MAJOR — Use With Caution
FDA-documented interaction. ACE inhibitors can significantly raise lithium levels. Monitor lithium levels closely when starting, adjusting, or stopping ACE inhibitors.
Evidence level: STRONG
Lisinopril (an ACE inhibitor for blood pressure) can increase lithium levels in your blood by changing how your kidneys handle sodium and lithium. This is important because lithium has a very narrow safe range.
ACE inhibitors reduce aldosterone and angiotensin II, decreasing renal sodium and lithium excretion. Can increase lithium levels significantly. FDA lithium label warns about ACE inhibitors.
If you take lithium and are prescribed lisinopril, get your lithium level checked within 1-2 weeks. Any dose change in lisinopril requires rechecking lithium levels. Stay well hydrated.
Take Lisinopril at the same time daily. Lithium follows its prescribed schedule. ACE inhibitors can be taken with or without food. If you develop a persistent dry cough, report it to your prescriber.
Higher risk for: those with renal impairment, hyperkalemia risk, concurrent potassium-sparing diuretics or potassium supplements, elderly, dehydrated patients, or those with bilateral renal artery stenosis.
Nausea, vomiting, tremor worsening, drowsiness, confusion, muscle weakness, increased urination or decreased urination
Request lithium level monitoring when starting or adjusting ACE inhibitor. Discuss alternative blood pressure medications that may have less effect on lithium (e.g., amlodipine).
ACE inhibitor interactions often involve potassium levels or blood pressure effects. Ask your doctor about ARBs as alternatives, or adjust the timing of the interacting substance. Monitor potassium levels and blood pressure regularly.
Lisinopril (an ACE inhibitor for blood pressure) can increase lithium levels in your blood by changing how your kidneys handle sodium and lithium. This is important because lithium has a very narrow safe range.
Take Lisinopril at the same time daily. Lithium follows its prescribed schedule. ACE inhibitors can be taken with or without food. If you develop a persistent dry cough, report it to your prescriber.
Nausea, vomiting, tremor worsening, drowsiness, confusion, muscle weakness, increased urination or decreased urination
ACE inhibitor interactions often involve potassium levels or blood pressure effects. Ask your doctor about ARBs as alternatives, or adjust the timing of the interacting substance. Monitor potassium levels and blood pressure regularly.
Request lithium level monitoring when starting or adjusting ACE inhibitor. Discuss alternative blood pressure medications that may have less effect on lithium (e.g., amlodipine).
Or browse the full interaction database (121,000+ pairs).