What to avoid while taking lisinopril?

October 12, 2025 •

3 min read

As of 2020, lisinopril was the fourth most prescribed medication in the United States, with nearly 20 million patients [1.7.3]. To ensure its effectiveness and your safety, it's crucial to understand what to avoid while taking lisinopril.

Quick Summary

When taking lisinopril, it is critical to avoid certain medications like NSAIDs and potassium-sparing diuretics. You should also limit alcohol and foods high in potassium to prevent adverse effects.

Key Points

NSAIDs: Avoid nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen, as they can reduce lisinopril's effectiveness and harm the kidneys [1.7.2, 1.7.3].
Potassium: Be cautious with potassium supplements, salt substitutes, and high-potassium foods (like bananas and potatoes) to prevent dangerously high potassium levels (hyperkalemia) [1.2.1, 1.5.4].
Alcohol: Limit or avoid alcohol as it can increase lisinopril's blood-pressure-lowering effect, causing dizziness and fainting [1.4.5].
Other Heart Medications: Do not take lisinopril with ARBs, aliskiren, or within 36 hours of Entresto to avoid severe side effects like hypotension, kidney failure, and angioedema [1.3.1, 1.3.4].
Diuretics: Use caution with 'water pills', especially potassium-sparing types, which significantly increase the risk of hyperkalemia when combined with lisinopril [1.8.1, 1.8.2].
Pregnancy: Do not take lisinopril if you are pregnant or planning to become pregnant, as it carries a boxed warning for causing fetal harm [1.2.5, 1.6.4].
Communication is Key: Always inform your doctor about all medications, supplements, and dietary habits to ensure lisinopril is safe and effective for you [1.7.3].

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure (hypertension), heart failure, and improve survival after a heart attack [1.6.4, 1.7.3]. It works by relaxing blood vessels, which allows blood to flow more smoothly and helps the heart pump more efficiently [1.6.4]. While highly effective, its safety and efficacy can be compromised by interactions with other substances. Being aware of these interactions is vital for anyone prescribed this medication.

Drug Interactions to Be Aware Of

Certain over-the-counter and prescription medications can interfere with lisinopril, leading to reduced effectiveness or an increased risk of serious side effects [1.7.3]. Always inform your healthcare provider of all medications you are taking, including supplements [1.3.2].

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Commonly used for pain and inflammation, NSAIDs like ibuprofen (Advil, Motrin) and naproxen (Aleve) can reduce lisinopril's ability to lower blood pressure [1.7.2, 1.7.5]. Combining them can also increase the risk of kidney damage, especially in older adults, those who are dehydrated, or individuals with pre-existing kidney disease [1.7.2, 1.7.3]. For pain relief, alternatives like acetaminophen (Tylenol) may be a safer option, but you should consult your doctor first [1.7.3].

Diuretics ('Water Pills')

Diuretics are often prescribed with lisinopril to enhance blood pressure control [1.8.2]. However, this combination can sometimes lower blood pressure too much, causing dizziness and fainting (hypotension) [1.8.1]. A specific class, called potassium-sparing diuretics (e.g., spironolactone, amiloride), poses a different risk. Both lisinopril and these diuretics can raise potassium levels in the blood; taking them together significantly increases the risk of hyperkalemia (dangerously high potassium) [1.8.1, 1.8.2].

Other Blood Pressure and Heart Medications

Dual blockade of the renin-angiotensin system—by combining lisinopril with an Angiotensin II Receptor Blocker (ARB) like losartan or valsartan, or with aliskiren—is generally not recommended [1.3.1, 1.3.4]. This combination heightens the risk of low blood pressure, high potassium levels, and acute kidney injury [1.3.1]. Additionally, taking lisinopril within 36 hours of a neprilysin inhibitor like sacubitril/valsartan (Entresto) is contraindicated due to an elevated risk of angioedema (severe swelling) [1.3.2, 1.3.4].

Lithium

For individuals taking lithium for bipolar disorder, lisinopril can increase lithium levels in the body, potentially leading to toxicity [1.3.1, 1.3.4]. If this combination is necessary, regular monitoring of serum lithium levels is essential [1.3.1].

Food, Drink, and Supplement Avoidance

Your diet can also play a significant role in how your body responds to lisinopril.

