Can lisinopril cause foot swelling? Understanding angioedema and other risks

October 10, 2025 •

4 min read

While angioedema is a rare but serious side effect of ACE inhibitors like lisinopril, occurring in 0.1% to 0.7% of users, it can cause swelling in the feet, face, and other parts of the body. This is one of the ways that can lisinopril cause foot swelling, though other medical issues may also contribute.

Quick Summary

Lisinopril, an ACE inhibitor, can cause foot swelling through a rare but serious side effect called angioedema. Less commonly, it may relate to kidney problems or underlying heart failure. Symptoms, risk factors, and management options should be understood to ensure patient safety.

Key Points

Angioedema is a serious, though rare, side effect: Lisinopril can cause angioedema, a severe swelling that can affect the feet, face, and throat, potentially requiring emergency care.
Swelling is not always angioedema: Other causes, such as underlying heart failure or rare kidney issues, can also cause foot swelling while on lisinopril.
Risk factors exist: Individuals of African descent, women, older adults, and those with a history of angioedema are at higher risk.
Symptoms of angioedema are distinct: It is typically non-pitting and non-itchy, unlike other fluid retention issues, and can occur at any time while taking the medication.
Never stop medication abruptly: If swelling occurs, contact your doctor immediately, but do not stop taking lisinopril without their guidance.
Alternative treatments are available: For confirmed lisinopril-induced swelling, doctors can prescribe alternative medications like ARBs that do not carry the same angioedema risk.

Understanding Lisinopril and Swelling

Lisinopril belongs to a class of drugs known as angiotensin-converting enzyme (ACE) inhibitors. It works by blocking the production of a hormone called angiotensin II, which helps relax blood vessels and lower blood pressure. While effective, like any medication, it carries potential side effects, including fluid retention that can manifest as swelling in the feet and ankles. It is important to differentiate between a common issue like simple fluid retention and the more serious but rare condition of angioedema.

Angioedema: A Rare But Serious Reaction

Angioedema is a severe adverse reaction associated with ACE inhibitors that can be life-threatening if it affects the throat or airway. Unlike a common allergic reaction, angioedema from lisinopril is caused by an accumulation of a substance called bradykinin. This buildup increases vascular permeability, allowing fluid to leak into the surrounding tissues and causing non-pitting swelling in the deeper layers of the skin. Although it most often affects the face, lips, tongue, and throat, it can also cause swelling of the feet and extremities. A key feature is the absence of itching or hives. Immediate medical attention is crucial if this occurs.

Other Potential Causes of Swelling

Besides angioedema, there are other, less common ways that lisinopril might be linked to foot and ankle swelling:

Kidney Problems: In rare instances, lisinopril can cause kidney injury, leading to a decrease in urine output and fluid retention that appears as swelling in the ankles and feet. Patients with pre-existing kidney problems may be at higher risk.
Worsening Heart Failure: Lisinopril is often prescribed for congestive heart failure. However, a sudden or unexplained increase in weight or swelling in the legs could signal a worsening of the heart condition itself, rather than a side effect of the medication.
Other Medications: Combining lisinopril with certain other drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs) or potassium-sparing diuretics, can increase the risk of kidney-related issues or elevated potassium levels, both of which can lead to complications.

Key Risk Factors for Lisinopril-Induced Angioedema

While anyone taking lisinopril could theoretically experience angioedema, certain individuals are at a higher risk. It is not a dose-dependent side effect, and can occur at any time, even after years of use.

Ethnicity: People of African and Hispanic descent have an increased risk of angioedema from ACE inhibitors.
Gender and Age: Women and individuals over the age of 65 have also been identified as being at an elevated risk.
Smoking: A history of smoking can increase susceptibility.
History of Swelling: Patients with a prior history of angioedema, or even a persistent cough from an ACE inhibitor, may be more susceptible.
Drug Interactions: Use of other medications like NSAIDs or certain immunosuppressants can increase the risk.

Distinguishing Lisinopril-Related Swelling

Accurately identifying the cause of swelling is crucial for proper management. A healthcare provider can help determine if it is related to lisinopril or another condition.

