Top 100 Drugs: #3 Lisinopril

Lisinopril (Zestril)

lih-SIN-oh-pril (ZESS-tril)

Common Uses: Hypertension (high blood pressure), heart failure, after heart attack

Mascot: “Licensed Zest drill”

Alternate mnemonics: 

 ❖ “Listen—your blood pressure just dropped!”

 ❖ “-prils put pressure in its place”

 ❖ “ACE up the sleeve against hypertension”

 ❖ “Lisino-chill pill for the arteries”

 ❖ “PRIL = Pressure Regulating Inhibitor of Lungs” – cough is a side effect of ACE inhibitors

 ❖ ACE Inhibitors song available on YouTube, Spotify, etc

Drug Class: Blood pressure medication: Angiotensin Converting Enzyme (ACE) inhibitor

Similar Drugs: Enalapril (#141), Ramipril (#187), Lisinopril/Hydrocholothiazide combo (#53)

Comparisons: Similar to angiotensin II receptor blockers (ARBs, -sartans)

    ➤ ARBs are often used instead if cough with ACE inhibitors is a problem

High-Alert Risk: ✅ Not high alert

Major Side Effects: Dry cough, high potassium, swelling of lips or throat

Look-Alike/Sound-Alike: Lisdexamfetamine (Vyvanse, stimulant for ADHD)

Narrow Therapeutic Index: No

Precautions: Avoid during pregnancy; monitor potassium and kidney labs; do not combine with ARBs (-sartans)

Routes: Oral

Easily Replaceable? Yes – several equivalent “-prils” are available.

Sample Test Questions:

Q: What side effect often leads to switching to an Angiotensin II receptor blocker (ARB)?

A: Dry cough

Q: Why should ACE inhibitors and ARBs be avoided in pregnancy?

A: Birth defects