High-Potassium Foods and Salt Substitutes

Lisinopril can cause the body to retain potassium [1.2.4]. Therefore, it is important to be cautious with high-potassium dietary intake [1.2.3]. While you may not need to eliminate them completely, you should monitor your intake of potassium-rich foods, especially if you have kidney problems [1.2.1, 1.5.6]. Foods high in potassium include:

Bananas and oranges [1.5.1]
Potatoes and sweet potatoes [1.2.2, 1.2.5]
Spinach and other dark leafy greens [1.2.2, 1.5.6]
Tomatoes and tomato sauce [1.5.6]
Avocados [1.5.6]

Many salt substitutes are high in potassium chloride and should be avoided unless specifically approved by your doctor [1.2.1, 1.2.4].

Alcohol

Combining lisinopril and alcohol can have an additive effect in lowering your blood pressure, which may lead to increased dizziness, lightheadedness, and fainting [1.2.3, 1.4.5]. This is most likely when starting treatment or after a dose increase [1.4.5]. Chronic alcohol consumption can also raise blood pressure, counteracting the medication's intended effect [1.4.4, 1.4.6]. It's best to limit or avoid alcohol while taking lisinopril and discuss safe consumption levels with your doctor [1.4.7].

Comparison of Items to Avoid


Category	Items to Avoid or Use with Caution	Potential Negative Interaction
Medications	NSAIDs (ibuprofen, naproxen), Potassium-Sparing Diuretics, ARBs, Aliskiren, Lithium, Entresto [1.7.3, 1.8.2, 1.3.4]	Reduced effectiveness, kidney damage, hyperkalemia, severe hypotension, angioedema, lithium toxicity [1.7.2, 1.8.1, 1.3.1]
Food & Drinks	High-potassium foods (bananas, potatoes, spinach), Alcohol [1.5.1, 1.4.5]	Hyperkalemia (high potassium), additive blood pressure lowering effect, dizziness, fainting [1.2.1, 1.4.5]
Supplements	Potassium supplements, Salt substitutes containing potassium chloride [1.2.4, 1.5.4]	Dangerously high potassium levels (hyperkalemia) [1.2.1]

Conclusion: Prioritizing Safety Through Communication

Lisinopril is a powerful tool for managing cardiovascular health, but its benefits depend on safe usage. The most significant risks involve interactions that can lead to dangerously high potassium levels, acute kidney injury, or severe hypotension. Avoiding or carefully managing NSAIDs, potassium supplements, salt substitutes, and certain other heart medications is critical. Open and continuous communication with your healthcare provider about all medications, supplements, and significant lifestyle changes, including diet and alcohol use, is the best way to prevent adverse interactions and ensure your treatment is both safe and effective [1.3.2, 1.7.3].

For more comprehensive drug information, you can visit the FDA's drug information portal.

Frequently Asked Questions

While NSAIDs like ibuprofen should be avoided, acetaminophen (Tylenol) is generally considered a safer option for pain relief as it does not have the same interactions. However, you should always consult your healthcare provider before taking any new medication [1.7.3].

Eating a single banana is unlikely to cause harm. The concern is with a consistently high dietary intake of potassium, which, when combined with lisinopril, can lead to high potassium levels (hyperkalemia), especially in those with kidney issues [1.2.1, 1.5.2]. Moderation and monitoring are key.

There is no strict waiting period, but because alcohol can enhance the blood-pressure-lowering effects of lisinopril, it's safest to limit or avoid it entirely [1.4.5, 1.4.6]. The risk of dizziness and fainting is highest when you first start the medication or change doses [1.4.5]. Discuss safe consumption levels with your doctor.

Yes, you should avoid salt substitutes that contain potassium chloride. Since lisinopril can already increase your potassium levels, using these substitutes can raise them to a dangerous level [1.2.4, 1.5.4].

Symptoms of hyperkalemia can be subtle but may include tiredness, weakness, nausea, muscle cramps, chest pain, or an irregular heartbeat. In some cases, there are no symptoms [1.8.2]. Your doctor should monitor your potassium levels with regular blood tests [1.3.1].

Lisinopril is often combined with certain diuretics like hydrochlorothiazide [1.8.2]. However, combining it with other classes like ARBs (e.g., losartan) or aliskiren is generally not recommended due to increased risks of low blood pressure, high potassium, and kidney problems [1.3.1].

You should be cautious. Some herbal supplements, such as alfalfa, dandelion, and horsetail, may increase potassium levels, interacting with lisinopril [1.2.5]. Always talk to your doctor or pharmacist before starting any new herbal product [1.2.5, 1.3.3].