Should You Take Lisinopril In The Morning Or At Night?
In our latest question and answer, our pharmacist discusses the potential benefits of dosing lisinopril in the evening.
Should I take lisinopril at night or in the morning?
Feb 05, 2024- While the FDA doesn't specify a preferred time, research suggests taking lisinopril in the evening may provide better blood pressure control during early morning hours when cardiovascular events are more likely to occur. Taking lisinopril at night may also help reduce side effects like dizziness and drowsiness. Talk to your doctor before changing when you take your lisinopril.
Answer
Thank you for contacting us! I'm happy to answer this for you.
The FDA-approved prescribing information for lisinopril does not specify whether it should be taken in the morning or evening.
However, several studies suggest that taking ACE inhibitors like lisinopril in the evening may offer benefits over morning dosing. This concept is known as chronotherapy, which involves timing medication administration to maximize efficacy and minimize side effects based on the body's circadian rhythms.
When discussing blood pressure medication, it's important to consider that cardiovascular events are more likely to occur in the early morning, coinciding with a rise in blood pressure due to the characteristic circadian pattern of blood pressure variability. Based on this, it is commonly thought that better control of early morning blood pressure can reduce the risk of negative cardiovascular events.
One study, specifically focusing on lisinopril, found that taking it at 10:00 PM resulted in a greater reduction in blood pressure during the high-risk period from 6:00 AM to 11:00 AM compared to other dosing times. The study concluded that evening timing is likely to be more effective in protecting against vascular risks than dosing at other times during the day due to better morning blood pressure control.
Similarly, studies on angiotensin-II receptor blockers (ARBs) like irbesartan, olmesartan, telmisartan, and valsartan, which are very similar to ACE inhibitors, have shown that taking these medications at bedtime, compared to in the morning, has a greater therapeutic effect on asleep blood pressure and a significant increase in the sleep-time relative blood pressure decline. This again, is thought to reduce the risk of negative cardiovascular events.
While longer-term studies are needed to specifically evaluate whether evening dosing of an ACE inhibitor like lisinopril reduces the risk of cardiovascular events, the evidence suggests that evening dosing may offer more benefits due to the higher cardiovascular risk in the early morning hours and the improved blood pressure control associated with evening dosing.
Additionally, it's important to note that a common side effect of blood pressure medication is dizziness, drowsiness, and lightheadedness. Taking blood pressure medication at night can help mitigate these effects.
Final Words
Summing up, although there is no 'official' recommendation regarding lisinopril dosing times, taking it at night may not only help reduce some of the side effects but may also offer better cardiovascular protection.
As always, be sure to take your medication as prescribed, and if you want to change your dosing time, be sure to talk to your doctor.
References & sources
- Management of antihypertensive treatment with Lisinopril: a chronotherapeutic approach — PubMed
- Circadian rhythms in blood pressure regulation and optimization of hypertension treatment with ACE inhibitor and ARB medications — PubMed
- Administration-time differences in effects of hypertension medications on ambulatory blood pressure regulation — PubMed
Glossary — Terms in This Answer
- FDA-approved
- Officially reviewed and authorized for safe use by the Food and Drug Administration, the U.S. government agency that oversees medications.
- ACE inhibitors
- A class of blood pressure medications that work by relaxing blood vessels to help blood flow more easily.
- Chronotherapy
- The practice of timing when you take medication to match your body's natural daily cycles for better effectiveness.
- Circadian rhythms
- Your body's natural 24-hour cycle that controls when you sleep, wake, and experience changes in blood pressure and other functions.
- Cardiovascular events
- Serious health problems involving the heart and blood vessels, such as heart attacks or strokes.
- Angiotensin-II receptor blockers
- A class of blood pressure medications similar to ACE inhibitors that work by blocking a hormone that narrows blood vessels.
- Therapeutic effect
- The positive health benefit or improvement that a medication produces in the body.
- Vascular risks
- The danger of developing problems with blood vessels that can lead to serious health complications.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
More answers from Brian →