Based on PubMed | Is fatigue a common side effect of lisinopril, and what should I do if it persists or worsens?

Fatigue can occur with lisinopril and is generally considered a recognized, usually mild side effect; if tiredness is severe, persistent, or accompanied by other symptoms (like dizziness, low blood pressure symptoms, swelling, or yellowing of the skin/eyes), you should contact your clinician for assessment. ^[1] Persistent “excessive tiredness” is listed among common side effects that should be discussed with your doctor if it does not go away. ^[1]

How common is fatigue with lisinopril?

• Fatigue (tiredness/weakness/low energy) appears among the commonly reported non-serious effects for lisinopril in authoritative drug information resources. ^[1] In broader clinical experience across ACE inhibitors, fatigue is a known but generally infrequent central nervous system symptom, usually affecting a minority of users. ^[2] In large clinical programs, fatigue has been reported among more frequent adverse events in people treated with lisinopril, especially when treating hypertension or heart failure, though not all events are necessarily caused by the drug. ^[3]

Why fatigue may happen

• Blood pressure lowering itself can make some people feel tired or lightheaded, especially after starting therapy or after a dose increase. ^[3] ACE inhibitors can also contribute to dizziness or orthostatic effects (blood pressure drops on standing), which can feel like fatigue. ^[3] Coexisting factors such as dehydration, low sodium intake, or concurrent diuretics may amplify these effects. ^{[4] [5]}

When to seek medical help now

• Seek urgent care if fatigue comes with warning signs of serious reactions, such as swelling of the face, lips, tongue, or throat, trouble breathing or swallowing (possible angioedema). ^[1] Seek prompt evaluation if fatigue is accompanied by fainting, marked dizziness, chest pain, or signs of infection or jaundice (yellow skin/eyes), since these can signal other problems that require immediate attention. ^[1]

What to do if fatigue persists or worsens

• Talk with your clinician if your tiredness is severe or does not improve after a short adjustment period; dosage changes or medication adjustments are sometimes considered when side effects do not resolve. ^[1] Practical steps that your clinician may recommend can include checking blood pressure sitting and standing, reviewing your dose timing, and assessing hydration and salt status, particularly if you also take a diuretic. ^[4] They may also check labs (kidney function and electrolytes) because ACE inhibitors can affect these parameters and abnormalities can contribute to fatigue. ^[6]

Self-care tips you can try

• Rise slowly from sitting or lying positions to reduce lightheadedness that can feel like fatigue. ^[7]
• Stay adequately hydrated unless you’ve been told to restrict fluids, as dehydration can worsen low blood pressure and tiredness. ^[4]
• Consider taking lisinopril at a consistent time each day; some people prefer evening dosing if daytime tiredness is an issue, but only change timing after discussing with your clinician. ^[3]
• Track your blood pressure and symptoms; share a log with your clinician to guide adjustments. ^[6]

If lisinopril isn’t tolerated

• If fatigue remains troublesome despite adjustments, your clinician may consider lowering the dose or switching to another class (for example, an angiotensin receptor blocker), balancing benefits and side effects; this is a common and reasonable approach when ACE inhibitor side effects persist. ^[7] Most ACE inhibitor side effects are mild and transient, and therapy can often be continued with monitoring, but ongoing, impactful fatigue deserves reassessment. ^{[8] [5]}

Quick reference: signs and next steps

• Expected/mild: general tiredness that improves over days to a few weeks monitor and mention at your next visit. ^[1]
• Persistent/worsening: tiredness that doesn’t improve, interferes with activities, or is paired with dizziness contact your clinician for dose, timing, or medication review. ^{[1] [4]}
• Urgent: swelling of face/tongue/throat or trouble breathing stop the drug and seek immediate medical care. ^[1]

Bottom line

• Fatigue is a known, usually mild side effect of lisinopril, but it should ease with time; if it is severe, persistent, or paired with other concerning symptoms, reach out to your clinician to review your dose, check blood pressure and labs, and discuss alternatives if needed. ^{[1] [3] [6]}