Lisinopril and Etozolin: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Etozolin
No brand names on recordLisinopril
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Etozolin is a water pill (a diuretic), and lisinopril is a blood pressure medicine known as an ACE inhibitor. When these two are taken together, the first dose of lisinopril can drop your blood pressure more than expected. This is because the water pill lowers the fluid and salt in your body, and then lisinopril relaxes your blood vessels on top of that.
You might feel dizzy or lightheaded, especially when standing up. The good news is this effect is usually temporary. Your care team can manage it easily by adjusting your doses and keeping an eye on your blood pressure, so please talk with your doctor or pharmacist before making any changes.
Effect: Additive first-dose postural hypotension when an ACE inhibitor (lisinopril) is added to loop diuretic therapy (etozolin). Rapid onset, probable evidence, moderate severity.
Mechanism: Pharmacodynamic, not pharmacokinetic. Diuretic-induced volume/sodium depletion plus ACE inhibitor vasodilation and reduced angiotensin II support precipitates exaggerated first-dose hypotension. ACE inhibition may paradoxically reduce GFR and natriuretic response, occasionally causing fluid retention.
- Consider holding the diuretic 2 to 3 days before initiating lisinopril where feasible.
- If not feasible, start a very low ACE inhibitor dose in the evening.
- Monitor BP closely for 4 hours post initial dose; track BP, volume status, and weight for up to 2 weeks after dose changes.
What happens
Postural hypotension (first dose)
Interaction Deep Dive
The addition of ACE inhibitors to loop diuretic regimens has been associated with severe postural hypotension. A hypotensive response to the first dose is frequently observed in individuals who are sodium depleted or hypovolemic as a result of diuretic use or dietary sodium restriction. This drop in blood pressure is typically short lived91017. While one would expect the combination to enhance natriuresis, ACE inhibitors may paradoxically diminish glomerular filtration along with the diuretic and natriuretic effects of diuretics, resulting in edema and fluid retention64. No clinically meaningful pharmacokinetic interactions have been documented between these two drug classes.
Why it happens (mechanism)
Vasodilation and relative intra-vascular volume depletion
How to manage this interaction
This combination is manageable with the right precautions. Keep taking both medicines exactly as prescribed unless your care team tells you otherwise.
Here is what your team may do:
- Where possible, briefly pause the diuretic a couple of days before starting lisinopril, then restart it if needed.
- If pausing is not an option, begin lisinopril at a very low dose, often at bedtime, and monitor your blood pressure closely for the first several hours.
- Check your blood pressure, weight, and fluid status regularly for up to two weeks after any dose change.
Tell your pharmacist or doctor if you feel dizzy, faint, or lightheaded when standing.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
3 reports — tap to read
a) In one study, captopril did not change the renal excretion or the diuretic action of furosemide in hypertensive patients 2. Nevertheless, more recent findings show that standard doses of captopril diminish the natriuretic and diuretic actions of furosemide in patients with mild to moderate congestive heart failure. While on furosemide, sodium excretion rose by 623%; this fell to 242% when captopril was added 3. Several authors have described weight gain, sodium retention, and peripheral edema in patients receiving diuretic therapy when ACE inhibitors were started 456.
b) In a single-dose study, oral benazepril (10 mg) and oral furosemide (40 mg) were given alone and together to 12 healthy volunteers. No significant effects on the pharmacokinetics of benazepril were seen. The urinary excretion of total furosemide fell by 10% to 20% during the combined administration. When single doses of each agent were given alone, blood pressure and pulse were not significantly affected. However, the combination produced a decrease in erect blood pressure and an increase in pulse rate. The greatest effects were seen four hours after administration (122 to 104 mm Hg and 87 to 107 beats per minute, respectively). Most subjects who received the combination experienced dizziness, which occurred together with the reductions in blood pressure 7.
c) Concurrent captopril and furosemide therapy has been reported to potentiate the hypotensive effects of captopril. In one patient with high plasma renin activity who received 50 mg captopril and intravenous furosemide, blood pressure fell sharply from 290/150 mm Hg to 135/60 mm Hg within 10 minutes 8.
Common questions
Can I take Lisinopril and Etozolin together?
Adding lisinopril to the diuretic etozolin can cause a sharp drop in blood pressure with the first dose, so expect closer monitoring and cautious, individualized dosing from your care team. Report any dizziness or fainting. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lisinopril and Etozolin interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How is the Lisinopril and Etozolin interaction managed?
This combination is manageable with the right precautions. Keep taking both medicines exactly as prescribed unless your care team tells you otherwise. Here is what your team may do: Where possible, briefly pause the diuretic a couple of days before starting lisinopril, then restart it if needed. If pausing is not an option, begin lisinopril at a very low dose, often at bedtime, and monitor your bl… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Lisinopril or Etozolin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (10)
- Vlasses PH, Ferguson RK, & Chatterjee K: Captopril: clinical pharmacology and benefit-to-risk ratio in hypertension and congestive heart failure. Pharmacotherapy 1982; 2:1-17. PubMed
- Fujimura A, Shimokawa Y, & Ebihara A: Influence of captopril on urinary excretion of furosemide in hypertensive subjects. J Clin Pharmacol 1990; 30:538-542. PubMed
- McLay JS, McMurray JJ, Bridges AB, et al: Acute effects of captopril on the renal actions of furosemide in patients with chronic heart failure. Am Heart J 1993; 126:879-886. PubMed
- Cleland JGF, Gillen G, & Dargie HJ: The effects of frusemide and angiotensin-converting enzyme inhibitors and their combination on cardiac and renal haemodynamics in heart failure. Eur Heart J 1988; 9:132-141. PubMed
- Odemuyiwa O, Gilmartin J, Kenny D, et al: Captopril and the diuretic requirements in moderate and severe chronic heart failure. Eur Heart J 1989; 10:586-590. PubMed
- Flapan AD, Davies E, Waugh C, et al: Acute administration of captopril lowers the natriuretic and diuretic response to a loop diuretic in patients with chronic cardiac failure. Eur Heart J 1991; 12:924-927. PubMed
- De Lepeleire I, Van Hecken A, Verbesselt R, et al: Interaction between furosemide and the converting enzyme inhibitor benazepril in healthy volunteers. Eur J Clin Pharmacol 1988; 34:465-468. PubMed
- Case DB, Atlas SA, Laragh JH, et al: Clinical experience with blockade of the renin-angiotensin-aldosterone system by an oral converting-enzyme inhibitor (SQ 14,255, captopril) in hypertensive patients. Prog Cardiovasc Dis 1978; 21:195-206.
- Clementy J, Schwebig A, Mazaud C, et al: Comparative study of the efficacy and tolerance of Capozide and Moduretic administered in a single daily dose for the treatment of chronic moderate arterial hypertension. Postgrad Med J 1986; 62(suppl 1):132.
- Gluck Z, Beretta-Piccoli C, & Reubi FC: Long-term effects of captopril on renal function in hypertensive patients. Eur J Clin Pharmacol 1984; 26:315-323. PubMed
Keep reading about Etozolin
Keep reading about Lisinopril
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