Lisinopril dosage
Lisinopril is a once-daily ACE inhibitor, and there is no single 'lisinopril dose' — the amount depends on why it was prescribed and is titrated by your doctor to your blood pressure, heart response, and kidney function. Every number on this page is quoted from the FDA prescribing information. We rate and explain the label; this is a reference, not a substitute for your prescriber.
This is reference, not a dosing instruction. Lisinoprilis prescription-only and the dose is individualized and titrated by a prescriber to your condition, response, kidney/liver function and other medicines. The figures below are the FDA label’s — do not start, change or stop a dose based on this page.
Approved for: High blood pressure (adults and children 6 years and older), systolic heart failure, and reducing the risk of death after a heart attack (acute myocardial infarction).
Available as: Oral tablets: 2.5, 5, 10, 20, 30, and 40 mg (an oral solution also exists).
| Use | What the label says |
|---|---|
| High blood pressure | Adults start at 10 mg once daily, then adjust to blood pressure. The FDA label states: '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.' If you already take a diuretic (water pill), the label starts lower, at 5 mg once daily, to avoid a sharp first-dose blood-pressure drop. |
| Heart failure | Start 5 mg once daily, added to a diuretic and (usually) digitalis. The label starts at 2.5 mg once daily if blood sodium is low (hyponatremia, serum sodium < 130 mEq/L). Then 'increase as tolerated to a maximum of 40 mg once daily.' |
| After a heart attack | Within 24 hours of a hemodynamically stable heart attack, the labeled regimen is: 'give Zestril 5 mg orally, followed by 5 mg after 24 hours, 10 mg after 48 hours and then 10 mg once daily,' continued for at least six weeks. A 2.5 mg start is used for the first 3 days if systolic blood pressure is low (≤ 120 mmHg and > 100 mmHg (below 100 mmHg the dose is withheld, not reduced)). |
Maximum dose
High blood pressure: usual range 20–40 mg/day; the label notes 'doses up to 80 mg have been used but do not appear to give greater effect,' so 40 mg is the practical ceiling. Heart failure and after a heart attack: maximum 40 mg once daily. Maximum drops to 40 mg/day and starting doses are halved in kidney impairment.
Dose adjustments
Lower starting doses apply in several situations. On a diuretic: 5 mg once daily. Heart failure with hyponatremia (sodium < 130 mEq/L): 2.5 mg. Kidney impairment — creatinine clearance 10–30 mL/min: halve the usual start (high blood pressure 5 mg; heart failure and heart attack 2.5 mg), titrate up to a maximum of 40 mg/day; on dialysis or creatinine clearance < 10 mL/min: start 2.5 mg once daily. Children 6+ with GFR > 30: start 0.07 mg/kg once daily (up to 5 mg), maximum 0.61 mg/kg (up to 40 mg). Elderly: the label says no dosage adjustment is necessary, but older adults can be more sensitive to blood-pressure drops.
Dosing safety — read before you rely on any number
BOXED WARNING (the FDA's most serious): 'When pregnancy is detected, discontinue [lisinopril] as soon as possible' — drugs acting on the renin-angiotensin system 'can cause injury and death to the developing fetus.' Angioedema: sudden swelling of the face, lips, tongue, throat or intestines can occur at any time during treatment and has been fatal; stop the drug and get emergency care. Hyperkalemia (high blood potassium): risk rises with kidney disease, diabetes, and potassium supplements or salt substitutes; potassium is monitored. First-dose and symptomatic hypotension: more likely with diuretics, low sodium, or dehydration.
Bottom line
There is no one-size lisinopril dose. A prescriber sets the starting dose by indication (typically 10 mg once daily for blood pressure, 5 mg for heart failure) and titrates to your response and kidney function — usually up to 40 mg/day. Use this page to understand a prescription, not to start, stop, or change a dose on your own.
Frequently asked questions
What is the maximum dose of lisinopril?
For high blood pressure the usual range is 20 to 40 mg per day; the FDA label notes 'doses up to 80 mg have been used but do not appear to give greater effect,' so 40 mg is the effective ceiling for most people. For heart failure and after a heart attack, the maximum is 40 mg once daily. Kidney impairment lowers these limits.
What is the starting dose of lisinopril?
The usual adult starting dose for high blood pressure is 10 mg once daily. It drops to 5 mg once daily if you already take a diuretic, and heart failure starts at 5 mg (or 2.5 mg if blood sodium is low). Kidney impairment lowers the starting dose further, and children are dosed by weight.
Is 40 mg of lisinopril a lot?
40 mg once daily is the top of the usual FDA range and a common maximum — a legitimate, fully approved dose, not an overdose. The label says going above 40 mg (up to 80 mg) adds no meaningful blood-pressure effect, which is why most prescribers stop at 40 mg rather than push higher.
What is the best time to take lisinopril?
Lisinopril is taken once daily, at about the same time each day, with or without food. Many people take it in the morning; some prescribers prefer bedtime. Consistency from day to day matters more than the exact hour — follow the timing your prescriber gives you.
Can I take lisinopril while pregnant?
No. Lisinopril carries an FDA Boxed Warning: 'When pregnancy is detected, discontinue [it] as soon as possible,' because it can injure or kill a developing fetus, especially in the second and third trimesters. If you are pregnant or planning pregnancy, contact your prescriber right away about a safer option — do not just stop on your own without medical advice.
What if I miss a dose of lisinopril?
MedlinePlus advises: 'Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.'
Sources
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Doses are transcribed from the FDA-approved label and are general reference information, not medical advice or a personal dose. Only a prescriber can set or change your dose. If you think you took too much, contact Poison Control (1-800-222-1222) or 911.