What is Lisinopril?
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor medication primarily used to treat high blood pressure (hypertension) [1.6.4]. By blocking the ACE enzyme, lisinopril helps relax and widen blood vessels, which lowers blood pressure [1.6.4]. It is also prescribed for treating heart failure and improving survival after a heart attack [1.6.2]. Due to its effectiveness and availability as a low-cost generic, it is one of the most commonly used drugs in its class [1.6.2].
Understanding Heartburn and GERD
Heartburn is a painful, burning sensation in the chest or throat that occurs when stomach acid backs up into the esophagus, the tube that carries food from your mouth to your stomach [1.5.6]. This backflow is known as acid reflux. If acid reflux symptoms happen more than twice a week, it may be diagnosed as gastroesophageal reflux disease (GERD) [1.5.6]. While many factors can trigger heartburn, including certain foods and lifestyle habits, some medications can also be a cause or an aggravating factor [1.4.1].
The Link: Can Lisinopril Cause Heartburn?
Yes, lisinopril can cause heartburn, although it is listed as a rare or less common side effect [1.2.3, 1.3.1]. Medical resources like the Mayo Clinic and MedlinePlus include heartburn, indigestion, and acid stomach among the potential gastrointestinal side effects of taking lisinopril [1.2.2, 1.2.3, 1.3.1].
ACE inhibitors as a class of drugs are known to potentially cause or worsen acid reflux [1.4.1, 1.4.4]. One expert notes that ACE inhibitors are a leading cause of medication-induced (iatrogenic) reflux and chronic cough [1.4.1]. The mechanism isn't fully clear but may be related to how these drugs affect the body beyond just blood vessels. For some patients, stopping the ACE inhibitor leads to a resolution of their reflux symptoms [1.4.2].
Other Gastrointestinal Side Effects
Besides heartburn, lisinopril can cause other digestive issues, though they are also generally uncommon. These can include [1.3.5, 1.2.4]:
- Diarrhea
- Nausea and vomiting
- Abdominal pain
- Constipation
- Gas (flatulence)
In very rare cases, a serious condition called intestinal angioedema (swelling of the intestines) can occur, causing severe abdominal pain, nausea, and vomiting [1.3.2, 1.3.9]. This requires immediate medical attention.
Managing Heartburn While Taking Lisinopril
If you experience heartburn while on lisinopril, it's crucial not to stop taking your medication without consulting your healthcare provider [1.2.1, 1.5.5]. Abruptly stopping blood pressure medication can be dangerous [1.6.3]. Your doctor can help determine if lisinopril is the cause and recommend the best course of action.
Here are some management strategies:
- Lifestyle Adjustments: Avoid common heartburn triggers like spicy, fatty, or acidic foods, caffeine, and alcohol [1.5.4]. Eating smaller, more frequent meals and avoiding late-night snacks can also help [1.5.4].
- Positional Changes: Remain upright for at least 30 minutes after taking your medication and for 3 to 4 hours after your last meal [1.5.2, 1.5.3]. Elevating the head of your bed by 4 to 6 inches can prevent nighttime reflux [1.5.2].
- Medication Timing: Taking lisinopril with food may help if it's causing stomach upset [1.2.7]. Always take pills with a full glass of water [1.5.1].
- Over-the-Counter (OTC) Aids: Antacids can provide quick, short-term relief. However, some antacids can interact with prescription drugs, so consult your doctor or pharmacist first [1.5.1]. H2 blockers and proton pump inhibitors (PPIs) are other options but should also be discussed with a provider, as they can have their own interactions [1.5.4].
Alternatives to Lisinopril
If heartburn is persistent and disruptive, your doctor might suggest an alternative blood pressure medication. Different classes of antihypertensive drugs have different side effect profiles [1.6.2].
| Medication Class | Examples | Potential for Heartburn/GI Side Effects |
|---|---|---|
| ACE Inhibitors | Lisinopril, Enalapril, Ramipril [1.4.1] | Can cause or worsen acid reflux and cough [1.4.1, 1.4.2]. |
| Angiotensin II Receptor Blockers (ARBs) | Losartan (Cozaar), Valsartan (Diovan) [1.6.4] | Generally have a lower incidence of cough and may be a suitable alternative [1.6.2]. GI side effects like diarrhea can still occur [1.6.3]. |
| Calcium Channel Blockers (CCBs) | Amlodipine (Norvasc), Diltiazem [1.6.4] | Can worsen GERD for some individuals [1.4.4, 1.4.7]. |
| Beta-Blockers | Metoprolol (Lopressor), Atenolol (Tenormin) [1.6.7] | Not typically associated with causing heartburn; GI side effects like diarrhea or nausea can occur [1.6.3]. |
| Diuretics (Water Pills) | Hydrochlorothiazide (HCTZ) [1.6.4] | Not generally linked to causing heartburn. Can cause other metabolic changes [1.6.2]. |
Switching medication should only be done under medical supervision. Your doctor will consider your overall health, other conditions, and potential side effects when choosing the best treatment for you [1.6.2].
Conclusion
While lisinopril is an effective medication for controlling high blood pressure, it can cause heartburn as a rare side effect [1.2.3, 1.3.1]. The broader class of ACE inhibitors is known to sometimes trigger or worsen acid reflux [1.4.1, 1.4.4]. If you experience persistent heartburn, it's essential to speak with your doctor. They can help you manage the symptom through lifestyle changes or determine if switching to an alternative medication, such as an ARB or beta-blocker, is the right choice for your cardiovascular health.
For more information on drug side effects, you can visit the official MedlinePlus website.
