Lisinopril is a medication prescribed to manage high blood pressure, heart failure, and to improve outcomes following a heart attack. Like many medications, lisinopril can cause skin reactions. This article explores lisinopril’s potential to cause skin reactions, including hives, and outlines steps to take if symptoms develop.
Lisinopril and Skin Reactions
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, can cause skin reactions, including hives (urticaria). Hives typically appear as itchy, raised welts on the skin that can be skin-colored, reddish, or purplish. These welts vary in size and shape, from small spots to large blotches, and can appear anywhere on the body. While skin rashes and itching are recognized, they are generally rare with lisinopril.
Hives often signal an allergic reaction, as the body releases histamine, causing small blood vessels to leak fluid. Although hives can be a mild allergic reaction, a more serious swelling, called angioedema, is a distinct concern with ACE inhibitors like lisinopril.
Recognizing Angioedema
Angioedema represents a deeper swelling of tissues, often affecting areas like the face, lips, tongue, throat, and extremities. Unlike typical hives, angioedema may not always be itchy and can sometimes be painful. When angioedema involves the throat or tongue, it can cause difficulty breathing, swallowing, or hoarseness, which can become a life-threatening emergency.
This swelling, particularly with ACE inhibitors, is often mediated by bradykinin, a chemical that causes blood vessels to widen and leak fluid into deeper tissues. ACE inhibitors prevent bradykinin’s breakdown, leading to its accumulation and subsequent swelling. This mechanism differentiates it from common allergic reactions that respond to antihistamines. Angioedema can develop at any point during lisinopril treatment, from hours after the first dose to months or even years later.
Steps to Take If Hives Appear
If any skin reaction occurs while taking lisinopril, contact a healthcare professional promptly. For severe symptoms such as sudden swelling of the lips, tongue, or throat, or any difficulty breathing or swallowing, immediate medical attention is necessary. Calling emergency services is advised, as these signs indicate a serious medical emergency.
For general hives without severe swelling or breathing issues, contact the prescribing doctor for guidance. Do not discontinue lisinopril independently or attempt self-treatment. The doctor may recommend stopping lisinopril and considering an alternative medication for blood pressure management. Angiotensin Receptor Blockers (ARBs) or calcium channel blockers are often preferred alternatives for patients who have experienced angioedema from ACE inhibitors, as they work differently and pose a lower risk of similar reactions.