Prinivil: 7 things you should know

Medically reviewed by Carmen Pope, BPharm. Last updated on Jan 3, 2024.

1. How it works

• Prinivil is a brand (trade) name for lisinopril.
• Lisinopril inhibits an enzyme called angiotensin-converting enzyme (ACE). This enzyme is involved in the production of angiotensin II, a powerful vasoconstrictor (narrows the arteries), which also stimulates the release of the hormone aldosterone from the adrenal glands (aldosterone increases blood pressure). By inhibiting this enzyme, lisinopril dilates (opens up) the arteries, reduces how hard the heart has to work to pump blood around the body, and lowers blood pressure. Lisinopril may be used to treat various heart conditions and certain types of kidney disease.
• Prinivil belongs to a group of medicines known as angiotensin-converting enzyme (ACE) inhibitors.

2. Upsides

• May be used to treat high blood pressure in adults and children over the age of six. Lowering blood pressure reduces the risk of further fatal and nonfatal cardiovascular events (such as strokes and heart attacks).
• Effective at reducing the signs and symptoms of heart failure.
• May increase survival odds when given within 24 hours of a heart attack (myocardial infarction).
• Prinivil is available as a generic under the name lisinopril.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• A headache and dizziness (the dizziness may be due to the blood pressure-lowering effect of Prinivil and may be more apparent when going from lying down to a sitting or standing position). Dizziness may also increase the risk of falls.
• A dry, persistent cough is also commonly reported. Blurred vision, sweating, urine changes, and increases in creatinine and potassium may also occur.
• Rarely, Prinivil may adversely affect kidney function. Monitoring of kidney function and potassium levels should occur periodically in those receiving Prinivil.
• Allergic reactions, including angioedema (swelling of airways and facial areas), are rare, but possible after Prinivil administration. The risk may be increased in people who have already experienced angioedema unrelated to ACE inhibitor administration, and in people of African-American descent.
• Dosages greater than 80mg may not be associated with a greater effect.
• The dosage of Prinivil may need adjusting in people with moderate-to-severe kidney disease.
• Prinivil may cause injury or death to a developing fetus. It should not be used during pregnancy or in women trying to become pregnant.
• May interact with some other medications including other antihypertensives, medicines that also retain potassium, diuretics, NSAIDs, lithium, injectable sodium aurothiomalate, and aliskiren

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

• Prinivil may be used to treat high blood pressure and heart failure and to increase survival following a heart attack. However, Prinivil may cause a dry, hacking cough attributable that may be difficult to tolerate and cause discontinuation of the drug.

5. Tips

• Can be taken without regard to meals.
• Treatments that lower blood pressure, such as Prinivil, should always be part of a comprehensive cardiovascular risk reduction plan that also targets, if appropriate, cholesterol-lowering, diabetes risk reduction, exercise, weight loss, and smoking cessation.
• Ensure you are adequately hydrated before starting Prinivil.
• Prinivil may make you feel dizzy, especially in the first few weeks of therapy and when going from a sitting or lying down position to standing. Always take your time when standing up. Talk with your doctor if this feeling persists.
• Call emergency services if your throat, face, or lips show signs of swelling.
• Your doctor should monitor your kidney function and potassium levels regularly.
• If you are taking Prinivil for high blood pressure, continue this medication even if you feel well. High blood pressure does not usually have symptoms.
• Do not use salt substitutes or potassium supplements while taking Prinivil, unless recommended by your doctor.
• If you also have diabetes, you may need to monitor your blood sugar levels more closely during the first few weeks of Prinivil therapy.
• Do not use Prinivil if you are pregnant or trying to become pregnant.

6. Response and effectiveness

• Starts to lower blood pressure within an hour of administration with peak effects seen within 6 hours.
• Lower doses may be needed in people with kidney disease.

7. Interactions

Medicines that interact with Prinivil may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with Prinivil. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with Prinivil include:

• aliskiren
• allopurinol (may enhance the potential for allergic reactions)
• amifostine
• amphetamines
• antipsychotic agents (may enhance the blood pressure-lowering effect)
• aspirin
• diuretics such as furosemide
• levodopa
• lithium
• NSAIDs, such as ibuprofen, diclofenac, and naproxen
• other ACE inhibitors (such as captopril or enalapril) or ARBs (such as candesartan or irbesartan)
• potassium supplements
• sodium aurothiomalate.

Prinivil may also cause blood sugar levels to drop more than expected when taken with diabetes medication, including insulin. Increased blood sugar monitoring may be required.

Note that this list is not all-inclusive and includes only common medications that may interact with Prinivil. You should refer to the prescribing information for Prinivil for a complete list of interactions.

References

• Prinivil (lisinopril) [Package Insert]. Revised 11/2023. Merck Sharp & Dohme Corp. https://www.drugs.com/pro/prinivil.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Prinivil only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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