From the FDA Drug Label
DOSAGE & ADMINISTRATION 2. 1 Hypertension Initial Therapy in adults: The recommended initial dose is 10 mg once a day. Dosage should be adjusted according to blood pressure response. The usual dosage range is 20 mg to 40 mg per day administered in a single daily dose. Doses up to 80 mg have been used but do not appear to give greater effect
The dose of lisinopril can be increased as tolerated.
- The initial dose is 10 mg once a day for adults with hypertension.
- The dose can be adjusted according to blood pressure response.
- The usual dosage range is 20 mg to 40 mg per day.
- Doses up to 80 mg have been used, but the drug label does not specify a particular titration schedule or timeframe for increasing the dose 1.
From the Research
Lisinopril dosage should typically be increased gradually, with adjustments made every 2-4 weeks, as more rapid titration may increase the risk of hypotension and other adverse effects 2. The usual starting dose is 5-10 mg once daily, which can be titrated up to a maximum of 40 mg daily based on blood pressure response.
- Key considerations when increasing the dose include:
- Monitoring blood pressure regularly
- Watching for side effects such as dizziness, headache, or elevated potassium levels
- Being cautious in patients who are volume-depleted from diuretic therapy, on salt restriction, or with heart failure. The medication works by inhibiting angiotensin-converting enzyme (ACE), which relaxes blood vessels and reduces blood pressure gradually over days to weeks, so allowing adequate time between dose adjustments helps ensure safety and proper assessment of the drug's full effect at each dose level 2. Some studies have shown that lisinopril can be effective in reducing blood pressure when used alone or in combination with other antihypertensive agents, such as hydrochlorothiazide or amlodipine 3, 4, 2. However, the most recent and highest quality study, which was published in 2019, found that different antihypertensive drug combinations, including lisinopril, were equally effective in reducing blood pressure and improving arterial stiffness in patients with essential hypertension 2. Therefore, the decision to increase the dose of lisinopril should be based on individual patient response and medical supervision, taking into account the potential benefits and risks of more rapid titration.