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.

Question

Should I take lisinopril at night or in the morning?

Asked by Fio46 On Feb 05, 2024

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Feb 17, 2024
Last updated Apr 12, 2024

Key points

  • The FDA-approved prescribing information for lisinopril does not specify whether it should be taken in the morning or evening.
  • However, studies suggest that taking ACE inhibitors like lisinopril in the evening may offer benefits over morning dosing, potentially reducing cardiovascular risks.

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

  • 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

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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