Is Lisinopril safe during pregnancy?
What the FDA-approved label for Lisinopril actually states in its Pregnancy Risk Summary — not a secondhand verdict. The decision is one to make with your prescriber.
What the label’s pregnancy summary says
The label carries a boxed warning and a §8.1 Pregnancy risk summary stating lisinopril can cause fetal harm. As a drug acting on the renin-angiotensin system, use in the second and third trimesters reduces fetal renal function and increases fetal and neonatal illness and death; it can cause oligohydramnios leading to reduced fetal kidney function, lung underdevelopment, skull and skeletal deformities, low blood pressure, and death. The label directs that when pregnancy is detected, lisinopril be discontinued as soon as possible. If there is no appropriate alternative, the mother should be told of the potential fetal risk and monitored with serial ultrasounds; exposed infants should be watched for low blood pressure, low urine output, and high potassium. Anyone pregnant or planning pregnancy should consult their prescriber — do not start or stop this medication on your own.
Frequently asked questions
Is Lisinopril safe to take during pregnancy?
The label flags a real concern for Lisinopril — see the summary above. This is not a drug to start or continue in pregnancy on your own; it needs a prescriber weighing the specific risks against the reason you would take it. The one universal rule: do not start or stop a medication in pregnancy without medical advice — an untreated condition can carry its own risk to a pregnancy.
What does the FDA label say about Lisinopril in pregnancy?
The summary above is transcribed from the label's Pregnancy Risk Summary (§8.1). Since 2015 FDA labels replaced the old A/B/C/D/X letter categories with a narrative that describes what human and animal data actually show, which is what you are reading here — not a single letter grade.
Is Lisinopril safe while breastfeeding?
That is a separate question the label answers in a different section (§8.2, Lactation), and it does not always match the pregnancy verdict. This page covers pregnancy only. For breastfeeding, ask your prescriber or pharmacist, or check the NIH LactMed database, which summarizes the drug-in-breast-milk evidence.
The questions people actually ask about lisinopril in pregnancy
Answered by MotherToBaby, the fact sheets written by the Organization of Teratology Information Specialists and published through the NIH. Quoted in full — we do not condense them.
I am taking lisinopril, but I would like to stop taking it before getting pregnant. How long does the drug stay in my body?
The time it takes the body to metabolize (to process) medication is not the same for everyone. In healthy, non-pregnant adults, it takes up to 72 hours, on average, for most of the lisinopril to be gone from the body.
I take lisinopril. Can it make it harder for me to get pregnant?
It is not known if lisinopril can make it harder to get pregnant.
Does taking lisinopril increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if lisinopril increases the chance for miscarriage.
Does taking lisinopril increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. It is not known if lisinopril increases the chance for birth defects when taken during the first trimester.
Does taking lisinopril in pregnancy increase the chance of other pregnancy-related problems?
Talk with your healthcare provider right away if you are pregnant and taking any ACE inhibitor, including lisinopril.
When used after the first trimester, ACE inhibitors such as lisinopril can cause low levels of amniotic fluid (fluid that surrounds the fetus during pregnancy). Low levels of amniotic fluid can lead to health problems for the developing fetus. Some of these problems include poor lung development, poor growth, poor development of the skull bones, birth defects, and problems with the development of the kidneys. In the most severe cases, fetal death could occur. ACE inhibitors can also cause low blood pressure and kidney failure in the newborn baby. There are some cases of babies who have died from these complications.
Does taking lisinopril in pregnancy affect future behavior or learning for the child?
Studies have not been done to see if lisinopril can increase the chance of behavior or learning issues for the child.
What screenings or tests are available to see if my pregnancy has birth defects or other issues?
Prenatal ultrasounds can be used to screen for some birth defects, such as skull bone and kidney defects. Ultrasound can also be used to track the growth of the pregnancy and the level of amniotic fluid (fluid that surrounds the fetus during pregnancy). Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning.
If a man takes lisinopril, could it affect fertility or increase the chance of birth defects?
Studies have not been done to see if lisinopril could affect male fertility (ability to get a woman pregnant) or increase the chance of birth defects above the background risk. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/ .
Quoted from MotherToBaby Fact Sheets — Lisinopril, published July 2024. MotherToBaby states its fact sheets should not take the place of medical care and advice from your healthcare providers.
Breastfeeding is a separate question — what LactMed says about lisinopril
More guides for Lisinopril
Source
Lisinopril — DailyMed FDA label (§8.1 Pregnancy, boxed warning) ↗
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The pregnancy information is transcribed from the drug’s FDA-approved label (§8.1) and mirrors what the label states — “insufficient data” is never rounded up to “safe.” This is general reference information, not medical advice. Whether to take any medication in pregnancy is a decision for you and your prescriber; do not start or stop a drug on your own, because an untreated condition can also carry risk.