Based on NIH | Can lisinopril cause muscle pain or cramps, and when should I seek medical advice?

Lisinopril and muscle pain or cramps: what to know Lisinopril can be associated with muscle symptoms, although this is not among its most common side effects. ^[1] When lisinopril is combined with a diuretic such as hydrochlorothiazide (a common fixed‑dose combination), muscle pain, cramps, or weakness are specifically listed as adverse effects that warrant medical attention. ^[2] Muscle symptoms may also signal electrolyte imbalances (like low sodium or high/low potassium) or dehydration, which can occur with diuretics and occasionally with ACE inhibitors, and should be assessed by a clinician. ^{[3] [4]}

How lisinopril could lead to muscle symptoms

• ACE inhibitors (the drug class that includes lisinopril) can raise potassium levels, and abnormal potassium whether high or low can cause muscle weakness, cramping, or palpitations. ^[4] Persistent or severe symptoms need evaluation and blood tests for electrolytes and kidney function. ^[5]
• When lisinopril is taken in a combination pill with hydrochlorothiazide, the diuretic can lower sodium and potassium, which increases the risk of muscle cramps and weakness; in that combination, “muscle pain, cramps, or weakness” is called out as a warning sign. ^{[2] [3]}
• Rarely, severe systemic reactions (for example, significant dehydration, kidney problems, or very abnormal potassium) can contribute to muscle injury; although uncommon, such scenarios deserve prompt care. ^{[4] [5]}

When to seek medical advice

• Contact your clinician soon if you develop new or worsening muscle pain, cramps, or weakness after starting lisinopril or changing the dose, especially if symptoms persist more than a few days. ^[6]
• Seek urgent care if muscle symptoms are accompanied by dark cola‑colored urine, severe weakness, fever, confusion, chest pain, or a rapid/irregular heartbeat, as these can indicate more serious problems. ^[2]
• If you are taking the lisinopril‑hydrochlorothiazide combination and notice muscle pain, cramps, or weakness, you should call your clinician, as these can be signs of electrolyte imbalance that need blood tests. ^{[2] [3]}

What your clinician may check

• Blood pressure, heart rate, and hydration status, because low blood pressure and dehydration can worsen cramps. ^[5]
• Blood tests for electrolytes (especially potassium and sodium), kidney function (creatinine, eGFR), and sometimes muscle enzyme levels (CK) if pain is severe or weakness is significant. ^{[5] [6]}
• Medication review to identify other drugs or supplements (for example, potassium supplements, salt substitutes, or NSAIDs) that can interact and shift electrolytes. ^{[4] [7]}

Practical steps you can take

• Stay hydrated and avoid sudden excess heat or sweating that can worsen electrolyte shifts, especially if your pill includes a diuretic. ^[3]
• Do not start potassium supplements or high‑potassium salt substitutes unless your clinician advises it, since ACE inhibitors can raise potassium. ^[4]
• Keep all scheduled checkups and lab tests; ongoing monitoring helps catch kidney or electrolyte changes early while using lisinopril or the lisinopril‑hydrochlorothiazide combo. ^{[3] [5]}

Key takeaways

• Lisinopril alone less commonly causes muscle symptoms, but they can occur and should be assessed, particularly after a dose change. ^[1]
• In the lisinopril‑hydrochlorothiazide combination, muscle pain, cramps, or weakness are red‑flag symptoms that merit contacting your clinician to check electrolytes and kidney function. ^{[2] [3]}
• Prompt evaluation is important if symptoms are severe or accompanied by alarming signs like dark urine, chest pain, fainting, or an irregular heartbeat. ^[2]