Lisinopril and Valsartan: 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
Lisinopril
Valsartan
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.
Lisinopril and valsartan work on the same body system, and using them together is not recommended. Lisinopril is an ACE inhibitor and valsartan is an ARB. Both lower blood pressure by acting on the renin-angiotensin system. Taking both at once is like doubling down on the same pathway, which can push things too far.
This can lead to blood pressure that drops too low (dizziness or fainting), rising potassium levels, and stress on your kidneys. It also raises the risk of angioedema, a serious swelling of the face, lips, or throat. The good news is your care team can manage this by choosing just one of these medicines. Please talk with your pharmacist or doctor before making any changes.
Contraindicated combination. Concurrent lisinopril (ACE inhibitor) and valsartan (ARB) produces dual RAAS blockade with no prodrug considerations affecting direction here.
- Direction/effect: Additive suppression of the renin-angiotensin-aldosterone system increases risk of hypotension, syncope, hyperkalemia, and renal impairment including acute renal failure; also increased angioedema risk.
- Evidence: Established.
- Management: Avoid combination. If switching from an ACE inhibitor to valsartan, allow a 36-hour washout. If co-use is unavoidable, closely monitor blood pressure, serum potassium, and renal function (SCr/eGFR).
What happens
Increased risk of angioedema and an increased risk of adverse events (ie, hypotension, syncope, hyperkalemia, changes in renal function, acute renal failure)
Interaction Deep Dive
Because it raises the likelihood of angioedema, taking valsartan together with an ACE inhibitor is contraindicated. When transitioning from an ACE inhibitor to valsartan, a washout interval of 36 hours should separate the doses of the two agents3. Combining valsartan (an angiotensin II receptor blocker) with an ACE inhibitor produces dual blockade of the renin-angiotensin-aldosterone system, which can heighten the risk of adverse effects such as hypotension, syncope, hyperkalemia, and altered renal function (including acute renal failure). Blood pressure, renal function, and electrolytes should be monitored closely24.
Why it happens (mechanism)
Dual blockade of the renin angiotensin aldosterone system
How to manage this interaction
This combination is generally avoided. Most patients should be on either an ACE inhibitor or an ARB, not both. Your care team decides which single agent is best for you.
- Do not start, stop, or change either medicine on your own. Bring your full medication list to your pharmacist or prescriber so they can review it.
- If your team is switching you from lisinopril to valsartan, they typically allow about a 36-hour gap between the two.
- If both are ever used together, expect closer monitoring of blood pressure, potassium, and kidney function.
- Seek urgent care for swelling of the face, lips, or throat, fainting, or severe dizziness.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) A systematic review with meta-analysis involving 18,160 patients who had heart failure or left ventricular dysfunction, drawn from 9 randomized trials, found that adding an angiotensin receptor blocker (ARB) to ACE inhibitor treatment was linked to a higher likelihood of adverse events prompting discontinuation of therapy when compared with ACE inhibitor treatment by itself. Every patient had NYHA functional class II to IV heart failure, an ejection fraction of 45% or lower, or left ventricular dysfunction occurring acutely after myocardial infarction. The medications studied were losartan, candesartan, valsartan, irbesartan, and telmisartan. Follow-up periods ranged from 4 weeks to 41 months. The analysis showed that combination therapy raised the risk of any adverse effect by 2.3%. Hypotension risk rose by 1.1%, the risk of worsening renal function rose by 1%, and hyperkalemia risk rose by 0.6%. In contrast, the risk of angioedema or cough was not significantly different between the treatment groups. When a combination approach is warranted, patients should be watched closely for possible adverse effects 1.
Common questions
Can I take Lisinopril and Valsartan together?
Lisinopril and valsartan together are contraindicated because dual RAAS blockade raises the risk of angioedema, low blood pressure, high potassium, and kidney problems. Talk with your pharmacist or doctor, since normally only one of these should be used. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lisinopril and Valsartan interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Lisinopril and Valsartan interaction managed?
This combination is generally avoided. Most patients should be on either an ACE inhibitor or an ARB, not both. Your care team decides which single agent is best for you. Do not start, stop, or change either medicine on your own. Bring your full medication list to your pharmacist or prescriber so they can review it. If your team is switching you from lisinopril to valsartan, they typically allow ab… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
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 Valsartan 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 a safer alternative to one of these medications for me?
References (4)
- Lakhdar R, Al-Mallah MH, & Lanfear DE: Safety and tolerability of angiotensin-converting enzyme inhibitor versus the combination of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker in patients with left ventricular dysfunction. J Card Fail 2008; 14(3):181-188.
- Product Information: Lotensin(R) oral tablets, benazepril HCl oral tablets. Validus Pharmaceuticals LLC (per FDA), Parsippany, NJ, 2014. DailyMed
- Product Information: ENTRESTO(R) SPRINKLE oral pellets, sacubitril valsartan oral pellets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2024.
- Product Information: EXFORGE oral tablets, amlodipine valsartan oral tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2019. DailyMed
Keep reading about Lisinopril
Keep reading about Valsartan
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist