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Prinivil (lisinopril) is a synthetic peptide derivative used to treat high blood pressure, heart failure, and to prevent further complications after a heart attack. It is also commonly used to prevent kidney and eye problems in people with diabetes.

Prinivil is useful in lowering the blood pressure of patients 6 years of age and older who have hypertension. Lowering blood pressure reduces the incidence of cardiovascular events, such as stroke and heart attack. Prinivil can be used as part of an overall cardiovascular risk management program, including, as appropriate, cholesterol management, diabetes management, antithrombotic therapy, quitting smoking, exercise, and salt intake reduction.

Prinivil reduces signs and symptoms of heart failure in patients with an inadequate response to diuretics and digitalis, and it reduces mortality of otherwise stable patients when administered within 24 hours of acute myocardial infarction.

Overcoming Hypertension with Prinivil

In hypertension Prinivil may be used in patients age 6 and up, though a doctor will need to determine daily dosage for patients under age 16.

For everyone else, treatment is quite similar:

  • Initial adult dose is 10 mg daily.
  • Dosage may be increased after several days of use to 20 or 40 mg, as needed, sufficient for the majority of patients.
  • Though unusual, some patients may need dosage increased to 80 mg per day. Do not exceed 80 mg per day.
  • In all cases, doses are typically taken just once per day.

Diuretics may be added if blood pressure is not adequately controlled by Prinivil alone; this is normally done before increasing dosage over 40 mg.

If a diuretic is already being taken prior to starting Prinivil, dosage of Prinivil will likely be cut in half---starting dosage of 5 mg.

Prinivil may be taken for as long as it provides benefit.

A Healthier Heart with Prinivil

Prinivil can be used to improve heart health in heart failure or after a heart attack, though the techniques to do so vary a little.

In heart failure, the initial adult dose when used with diuretics or digitalis is 5 mg once a day. In patients with hyponatremia, the initial adult dose is 2.5 mg once a day. Once it has been established that the patient tolerates the medication well, dosage may be increased to 40 mg once a day.

For acute myocardial infarction the first dose of Prinivil should be administered within 24 hours of the myocardial infraction. Patients should take 5 mg orally, followed by 5 mg after 24 hours, 10 mg after 48 hours, and then 10 mg once daily. Use of the medication should continue for as long as it provides benefit, at least 6 weeks.

In patients with a low systolic blood pressure, treatment should start with 2.5 mg during the first 3 days after the myocardial infarction. If hypotension occurs, consider doses of 2.5 or 5 mg. If prolonged hypotension occurs, discontinue Prinivil.

Important Precautions

Prinivil should not be taken by women who are pregnant or plan to become so.

The medication is not suitable for those with a history of angioedema, or who have diabetes and are already taking aliskiren.

Prinivil dose must be adjusted in those with poor kidney function. Since Prinivil is removed by dialysis, dosing changes must also be considered for people on dialysis.

Depending upon the condition being treated patients taking Prinivil may experience:

  • Headache
  • Dizziness
  • Cough
  • Difficulty swallowing
  • Difficulty breathing
  • Fatigue
  • Diarrhea
  • Skin reactions
  • Hypotension
  • Renal dysfunction
  • Chest pain
  • Hyperkalemia
  • Syncope

Most of the above side effects are mild and not cause for concern unless severe. Likewise most will stop occurring as the body adjusts to treatment. Be aware, however, particularly those taking this medication for heart health, that low blood pressure can be a serious problem with Prinivil and the condition should be monitored closely.


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Medicines have benefits and some have risks. Always read the label and use only as directed. If symptoms persist or you have side effects see your health professional.

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