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This medication carries several important safety warnings and precautions that need careful consideration. Review the following information and discuss any concerns with your healthcare provider.

• Pregnancy Warning: This medication can cause severe and potentially fatal harm to an unborn baby and should not be used during pregnancy. If you are currently pregnant, planning to become pregnant, or suspect you may be pregnant while taking this medication, it is crucial to inform your healthcare provider immediately. They will advise on safer alternatives for managing your condition.

• Angioedema Risk: Users of this medication, which includes ACE inhibitors like lisinopril (Zestril), may experience a rare but serious allergic reaction known as angioedema. This condition can cause swelling in various body parts, including the face, throat, and tongue, potentially leading to breathing difficulties. You are at a higher risk if you are Black, female, or an older adult. Seek immediate medical attention if you experience any swelling, stomach pain, or breathing issues. Discontinue the medication if angioedema occurs.

• Low Blood Pressure: This medication can cause a significant drop in blood pressure, which may result in dizziness, tiredness, or lightheadedness. This is more likely when starting the medication or after a dose increase. Stay hydrated, and if you experience symptoms, sit down slowly and contact your healthcare provider. Immediate medical attention is necessary if you experience a fall or hit your head.

• Kidney Health Concerns: While generally beneficial for the kidneys, this medication can sometimes exacerbate kidney problems, particularly in patients with specific conditions like renal artery stenosis or severe heart failure. Regular kidney function tests may be required. Inform your provider if you notice decreased urination.

• High Potassium Levels: This medication can increase potassium levels in your body, posing a risk to heart health. Those with diabetes, kidney issues, or who are on other potassium-raising medications are at increased risk. Notify your healthcare provider if you experience symptoms such as nausea, muscle weakness, or an abnormal heartbeat.

• Liver Health Risks: In rare cases, this medication may lead to liver problems, including liver failure, especially in individuals with a history of liver issues or significant alcohol consumption. Your provider may conduct periodic liver function tests. Report any signs of liver problems, like fatigue, abdominal pain, or yellowing of the skin, to your provider immediately.

• Contraindications: This medication should not be used if you have a history of angioedema, are taking aliskiren (Tekturna) with high blood sugar, or are using neprilysin inhibitors such as Entresto (sacubitril/valsartan) within 36 hours of taking this medication. Discuss these conditions with your healthcare provider to ensure safe use.

Common side effects:

• Dizziness
• Lightheadedness
• Tiredness
• Headaches
• Dry cough

Less common but important to monitor:

• Drop in blood pressure
• Increase in creatinine levels

Serious side effects:

• Kidney problems
• Potentially fatal liver issues
• Severe allergic reaction (angioedema)

Interactions with high risk of serious adverse effects and should be avoided:

• Aliskiren
• Sacubitril

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Everolimus
• Sirolimus
• Lithium
• Losartan
• Valsartan
• Potassium
• Drospirenone
• Aspirin
• NSAIDs (e.g., Ibuprofen, Naproxen)
• Bee/wasp sting allergy desensitization injections