lisinopril

12 interactions related to lisinopril

lisinopril + potassium

Lisinopril blocks the renin-angiotensin-aldosterone system, reducing aldosterone secretion and impairing the kidneys' ability to excrete potassium. Adding potassium supplements on top of this can push serum potassium into dangerous territory, especially in older adults or those with reduced kidney function.

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lisinoprilpotassiumace inhibitorhyperkalemiablood pressureraaskidneysupplement interaction

lisinopril + salt substitutes

Potassium-based salt substitutes (potassium chloride replacing sodium chloride) can deliver hundreds of milligrams of potassium per teaspoon. Combined with lisinopril's impairment of renal potassium excretion, this combination has caused multiple documented cases of life-threatening hyperkalemia, including cardiac arrest.

critical
lisinoprilsalt substitutepotassium chlorideace inhibitorhyperkalemiacardiac arrestblood pressurenosalt

lisinopril + licorice

Glycyrrhizin in licorice mimics aldosterone, causing the kidneys to retain sodium and water and excrete potassium. This raises blood pressure and directly opposes lisinopril's antihypertensive effect, while also driving hypokalemia that can complicate other cardiovascular risks.

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lisinoprillicoriceglycyrrhizinace inhibitorblood pressurehypertensionpseudoaldosteronismherb interaction

cayenne + ace inhibitors

Capsaicin, the active component of cayenne, can trigger or worsen the dry cough characteristic of ACE inhibitor therapy by sensitizing airway cough receptors. A published case report describes topical capsaicin inducing cough in a patient already on an ACE inhibitor.

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cayennecapsaicinace-inhibitorlisinoprilcoughbradykininhypertensiondrug-interaction

radish + ace inhibitors

Radish contains moderate amounts of dietary nitrate and potassium. Nitrate becomes nitric oxide and modestly relaxes blood vessels, while potassium adds to the elevated potassium levels that ACE inhibitors already cause. In normal food portions the effect is small, but very large or supplement-level intake can matter.

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radishdaikonace inhibitorlisinoprilpotassiumnitrateblood pressurehyperkalemia

lithium + ace inhibitors

ACE inhibitors reduce glomerular filtration rate and decrease sodium delivery to the distal nephron, which lowers renal lithium clearance and can raise serum lithium by approximately 36 percent. Toxicity may emerge with delayed onset 3 to 5 weeks after starting the ACE inhibitor, particularly in older adults and those with reduced renal function.

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lithiumace inhibitorlisinoprilenalaprilramiprilrenal clearancebipolar disorderhypertensiondrug toxicity

oranges + ace inhibitors

Oranges and orange juice are high in potassium (about 240 mg per medium orange, 450-500 mg per cup of juice), and ACE inhibitors reduce aldosterone and renal potassium excretion. Heavy consumption of oranges or orange juice with ACE inhibitors can raise serum potassium, with greater risk in patients with reduced kidney function.

moderate
orangesorange juiceace inhibitorpotassiumhyperkalemiablood pressurefood-drug interactionlisinopril

potatoes + ace inhibitors

Potatoes are very high in potassium (a medium baked potato with skin contains about 900 mg), and ACE inhibitors reduce aldosterone-mediated potassium excretion. Regular large servings of potatoes combined with ACE inhibitors can raise serum potassium, particularly in patients with chronic kidney disease, heart failure, or diabetes.

moderate
potatoesace inhibitorpotassiumhyperkalemiablood pressurefood-drug interactionlisinoprilkidney

pomegranate + ace inhibitors

Pomegranate polyphenols (pedunculagin, punicalin, gallagic acid) directly inhibit angiotensin-converting enzyme, and clinical trials show pomegranate juice lowers systolic and diastolic blood pressure on its own. Combined with prescription ACE inhibitors the effects can stack, potentially causing additive hypotension, dizziness, or hyperkalemia.

moderate
pomegranateace inhibitorslisinoprilramiprilenalaprilblood pressurehypotensionsynergy

salt substitute + lisinopril

Salt substitutes are typically potassium chloride and can deliver hundreds of milligrams of potassium per small serving. Lisinopril and other ACE inhibitors reduce aldosterone and decrease potassium excretion. Combining them can cause clinically significant hyperkalemia, particularly with chronic kidney disease, diabetes, or other potassium-raising drugs.

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salt substitutelisinoprilace inhibitorpotassium chloridehyperkalemiablood pressuredrug interactionkidney

bananas + lisinopril

Lisinopril is an ACE inhibitor that reduces aldosterone and increases serum potassium. Combined with high dietary potassium from bananas and other potassium-rich foods, this can cause hyperkalemia, particularly in patients with reduced kidney function or those also taking potassium-sparing diuretics.

moderate
bananaslisinoprilace inhibitorpotassiumhyperkalemiablood pressurefood-drug interactionhypertension

avocado + ace inhibitors

Avocados are a high-potassium food (about 487 mg per half avocado), and ACE inhibitors reduce aldosterone-driven potassium excretion. Frequent large servings of avocado combined with ACE inhibitors can contribute to hyperkalemia, especially in patients with kidney impairment or other potassium-raising medications.

moderate
avocadoace inhibitorpotassiumhyperkalemiablood pressurefood-drug interactionlisinoprilramipril