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This medicine will have an additive effect with other medicines that decrease blood pressure, particularly other medicines used to treat high blood pressure (antihypertensives). In people taking antihypertensive medicines it may cause a large drop in blood pressure with the first dose or after any dose increases, particularly in people taking diuretic medicines such as furosemide. This may cause dizziness, which can usually be relieved by lying down until the symptoms pass. If you frequently feel dizzy while taking this medicine in combination with other blood pressure lowering medicines you should let your doctor know, as your doses may need adjusting. Other medicines that decrease blood pressure include the following:
- alpha-blockers such as prazosin (these are also used to treat an enlarged prostate gland)
- beta-blockers such as propranolol
- calcium-channel blockers such as verapamil, nifedipine
- clonidine
- diuretics, eg furosemide, bendroflumethiazide
- nitrates, eg glyceryl trinitrate
- certain antidepressants
- certain antipsychotics
- alprostadil
- baclofen
- benzodiazepines, eg temazepam.
Non-steroidal anti-inflammatory drugs (NSAIDs, eg indometacin, aspirin, ibuprofen) may reduce the blood pressure lowering effect of this medicine, and may increase the risk of a decline in kidney function.
There may be a risk of raised potassium levels in the blood (hyperkalaemia) if any of the following medicines are taken with lisinopril, hence these are not normally recommended for use in combination with this medicine. If you are taking any of the following with this medicine you should have regular blood tests to monitor the amount of potassium in your blood:
- potassium-sparing diuretics (eg spironolactone, triamterene, amiloride)
- potassium supplements
- potassium-containing salt substitutes (eg Lo-Salt)
- ciclosporin
- heparin.
There may be a risk that the amount of potassium in the blood could fall too low (hypokalaemia) if any of the following medicines are taken in combination with this medicine:
- amphotericin
- corticosteroids
- carbenoxolone
- beta-agonist bronchodilators such as salbutamol
- stimulant laxatives, eg bisacodyl.
This medicine may increase the blood level of the medicine lithium and for this reason, it is not normally recommended for people taking lithium. People taking this medicine in combination with lithium should have the level of lithium in their blood closely monitored.
Lisinopril may possibly enhance the blood sugar lowering effect of insulin and oral antidiabetic medicines, and so could increase the risk of low blood sugar (hypoglycaemia). On the other hand, hydrochlorothiazide may increase blood sugar levels. People with diabetes should therefore carefully monitor their blood sugar while taking this medicine, particularly in the first few weeks of treatment.
There may be an increased risk of a drop in the normal numbers of white blood cells in the blood if this medicine is taken in combination with any of the following medicines:
- allopurinol
- azathioprine
- immunosuppressant therapy
- procainamide.
Other medicines containing the same active ingredients
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