Temsirolimus and Lisinopril: 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
Temsirolimus
Lisinopril
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.
You've been prescribed temsirolimus (a cancer medicine) and lisinopril (a blood pressure medicine). When these two are used together, there is a higher chance of a reaction called angioedema. This is swelling that usually shows up in the face, lips, tongue, or throat, and it can come on days to weeks after starting, not right away.
In one study, this happened in about 7 out of 100 people on this kind of combination. That's worth taking seriously, but it's also something your care team can manage. Please keep taking both medicines as prescribed and don't stop on your own. Talk with your doctor or pharmacist, since a different type of blood pressure drug may be a safer choice for you.
Effect: Increased risk of angioedema with concomitant ACE inhibitor (lisinopril) and mTOR inhibitor (temsirolimus).
- Direction/magnitude: Additive risk; reported angioedema incidence ~6.6% with an ACEi plus mTOR inhibitor vs ~0.8% when an ARB was substituted (everolimus/sirolimus data).
- Onset: Delayed. Evidence: Established. Mechanism: Unknown (neither is a prodrug relevant here; likely additive effects on bradykinin/vascular permeability pathways).
- Management: Consider substituting an ARB for the ACE inhibitor. If combination continues, monitor for facial, oral, or laryngeal swelling and counsel the patient on warning signs. Individualize therapy per the care team.
What happens
Increased risk of angioedema
Interaction Deep Dive
Exercise caution when an ACE inhibitor is combined with a mammalian target of rapamycin (mTOR) inhibitor, because the pairing may raise the likelihood of angioedema. In one study, angioedema occurred in 6.6% of patients receiving this combination. To sidestep this risk, consider substituting an angiotensin receptor blocker (ARB) for the ACE inhibitor; the reported angioedema incidence among patients taking an ARB together with either everolimus or sirolimus was 0.8%1.
Why it happens (mechanism)
Unknown
How to manage this interaction
Your care team can manage this safely. Here is what they typically consider:
- Switching medicines: Your team may replace the ACE inhibitor (lisinopril) with a related blood pressure drug called an ARB, which appears to carry a much lower risk of this swelling.
- Closer monitoring: If you stay on both, your team may watch you more closely for any swelling.
What you should do: Keep taking both medicines as prescribed unless your prescriber tells you otherwise. Contact your pharmacist or doctor to review your options, and seek urgent care right away if you notice swelling of the face, lips, tongue, or throat, or any trouble breathing or swallowing.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) A retrospective study reported that angioedema occurred in 6.6% of patients using both an ACE inhibitor and a mammalian target of rapamycin (mTOR) inhibitor. The average time until onset was 123 days, and the majority of cases were mild to moderate and resolved after treatment with steroids and/or stopping the drug. Among patients taking mTOR inhibitors without a concurrent ACE inhibitor, angioedema occurred in 1.9%, while two earlier studies described an incidence of ACE inhibitor-induced angioedema between 0.3% and 0.68%. For patients receiving an angiotensin receptor blocker together with an mTOR inhibitor, the incidence was 0.8% 1.
Common questions
Can I take Temsirolimus and Lisinopril together?
Combining lisinopril with temsirolimus raises the risk of angioedema (dangerous swelling), so ask your doctor or pharmacist whether an ARB would be a safer blood pressure option; get emergency help if facial, mouth, or throat swelling occurs. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Temsirolimus and Lisinopril interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How is the Temsirolimus and Lisinopril interaction managed?
Your care team can manage this safely. Here is what they typically consider: Switching medicines: Your team may replace the ACE inhibitor (lisinopril) with a related blood pressure drug called an ARB, which appears to carry a much lower risk of this swelling. Closer monitoring: If you stay on both, your team may watch you more closely for any swelling. What you should do: Keep taking both medicine… 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 Temsirolimus or Lisinopril 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 (1)
- Duerr M, Glander P, Diekmann F, et al: Increased incidence of angioedema with ACE inhibitors in combination with mTOR inhibitors in kidney transplant recipients. Clin J Am Soc Nephrol 2010; 5(4):703-708. PubMed
Keep reading about Temsirolimus
Keep reading about Lisinopril
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