Based on NIH | Can Lisinopril cause hair loss, how common is this side effect, and what should I do if I notice thinning hair after starting it?

Lisinopril and hair loss: what we know Lisinopril can be associated with hair loss (alopecia), but it appears to be uncommon. ^[1] In official prescribing information, alopecia is listed among “other” adverse effects, which typically indicates a low frequency compared with common effects like cough or dizziness. ^[1] Large safety summaries of lisinopril emphasize side effects such as cough, dizziness, low blood pressure, high potassium, and rare angioedema; hair loss is not highlighted as a frequent problem in these datasets, suggesting it is rare. ^[2] General drug references for lisinopril also focus on more typical side effects and do not list hair loss as a common or expected reaction. ^[3]

How common is it?

• In clinical programs of several thousand lisinopril‑treated people, commonly reported side effects included cough, dizziness, headache, nausea, diarrhea, and fatigue; alopecia was not among the frequent events reported, implying a low incidence. ^[2]
• The U.S. product labeling includes alopecia in a catch‑all “other” category, without a specific percentage, which generally indicates that it occurred rarely in reports after marketing rather than as a consistent finding in trials. ^[1]

Why might hair loss occur?

• When hair shedding is medication‑related, it most often reflects telogen effluvium a temporary shift that pushes more hairs into the shedding phase typically starting 1–3 months after a trigger such as a new drug, illness, major stress, or surgery. ^[4]
• Not all new hair loss after starting a medicine is caused by the medicine; common confounders include thyroid problems, iron deficiency, recent fever/illness, weight changes, and hereditary pattern hair loss. ^[4]

How to tell if lisinopril is the cause

• Timing: Drug‑related shedding usually starts weeks to a few months after starting or increasing the dose, and it is diffuse thinning rather than patchy bald spots. ^[4]
• Exclusion: A clinician will typically review other causes (thyroid labs, iron studies, recent illnesses, diet, stress) before attributing shedding to lisinopril. ^[4]
• Class effect possibility: Alopecia has been reported with various ACE inhibitors, suggesting a potential class effect, though it remains rare. ^{[5] [6]}

What to do if you notice thinning hair

• Do not stop lisinopril on your own; sudden discontinuation can lead to uncontrolled blood pressure or worsening heart failure, depending on why you take it. ^[3]
• Discuss the timing and pattern of hair loss with your clinician; they may check for other causes such as thyroid disease or iron deficiency and review your full medication list (including supplements). ^[4]
• If lisinopril is suspected, your clinician may consider a monitored drug “dechallenge” (switching to another blood pressure medicine) to see if shedding improves over the next 2–3 months. ^[4]
• Alternative options: If you need renin‑angiotensin system blockade, an angiotensin receptor blocker (ARB) may be considered; if not required, other classes (calcium‑channel blockers, thiazide diuretics, beta‑blockers) may be options based on your conditions. ^[7]
• Supportive hair care: Gentle hair practices, adequate protein and iron intake, and addressing stress can help reduce shedding during recovery. ^[8]
• Treatments for shedding: If the pattern fits telogen effluvium, shedding often improves within months after removing the trigger; topical minoxidil can be considered to support regrowth, depending on your clinician’s advice and your specific diagnosis. ^{[9] [10]}

When to seek urgent care

• If hair loss is accompanied by signs of a serious reaction such as facial, tongue, or throat swelling, hoarseness, or trouble breathing seek emergency care immediately, as this can indicate angioedema, a rare but potentially life‑threatening ACE‑inhibitor reaction. ^[3]
• Lisinopril‑related angioedema, while uncommon, can progress rapidly and requires urgent evaluation. ^[11]

Key takeaways

• Lisinopril can cause hair loss, but available evidence suggests it is uncommon. ^{[1] [2]}
• Many other, more common factors can cause shedding; a careful evaluation helps avoid stopping a helpful blood pressure medicine unnecessarily. ^[4]
• If lisinopril is the likely trigger, hair typically improves within months after switching medications, with supportive measures to aid regrowth. ^{[4] [9] [10]}

Would you like help reviewing your medication list and timeline to estimate how likely lisinopril is to be the cause?