Based on NIH | Can lisinopril cause headaches, and what should I do if I develop one while taking it?

Overview

Yes, lisinopril can cause headaches in some people. Headache is listed among the common side effects of lisinopril and of the lisinopril/hydrochlorothiazide combination. ^[1] Headache is also noted alongside other frequent reactions such as dizziness and cough. ^[2] In clinical safety summaries of ACE inhibitors, headache has been reported in a small percentage of users and is considered an uncommon but recognized adverse effect. ^[3]

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How common is headache with lisinopril?

Headache appears among the most frequently reported clinical adverse experiences in lisinopril-treated hypertensive patients in large safety assessments. ^[4] Across ACE inhibitors, reported headache rates around a few percent have been described, similar to other drugs in the class. ^[3] While common, most headaches are mild and tend to improve as your body adjusts to the medication. ^[1]

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Why might lisinopril cause headache?

There are a few plausible reasons:

• Blood pressure shifts: Early in treatment or after dose changes, transient lightheadedness can occur due to blood pressure changes, and headache may accompany these shifts. ^[5]
• Class effect: Headache is a known, non‑serious adverse effect seen with ACE inhibitors broadly. ^[6] This pattern suggests a class pharmacology component rather than a unique problem with one brand. ^[3]

Importantly, lisinopril has also been studied for migraine prevention at low doses, showing reductions in headache burden in some trials; this means the relationship between ACE inhibitors and headache can be complex and individualized. ^[7]

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What to do if you develop a headache on lisinopril

• Monitor and document: Keep track of timing (relative to your dose), severity, triggers, and your blood pressure readings if you have a home monitor. This helps your clinician decide whether the headache relates to the medication or to fluctuating blood pressure. ^[1]
• Hydration and posture: Dehydration and standing up quickly can worsen dizziness and headache; rise slowly and drink adequate fluids unless you’ve been advised to restrict fluids. ^[5] If you feel dizzy, lie down and then sit a moment before standing to reduce symptoms. ^[8]
• Avoid excess alcohol and NSAIDs: Overuse of pain relievers like ibuprofen can cause rebound headaches and may interact with blood pressure control; discuss any regular use of over‑the‑counter meds with your clinician. ^[9]
• When to call your clinician: If headaches are severe, persistent, or accompanied by worrisome symptoms (fainting, chest pain, swelling of face/tongue, difficulty breathing), you should seek medical advice promptly. ^[2] If the headache does not improve or becomes troublesome, your clinician may adjust your dose or consider an alternative medication. ^[1]

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Red flags that need urgent attention

• Swelling of the face, tongue, throat, trouble breathing or swallowing (possible angioedema): get immediate help. ^[2]
• Fainting or marked lightheadedness suggesting low blood pressure: contact your clinician. ^[10]
• Signs of infection with fever and severe sore throat, or yellowing of the skin/eyes: urgent evaluation is advised. ^[10]

These are rare but serious effects and are handled differently from routine, mild headaches. ^[2]

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Practical steps to reduce headache risk

• Start low, go slow: Many clinicians begin with a lower lisinopril dose and increase gradually to minimize side effects like dizziness and headache. ^[11]
• Check blood pressure at home: Identifying patterns (e.g., headache soon after dosing with lower readings) can guide dose timing or adjustments. ^[5]
• Consistent dosing and lifestyle: Take lisinopril at the same time daily and follow any advised low‑salt diet or exercise plan, which supports smoother blood pressure control. ^[12]
• Manage other contributors: Illness with vomiting or diarrhea can cause dehydration, increasing dizziness and headache risk; contact your clinician if you become sick while on lisinopril. ^[8]

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When headaches might improve on ACE inhibitors

Interestingly, low‑dose lisinopril has shown benefit for migraine prevention in controlled and open‑label studies, reducing headache hours and days in some adults. ^[7] This means some users may actually experience fewer migraines on lisinopril, particularly if migraines are part of their history. ^[7]

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Summary table: Headache and lisinopril

Topic	Key points
Is headache a known side effect?	Yes; listed among common side effects of lisinopril and lisinopril/HCTZ. [1] [2]
How often does it occur?	Reported among frequent adverse experiences in trials, typically a few percent with ACE inhibitors. [4] [3]
Likely mechanisms	Blood pressure changes, class pharmacology effects. [5] [6]
Self-care	Hydration, rise slowly, track symptoms and BP, cautious use of OTC pain meds. [5] [8] [9]
Call clinician if…	Headache is severe/persistent or accompanied by swelling, breathing trouble, fainting. [2] [10]
Potential upside	Low‑dose lisinopril may reduce migraine burden in some individuals. [7]

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Bottom line

Headache can occur with lisinopril, usually mild and transient, but it’s wise to monitor symptoms and blood pressure and to reach out to your clinician if headaches are severe, persistent, or accompanied by red‑flag signs. ^[1] Keeping hydration steady, changing positions slowly, and maintaining consistent dosing and lifestyle measures can help reduce headache risk while on lisinopril. ^{[5] [8]} If headaches don’t settle, dose adjustments or an alternative medication may be considered. ^[1]