Does Lisinopril Cause High Potassium?

In our latest question and answer, the pharmacist discusses whether or not lisinopril can cause high potassium levels.

Jan 19, 2018

mike asked

Is 60 mg lisinopril too much to take daily?  My last blood panel indicated that I had high potassium.

Answer

The maximum recommended dose for Zestril (lisinopril) varies depending on the indication, or reason why you’re taking the medication. For heart failure, the maximum recommended dose is 40 mg per day. For hypertension, also known as high blood pressure, the maximum recommended dose is 80 mg per day. In patients with poor kidney function with a creatinine clearance less than 30 mL/minute, the maximum recommended dose is 40 mg per day.

 

Can Lisinopril Cause High Potassium?

ACE inhibitors like lisinopril are known to increase the risk of having hyperkalemia, or high potassium. The normal range for potassium is 3.5 to 5.0 mEq/L, but your physician may allow for variances to this range depending on your situation. Sometimes, potassium levels will be increased when beginning therapy with ACE inhibitors, but may improve over time. The effect on both blood pressure and potassium levels is enhanced with higher doses of ACE inhibitors. Hyperkalemia may also be associated with poor renal function and a serum creatinine test may be warranted to assess your kidney function.

Although lisinopril is generally well tolerated, other common side effects include hypotension, dizziness, and dry cough. Angioedema, or swelling of the tongue, lips, and throat may also occur in patients on ACE inhibitors. This typically happens within the first week of treatment, but rarely occurs later in therapy.

 

What Are The Benefits Of Lisinopril Therapy?

Lisinopril (Zestril) is an Angiotensin-converting enzyme (ACE) inhibitor that can be used for hypertension, heart failure, heart attack, and diabetic kidney or eye conditions. Lisinopril was approved in 1987, however, the number of FDA approved indications has expanded since then.  

Lisinopril and other ACE inhibitors are one of the most common blood pressure medications used in the United States. ACE inhibitors are effective in reducing blood pressure and are usually well tolerated. Additionally, ACE inhibitors have cardiac protective effects outside of the impact on blood pressure. Although ACE inhibitors can cause a slight worsening in your serum creatinine in the near term, they are thought to be renal protective over the long term.

 

Source: Zestril package insert

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