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Key takeaways
Lisinopril is an ACE inhibitor – not a beta blocker or diuretic.
It works by relaxing blood vessels to improve circulation.
People take lisinopril long-term for high blood pressure, heart failure, after a heart attack, diabetic nephropathy, or migraine prevention.
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that relaxes blood vessels and improves circulation. Lisinopril is a commonly prescribed medication. It was the sixth-most-popular drug in 2025, according to SingleCare prescription-fill data.
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What is lisinopril?
Lisinopril is a blood pressure medication in the ACE inhibitor class. It blocks the conversion of angiotensin I to angiotensin II. Angiotensin II is a substance that constricts blood vessels, reducing blood flow and causing high blood pressure. By blocking the conversion of angiotensin I to angiotensin II, blood vessels relax and blood circulation to the heart improves.
What does lisinopril treat?
“I prescribe lisinopril most commonly to treat high blood pressure, but I also use it for patients with heart failure, a prior heart attack, diabetes with kidney involvement, or other conditions where protecting the heart and kidneys is important,” says Sam Setareh, MD, Director of Clinical Cardiology at Beverly Hills Cardiovascular and Longevity Institute and Attending Cardiologist at Cedars-Sinai Medical Center. He also says that lisinopril may be used off-label for migraine prevention.
High blood pressure
“Lisinopril works by relaxing blood vessels and reducing strain on the heart, which lowers blood pressure and improves long-term cardiovascular outcomes,” Dr. Setareh says. The typical initial dosage of lisinopril for high blood pressure in adults is 10 mg once daily. However, your doctor may increase the dose as needed, but it should not exceed 40 mg per day. Dosage is based on weight in children aged 6 and older. Usually, the initial starting dose is 0.07 mg per kg of body weight or 5 mg per day. The dose may be titrated up to 0.61 mg per kg or 40 mg per day.
“In most cases, lisinopril is a long-term medication. High blood pressure is usually a chronic condition, so treatment is ongoing rather than temporary,” Dr. Setareh says. “That said, the timeline depends on the individual patient. If blood pressure improves significantly due to weight loss, lifestyle changes, or treatment of an underlying cause, [a healthcare provider] may be able to reduce the dose or stop the medication.”
Heart failure
Heart failure occurs when the heart is unable to pump blood as it should to meet the body’s needs. In such cases, your healthcare provider may prescribe lisinopril to improve blood circulation.
The recommended starting dosage of lisinopril for heart failure for adults is 5 mg once daily. It may be higher depending on your healthcare provider’s preference, but it should not exceed 40 mg per day. For children, contact your healthcare provider to determine the appropriate dose.
Heart attack
Your doctor may also prescribe lisinopril after a heart attack (myocardial infarction). A heart attack occurs when blood flow to one of the arteries supplying the heart is blocked. After a heart attack, some heart muscles may be unable to pump blood effectively. Lisinopril may be prescribed, often within 24 hours of a heart attack, to help improve heart function and increase survival.
The dosage of lisinopril for heart attacks is 5 mg within 24 hours of symptom manifestation, and 5 mg after 24 hours. In the following weeks, the healthcare provider may increase the dosage to 10 mg once daily.
Diabetic nephropathy (off-label)
Diabetic nephropathy is a type of kidney disease that’s a complication of diabetes. It’s characterized by albumin in the urine (albuminuria), which is a protein produced by the liver.
“Beyond the FDA-approved indications, I often prescribe lisinopril for patients with diabetes and kidney disease, particularly when albuminuria is present, as ACE inhibitors like lisinopril help slow the progression of diabetic kidney disease,” Dr. Setareh says.
At least 10 mg of lisinopril daily can reduce the risk of progression from microalbuminuria (moderate urine albumin) to macroalbuminuria (significant increase in urine albumin) in people with diabetes, according to a study in Evidence-Based Practice.
Migraines (off-label)
Lisinopril is also used off-label for migraine prevention. In one study, patients taking 10 mg of lisinopril once daily for 1 week, followed by 20 mg once daily for 11 weeks, had significant reductions in headache frequency, duration, and severity compared with those receiving a placebo.
Lisinopril vs. beta blockers
Lisinopril is part of a class of medications called ACE inhibitors. “These medications inhibit a protein that causes blood vessels to constrict, thereby improving blood pressure,” says Cheng-Han Chen, MD, a board-certified interventional cardiologist and Medical Director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA. “Beta blockers lower blood pressure through a different mechanism, by both lowering the force by which the heart beats, and by widening the blood vessels to improve blood flow.”
“I typically prescribe beta blockers when patients have specific indications such as a prior heart attack, certain heart rhythm disorders, or heart failure, while lisinopril is often a first-line option for blood pressure control and organ protection,” says Dr. Setareh.
RELATED: What can I take instead of lisinopril?
Lisinopril vs. diuretics
Lisinopril is not a diuretic, but it can be taken with a diuretic.
“Diuretics lower blood pressure by making your kidneys excrete more sodium and water, decreasing the volume circulating in your blood vessels, [and] lowering blood pressure,” says Dr. Chen.
“In clinical practice, I often prescribe lisinopril together with a diuretic because the two medications work through complementary mechanisms and can provide more effective blood pressure control,” says Dr. Setareh.
What to know before taking lisinopril
“I often choose lisinopril because it is well-studied, effective, and generally well-tolerated,” Dr. Setareh says.
However, like most drugs, lisinopril has some side effects and warnings.
Lisinopril side effects include high potassium levels, dry cough, angioedema (skin swelling of the face), low blood pressure, dizziness, headache, and reduced blood flow to the kidneys.
Pregnant women and children younger than 6 years old should not take lisinopril.
Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and naproxen, and potassium supplements can interact with lisinopril. Tell your healthcare provider about all your medications and supplements to avoid any risk of drug interactions.
Read the prescription label carefully before using lisinopril. A healthcare provider might start you on an alternative dose of 2.5-10 mg once daily and gradually increase it to the appropriate dose for your condition.
RELATED: Lisinopril dosage guide
Lisinopril is not a cure for any of the medical conditions it’s prescribed for. Therefore, do not stop using lisinopril before talking to your healthcare provider. “For patients with high blood pressure, heart failure, or kidney disease, lisinopril is often part of a long-term strategy to reduce future cardiovascular risk,” says Dr. Setareh.
Expert takeaway
“Lisinopril is one of the most commonly prescribed medications for high blood pressure. It is generally safe and well-tolerated, with few side effects. However, one of the most common side effects I see in clinical practice is a persistent dry cough. If you notice a tickle in the back of your throat, contact your provider, as an alternative medication may need to be prescribed,” says Madeline Remelius, Pharm.D., a clinical pharmacist in Sarasota, FL, and a member of the SingleCare Medical Review Board
- Zestril (Lisinopril) prescribing information, FDA (2014)
- Lisinopril, Mayo Clinic
- What is the optimal dosing of lisinopril for renal protection in normotensive patients with diabetes and moderate albuminuria (30–299 mg/d)? Evidence-Based Practice (2018)
- Lisinopril as a prophylactic agent for migraine: a randomised double blind placebo controlled crossover prospective study in Kashmir, International Journal of Advances in Medicine (2021)