Lisinopril and Yohimbine: 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
Yohimbine
No brand names on record
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.
Here's what's going on. Lisinopril is a blood pressure medicine that helps relax your blood vessels and bring your numbers down. Yohimbine, which is often found in herbal or supplement products, does the opposite. It can trigger your body to release more of a stress chemical called norepinephrine, which tightens blood vessels and can push your blood pressure up.
So if you take them together, the yohimbine may work against your lisinopril and make it harder to keep your blood pressure controlled. The good news is this is easy to manage. Talk with your pharmacist or doctor before using any yohimbine-containing product so they can guide you safely.
Effect: Yohimbine may antagonize the antihypertensive effect of lisinopril, risking inadequate BP control.
Mechanism (PD, not PK): Yohimbine increases norepinephrine release via central sympathetic stimulation and alpha-2 adrenergic blockade, producing vasoconstriction and reflex sympathetic activation. This directly opposes ACE-inhibitor-mediated vasodilation. Neither agent is metabolized in a way that drives this; it is a pharmacodynamic opposition.
- Direction: reduced lisinopril effectiveness
- Onset: rapid
- Evidence: theoretical; yohimbine has raised BP in normotensive and hypertensive subjects
- Management: avoid concomitant use; if unavoidable, monitor BP closely and individualize therapy.
What happens
Reduced angiotensin converting enzyme inhibitor effectiveness
Interaction Deep Dive
From a theoretical standpoint, yohimbine could directly oppose the blood pressure lowering action of angiotensin converting enzyme inhibitors, which may lead to insufficient control of blood pressure in patients with hypertension. Multiple studies have shown that yohimbine raised blood pressure in both hypertensive and normotensive patients12345. The elevation in norepinephrine release attributed to yohimbine is thought to occur through at least one of three pathways: direct stimulation of sympathetic outflow originating in the brain; blockade of inhibitory alpha-2 adrenergic receptors located on sympathetic nerve endings; or blockade of alpha-2 adrenergic receptors on vascular smooth muscle, producing vasodilation that triggers reflexive increases in sympathetic outflow4.
Why it happens (mechanism)
Increased norepinephrine release by yohimbine
How to manage this interaction
What your care team may do:
- Generally advise avoiding yohimbine-containing products while you take lisinopril, since yohimbine can push blood pressure up and work against your medicine.
- If any yohimbine use is considered, your team may monitor your blood pressure more closely and adjust and individualize your treatment.
What you should do:
- Keep taking your lisinopril exactly as prescribed.
- Tell your pharmacist or doctor before starting any supplement or product that contains yohimbine.
- Report symptoms like a rising blood pressure reading, headache, or a racing heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
5 reports — tap to read
a) In a placebo-controlled study involving 25 healthy volunteers and 29 sex- and age-matched, untreated patients with mild to moderate hypertension, oral yohimbine 10 mg caused a significant rise in diastolic blood pressure after 10 minutes of standing, occurring only in the hypertensive patients. Yohimbine led to a significant elevation in plasma norepinephrine concentrations in both groups. Dopamine concentrations rose significantly only in the normotensive participants following yohimbine (specific values not reported) 1.
b) In a study of 25 adult patients with uncomplicated essential hypertension, oral yohimbine 21.6 mg triggered norepinephrine release and produced a pressor effect. At baseline, systolic and diastolic blood pressures were 144 +/- 4 and 83 +/- 3 mmHg, respectively. Patients stopped any antihypertensive treatment 2 weeks before the study. One hour after receiving yohimbine, systolic pressure rose to 150 +/- 5 mmHg (p less than 0.01) and diastolic pressure rose to 86 +/- 3 mmHg (p less than 0.01). Heart rate did not change significantly with yohimbine. Norepinephrine concentrations rose from 293 +/- 29 picograms (pg)/mL (1.732 +/- 0.171 nanomol (nmol)/L) at baseline to 486 +/- 67 pg/mL (2.873 +/- 0.396 nmol/L) one hour after yohimbine 2.
c) Oral yohimbine 0.2 mg/kg raised plasma noradrenaline concentrations by 67% in 9 hypertensive patients and by 178% in 6 normotensive patients. Blood pressure rose significantly with yohimbine in the hypertensive subjects but not in the normotensive subjects. Patients were not taking medications affecting blood pressure or the sympathetic nervous system; hypertensive patients averaged 68 years of age and normotensive patients averaged 63 years 3.
d) In a study of 19 hypertensive patients and 19 normotensive patients, intravenously administered yohimbine raised mean arterial pressure and norepinephrine and epinephrine concentrations in all patients (p less than 0.001). Yohimbine was given as a 0.125 mg/kg bolus followed by a 0.001 mg/kg/minute infusion over 15 minutes. Patients stopped all medications 2 weeks prior to the study. Hypertensive patients averaged 35 years of age and normotensive patients averaged 30 years. Mean arterial pressure rose from 106 +/- 4 mmHg to 127 +/- 5 mmHg in the hypertensive group and from 88 +/- 2 mmHg to 101 +/- 3 mmHg in the normotensive group; in all patients the increase was significant compared with baseline 4.
e) In a randomized, double-blind study of 17 male volunteers, oral yohimbine 40 mg raised the rate at which norepinephrine appeared in the plasma (p less than 0.005) without lowering norepinephrine clearance. Plasma epinephrine rose significantly. Diastolic blood pressure increased (p less than 0.01), as did mean arterial blood pressure and pulse (p less than 0.025) 5.
Common questions
Can I take Lisinopril and Yohimbine together?
Yohimbine can raise blood pressure and work against lisinopril, so it is best avoided while on this medicine. Check with your pharmacist or doctor before using any yohimbine product. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lisinopril and Yohimbine 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 Yohimbine interaction managed?
What your care team may do: Generally advise avoiding yohimbine-containing products while you take lisinopril, since yohimbine can push blood pressure up and work against your medicine. If any yohimbine use is considered, your team may monitor your blood pressure more closely and adjust and individualize your treatment. What you should do: Keep taking your lisinopril exactly as prescribed. Tell yo… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
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 Yohimbine 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 (5)
- Musso NR, Vergassaol C, Pjende A, et al: Yohimbine effects on blood pressure and plasma catecholamines in human hypertension. Am J Hypertens 1995; 8(6):565-571. PubMed
- Grossman E, Rosenthal T, Peleg E, et al: Oral yohimbine increased blood pressure and sympathetic nervous outflow in hypertensive patients. J Cardiovasc Pharmacol 1993; 22(1):22-26.
- Damase-Michel C, Tran MA, Llau ME, et al: The effect of yohimbine on sympathetic responsiveness in essential hypertension. Eur J Clin Pharmacol 1993; 44(2):199-201. PubMed
- Goldstein DS, Grossman E, Listwak S, et al: Sympathetic reactivity during a yohimbine challenge test in essential hypertension. Hypertension 1991; 18(Suppl 5):III40-48. PubMed
- Murburg MM, Villacres EC, Ko GN, et al: Effects of yohimbine on human sympathetic nervous system function. J Clin Endocrinol Metab 1991; 73(4):861-865. PubMed
Keep reading about Lisinopril
Keep reading about Yohimbine
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
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