives may include:

• Medications from other drug classes: One common alternative is switching to an angiotensin II receptor blocker (ARB), such as Cozaar (losartan). Diuretics and beta blockers are also options to discuss with your provider.
• Other ACE inhibitors: Your healthcare provider may recommend switching to another drug that belongs to the same class as lisinopril, such as Lotensin (benazepril), Monopril (fosinopril), or Vasotec (enalapril).
• Lifestyle and dietary changes: Making lifestyle changes such as staying physically active, limiting alcohol intake, managing weight, and getting enough sleep can support blood pressure regulation. These changes, along with dietary adjustments such as reducing salt (sodium) intake and adopting the DASH eating plan, can be used with or without drug therapy to manage blood pressure and lower the risk of heart conditions.

Frequently asked questions about lisinopril elimination

Here are answers to some frequently asked questions about lisinopril.

Can I speed up lisinopril’s elimination?

There is no way to speed up lisinopril’s elimination. The kidneys determine the medication’s elimination time, says Dr. Gray. “More than 90% of lisinopril is excreted unchanged in the urine. Being adequately hydrated will ensure your kidneys work optimally, and you excrete the drug normally,” she explains. However, drinking more water won’t make it leave your system faster.

Will food or drink affect how long it stays in your system?

Food does not affect the absorption or bioavailability of lisinopril. This medication does not undergo liver metabolism, so what you eat or drink will not significantly affect how long it stays in your system.

What if I experience side effects after stopping?

If you experience any adverse effects after stopping lisinopril, it’s important to speak with your healthcare provider. They will want to know the details of what you experience, including when it started and how it feels. They may run tests if necessary and discuss the next course of action with you.