Supplements and Lisinopril.
Lisinopril, sold under the brand names Zestril, Carace, is an ACE inhibitor: it lowers blood pressure by blocking the conversion of angiotensin I to angiotensin II.
Lisinopril is the second most prescribed ACE inhibitor in England after ramipril. It blocks the same target as ramipril, with a slightly longer plasma half life. The clinical and supplement profiles mirror ramipril almost exactly. Dry cough in 10 to 15 percent of patients (the most common reason for switching to an ARB). Annual U&E monitoring. Additive blood pressure interactions with the nitrate pathway supplements (beetroot, hibiscus, garlic). The NSAID interaction is the most clinically important. Chronic ibuprofen or naproxen blunts the antihypertensive effect of lisinopril and adds renal stress, especially in older patients with already borderline GFR. Supplements that shift potassium warrant care. Liquorice taken at high intake opposes the BP effect via sodium retention. Potassium-rich supplements can push potassium higher than the GP intended, particularly if the patient is also on a potassium-sparing diuretic.
Below are the 7 documented pairs we have explicitly assessed against Lisinopril in the Distil database: 1 red and 6 amber. The pairs cluster around 3 mechanisms: Additive hyperkalaemia (raised potassium), Additive blood-pressure lowering, and Reduced renal lithium clearance. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Additive hyperkalaemia (raised potassium)
Lisinopril raises blood potassium by reducing how much the kidneys pass out. A potassium supplement adds more potassium on top. Together they can push potassium high enough to affect the heart rhythm, which can be dangerous. Do not take a potassium supplement alongside lisinopril unless your GP has specifically advised it and is checking your blood potassium.
Additive blood-pressure lowering
Beetroot lowers blood pressure through the nitric oxide pathway. Lisinopril lowers it by blocking the angiotensin-converting enzyme. Used together, the combined blood-pressure effect tends to be larger than either alone. Watch for dizziness on standing, especially in the first two weeks. If symptoms appear, tell your GP.
Hibiscus tends to lower blood pressure on its own, and lisinopril lowers it by blocking the angiotensin-converting enzyme. Taken together the blood-pressure effects may stack, so watch for dizziness on standing, especially in the first couple of weeks. If symptoms appear, tell your GP.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
L-citrulline lowers blood pressure modestly through the nitric oxide pathway, and lisinopril lowers blood pressure by blocking the renin-angiotensin system. Used together, the combined blood-pressure effect is mild but real. Watch for dizziness on standing, especially in the first two weeks. If symptoms appear, tell your GP.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Spirulina has a mild blood-pressure-lowering effect of its own, shown in human trials. Lisinopril lowers blood pressure by blocking the angiotensin-converting enzyme. Used together, the combined effect tends to be a little larger than the medicine alone. Watch for dizziness on standing in the first couple of weeks, and tell your GP if it happens so your dose can be reviewed.
Taurine tends to lower blood pressure on its own, and lisinopril lowers it by blocking the angiotensin-converting enzyme. Taken together the blood-pressure effects may stack, so watch for dizziness on standing, especially in the first couple of weeks. The added effect tends to be modest. If symptoms appear, tell your GP.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Reduced renal lithium clearance
ACE inhibitor blood pressure tablets such as lisinopril can reduce how well the kidneys clear lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution, especially in older people. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take an ACE inhibitor, check with your pharmacist or GP before using a lithium supplement.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
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This page checks the pairs you enter. The personalised Distil report goes further:
- the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
- where your current routine may be leaving you short of your goals
- the evidence-backed compounds worth adding, and the ones worth dropping
It's a paid report: £79, or £49 for the first 25 customers. The interactions check is one section of it, and you can read a real one in full before you buy.
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