Comparison of Swelling Causes


Symptom	Lisinopril-Induced Angioedema	Congestive Heart Failure (CHF)	Simple Edema/Other Causes
Location	Often involves face, lips, and tongue; can also affect extremities.	Typically affects dependent areas like feet, ankles, and legs due to gravity.	Can be localized or widespread, depending on the cause (e.g., injury, vein issues).
Feel	Non-pitting; pushing on the skin does not leave a dent.	Pitting; pushing on the skin leaves an indentation.	Varies depending on the cause.
Onset	Can be sudden or delayed, occurring anytime during treatment.	Develops gradually over time as the heart's pumping ability weakens.	Varies, from immediate (injury) to gradual (venous insufficiency).
Associated Symptoms	Often painless and without hives or itching; can have hoarseness or difficulty breathing.	Shortness of breath, chest pain, fatigue, and rapid weight gain.	Varies; may include localized pain, redness, or itching.

Management and When to Seek Help

If you notice swelling in your feet or other parts of your body while taking lisinopril, it is essential to contact your healthcare provider immediately. Do not stop taking the medication on your own without first seeking medical advice, as this can lead to uncontrolled high blood pressure.

If angioedema is suspected, especially with swelling of the face, tongue, or throat, seek emergency medical care immediately.

Your doctor will evaluate your symptoms and determine the cause. If lisinopril is identified as the cause, they may recommend switching to an alternative blood pressure medication, such as an angiotensin II receptor blocker (ARB), which works similarly but does not carry the same risk of angioedema. For general medication-induced swelling, your doctor might suggest:

Elevating your feet: Keeping your feet raised above heart level can help fluid drain.
Compression stockings: These can prevent fluid from pooling in your ankles and feet.
Reducing salt intake: A low-salt diet can minimize fluid retention.
Increasing movement: Gentle exercise, like walking, helps improve circulation.

For more detailed information on lisinopril, consult reliable sources such as the Lisinopril: MedlinePlus Drug Information page.

Conclusion

While foot swelling can be caused by lisinopril, the most serious concern is angioedema, a rare but life-threatening side effect. Less commonly, swelling may be related to kidney complications or an underlying heart condition being treated by the medication. The key takeaway for anyone experiencing swelling is to contact a healthcare professional promptly. They can accurately diagnose the cause and, if necessary, adjust your medication plan to ensure your safety and continued health. Never disregard swelling, especially if it is sudden, severe, or accompanied by other concerning symptoms. Proper evaluation is the most important step.

Frequently Asked Questions

Angioedema from lisinopril is a rare side effect, occurring in approximately 0.1% to 0.7% of patients who take ACE inhibitors. Despite its rarity, it is the leading cause of drug-induced angioedema in the United States because of how widely ACE inhibitors are prescribed.

Signs include sudden, non-itchy, non-pitting swelling, often starting in the lips, tongue, or face, and potentially spreading to the hands, feet, and throat. Difficulty breathing or swallowing is a medical emergency.

If you experience any new swelling, contact your healthcare provider immediately. They can help determine the cause and decide if you need to adjust or change your medication. Do not stop taking lisinopril without consulting a doctor.

Yes, although rare, lisinopril can cause kidney problems, including acute kidney failure, which can lead to fluid retention and swelling of the ankles and feet. Your doctor will monitor your kidney function with blood tests.

The primary treatment is to immediately stop taking lisinopril. If the airway is compromised, emergency medical intervention is needed. Antihistamines, corticosteroids, and epinephrine are often ineffective for this type of swelling.

For patients who experience angioedema with an ACE inhibitor, a different class of medication, such as an angiotensin II receptor blocker (ARB), is often recommended as an alternative. ARBs do not act on the same pathway that causes angioedema.

Yes, angioedema from ACE inhibitors is not always time-dependent and can occur weeks, months, or even years after starting treatment. This is why it's crucial to be aware of the symptoms regardless of how long you have been taking the medication.

For mild fluid retention, elevating your legs, wearing compression stockings, and reducing your salt intake can help. Gentle exercise can also improve circulation.