Can you take lisinopril if you have COPD?

October 11, 2025 •

3 min read

With cardiovascular issues being a common comorbidity, the question of whether you can safely take lisinopril if you have COPD is crucial for many patients managing both conditions. While generally considered safe, there are important considerations for this medication class, particularly regarding a common side effect, the persistent cough.

Quick Summary

Lisinopril is often safe for individuals with COPD, but potential side effects like a persistent cough require monitoring. Angiotensin receptor blockers (ARBs) may be a viable alternative with a lower cough risk.

Key Points

Lisinopril is generally safe for COPD patients: Studies indicate that ACE inhibitors like lisinopril are typically safe for individuals with COPD, especially those also managing heart failure.
Risk of a dry cough: The most common and bothersome side effect for COPD patients taking lisinopril is a persistent, dry cough, which can sometimes interfere with daily life.
Angiotensin Receptor Blockers (ARBs) are a viable alternative: For patients who experience a cough, ARBs like losartan are a recommended alternative that work similarly but carry a much lower risk of causing a cough.
Benefits outweigh risks for many: Despite the risk of a cough, the cardiovascular benefits of ACE inhibitors may outweigh the risks for many patients, especially those with co-occurring heart failure.
Personalized care is crucial: A healthcare provider should carefully assess a patient's individual health status and comorbidities before prescribing lisinopril or any alternative treatment.
Regular monitoring is necessary: Patients taking lisinopril should be regularly monitored for side effects such as cough, dizziness, and changes in potassium levels.

Understanding Lisinopril and COPD

For people managing Chronic Obstructive Pulmonary Disease (COPD), the presence of other chronic conditions, or comorbidities, is a significant concern. Hypertension, or high blood pressure, is one of the most common comorbidities, increasing the risk of cardiovascular events and worsening overall health outcomes. Lisinopril is a widely used medication to treat high blood pressure and other heart conditions, but its interaction with a sensitive respiratory system requires a careful look.

What is Lisinopril?

Lisinopril belongs to a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by blocking an enzyme that constricts blood vessels and causes fluid retention, leading to relaxed blood vessels, lower blood pressure, and a reduced workload on the heart. It is used for hypertension, congestive heart failure, and to improve survival after a heart attack.

The Connection Between COPD and Hypertension

COPD and hypertension share risk factors like smoking and inflammation. Chronic inflammation from COPD can contribute to cardiovascular disease. Managing hypertension in patients with compromised lung function needs caution as some blood pressure medications can affect respiratory health.

The Safety Profile of Lisinopril in COPD Patients

ACE inhibitors like lisinopril are generally considered safe for most COPD patients. Guidelines and studies suggest they are a recommended option for hypertension in COPD patients, especially with heart failure. Some observational studies also link prior ACE inhibitor use to decreased mortality in patients hospitalized with acute COPD exacerbations, although more research is needed.

Potential Side Effects and Considerations

A significant concern for COPD patients taking lisinopril is the risk of a dry, persistent cough. This side effect is due to the accumulation of bradykinin. A new or worsening cough can be distressing for someone with COPD. It can disrupt daily life and sleep. Other potential side effects include dizziness, hyperkalemia, and angioedema.

Alternative Medications and Treatment Strategies

If lisinopril causes a bothersome cough, or for other reasons, alternatives for managing hypertension in COPD patients are available. ARBs, such as losartan, are a good alternative and have a much lower risk of cough. Other safe options include calcium channel blockers, thiazide diuretics, and cardioselective beta-blockers.

Comparison of Lisinopril and ARBs for COPD Patients


Feature	Lisinopril (ACE Inhibitor)	Angiotensin II Receptor Blocker (ARB)
Primary Mechanism	Blocks ACE.	Blocks angiotensin II receptors.
Risk of Cough	Significant risk (5-20%).	Much lower risk (<3%).
Safety in COPD	Generally safe, but cough can be an issue.	Considered safe and well-tolerated.
Clinical Outcomes	Some studies suggest benefits in reducing mortality with COPD exacerbations.	Studies indicate potential for lower pneumonia and exacerbation risk compared to ACE inhibitors.
Common Examples	Lisinopril, Enalapril, Ramipril.	Losartan, Valsartan, Candesartan.

Importance of Personalized Care and Monitoring

Managing multiple chronic diseases requires a personalized approach. Your doctor will weigh lisinopril's benefits against risks such as the cough. Discuss all conditions and medications with your doctor. Regular check-ups are crucial to assess blood pressure, monitor for side effects like cough, evaluate lung function, and consider dose adjustments or alternatives.

Conclusion

While generally safe, taking lisinopril with COPD has important considerations. It can provide significant cardiovascular benefits but carries the risk of a persistent cough. ARBs are a safe and effective alternative with a lower cough risk. The decision to use lisinopril or an alternative should always be made in consultation with a healthcare provider, tailoring the treatment plan to individual needs. Regular monitoring and open communication are vital.

Frequently Asked Questions

No, while generally safe, the risk of a persistent cough and other side effects requires careful consideration and monitoring, especially for those with airway hyperreactivity. It is crucial to discuss your specific case with your doctor.

The ACE inhibitor class of drugs can cause a dry, persistent cough due to the accumulation of bradykinin, a substance that is normally broken down by the ACE enzyme. This does not occur with ARBs.

Angiotensin Receptor Blockers (ARBs), such as losartan, are a common and effective alternative for blood pressure control that do not typically cause a cough.

Yes, for patients who also have heart conditions like heart failure, ACE inhibitors like lisinopril can provide significant cardiovascular benefits and improve outcomes. Some observational studies also link ACE inhibitor use to decreased mortality in COPD exacerbations.

You should monitor for a persistent cough, shortness of breath, dizziness (due to low blood pressure), and signs of high potassium levels. Regular follow-up with your doctor is essential.

In this case, ACE inhibitors or ARBs are often the recommended first-line treatment for high blood pressure due to their benefits for heart failure outcomes, though monitoring is still necessary.

In addition to ACE inhibitors and ARBs, calcium channel blockers and thiazide diuretics are often used and considered safe for managing hypertension in COPD patients.