Lisinopril is a widely prescribed medication primarily used for managing high blood pressure (hypertension). It is also used to treat heart failure and improve survival following a heart attack. This medication belongs to a class of pharmaceuticals called Angiotensin-Converting Enzyme (ACE) inhibitors. By limiting the action of chemicals that constrict blood vessels, Lisinopril helps blood flow more smoothly, allowing the heart to pump more efficiently.
Confirming the Connection
Dry mouth, formally known as xerostomia, is a recognized side effect associated with taking Lisinopril and other ACE inhibitors. Xerostomia refers to the subjective feeling of oral dryness. While a persistent dry cough is more frequently discussed, xerostomia is listed as a potential, though generally less common, adverse reaction to the drug.
The severity of oral dryness can vary widely among patients, ranging from mild irritation to a more bothersome symptom. Dry mouth is a documented occurrence for a percentage of patients using ACE inhibitors, making it a known risk when beginning treatment. This side effect is typically considered mild to moderate and does not affect every person who takes the medication.
Understanding the Physiological Cause
The mechanism by which Lisinopril treats high blood pressure is directly linked to how it can lead to a dry mouth sensation. As an ACE inhibitor, the drug works by blocking the angiotensin-converting enzyme, a key component of the body’s renin-angiotensin-aldosterone system. This blockade prevents the conversion of angiotensin I into angiotensin II, a potent vasoconstrictor that narrows blood vessels.
A secondary consequence of blocking the ACE enzyme is the accumulation of bradykinin, as the inhibited enzyme is also responsible for breaking it down. Increased levels of bradykinin cause irritation in the mucous membranes, which is thought to cause the persistent dry cough side effect. This accumulation of bradykinin is hypothesized to affect the function of the salivary glands. This effect may be due to direct irritation or by altering the perception of moisture in the mouth, leading to xerostomia.
Managing Xerostomia
Several practical strategies can help manage the discomfort of dry mouth (xerostomia) while taking Lisinopril. A foundational action is to consistently increase fluid intake by sipping water frequently throughout the day. Keeping the oral tissues moist helps alleviate the parched sensation and protects the mouth and throat.
Stimulating the flow of natural saliva can also provide relief. Chewing sugar-free gum or sucking on sugar-free lozenges, particularly those containing xylitol, encourages the salivary glands to produce more moisture. Over-the-counter products designed to replace natural saliva, such as artificial saliva sprays, gels, or rinses, can also be utilized. These substitutes coat the mouth tissues, offering temporary relief from dryness.
It is helpful to avoid substances that worsen dehydration or irritate dry oral tissues. Limiting the consumption of caffeinated beverages, alcohol, and excessive salt prevents further drying of the mouth. Patients should also choose toothpastes and mouthwashes that do not contain alcohol, as this ingredient can exacerbate dryness.
When to Seek Medical Guidance
If dry mouth symptoms become severe, or if self-management techniques are not providing adequate relief, consult with your prescribing physician or pharmacist. Seek professional guidance if xerostomia interferes with fundamental daily activities, such as eating, speaking, or sleeping. Chronic dry mouth also increases the risk of oral health issues, including dental decay, so persistent dryness warrants a dental check-up.
Contact your doctor if you are considering stopping the medication or changing the dosage due to discomfort. Only a healthcare professional can safely adjust your prescription or transition you to an alternative treatment, such as an Angiotensin II Receptor Blocker (ARB). Any sign of severe swelling in the face, lips, tongue, or throat (angioedema) requires immediate emergency medical attention.