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Lisinopril, ACE Inhibitors and Supplement Interactions -- prescription bottle of lisinopril on desk with blood pressure cuff

Answer:

Yes, if you take lisinopril (Zestril, Prinivil) or another ACE inhibitor such as enalapril (Vasotec), quinapril (Accupril), benazepril (Lotensin), or ramipril (Altace) for high blood pressure or congestive heart failure, certain supplements may cause problems and a particular mineral supplement should be taken at a different time of day than your ACE inhibitor.

There are no supplements that you should necessarily take because you are on an ACE inhibitor.

Avoid:

Potassium supplements should be avoided by people taking lisinopril (Zestril, Prinivil) ramipril (Altace) or other ACE inhibitors that can increase potassium levels. Taking potassium supplements with these medications could potentially increase the risk of dangerously high blood levels of potassium, a condition called hyperkalemia. Do not take potassium without medical supervision. (Be aware that coconut water can contain high amounts of potassium).

Licorice contains glycyrrhizin, a compound that can increase sodium retention and blood pressure (Deutch, Foods 2019). Licorice supplements and other licorice products that have had glycyrrhizin removed, known as deglycyrrhizinated licorice (DGL), are available and may not have the same adverse effects as licorice containing glycyrrhizin (Omar, Ther Adv Endocrinol Metab 2012; NIH 2020).

Use with caution:

Arginine may cause a mild reduction in blood pressure, although not all studies have shown a consistent effect (Komers, J Hypertens 2000; Zoja, Kidney Int 2003). Use arginine cautiously if taking lisinopril.

St. John's Wort may increase sensitivity to the sun (photosensitivity), as can lisinopril and other ACE inhibitors (Lisinopril Prescribing Information 2008; Friedman, Arch Intern Med 2012). It's possible that taking St. John's wort while taking an ACE inhibitor could increase this effect. (The herb Dong Quai may also increase sun sensitivity, and potentially have a similar effect (National Toxicology Program 2008).

Take at a different time of day:

Although there is some preliminary evidence that iron supplements may help to alleviate dry cough caused by ACE inhibitors, iron may interfere with the absorption of ACE inhibitors (and likewise, these drugs may inhibit the absorption of iron). To be safe, it's best to take iron supplements and ACE inhibitors at different times of the day.

ACE-inhibitors may reduce this mineral:

Be aware that lisinopril and other ACE inhibitors may deplete zinc levels in the body and increase the risk of zinc deficiency (Golik, J Am Coll Nutr 1998; Trasbare, J Trace Elem Med Biol 2007). However, there does not appear to be research on the effects of zinc supplementation in people taking these drugs, so consult your physician before taking zinc supplements.

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Daniel18241
August 22, 2019

I have found Dark Chocolate to be an effective blood pressure controller. And, it don't taste
half bad neither!
Cheerio

ConsumerLab.com
August 26, 2019

Hi Daniel - Be aware that while cocoa flavanols may modestly reduce blood pressure in healthy people, the benefit in people with hypertension appears to be quite limited. See the "What It Does" section of the Cocoas and Dark Chocolates Review https://www.consumerlab.com/reviews/cocoa-powders-and-chocolates-sources-of-flavanols/cocoa-flavanols/#njike.

Daniel18262
August 26, 2019

Your information re chocolate and blood pressure is taken as offered. Thank you for your clarification. I stand corrected, sort of. However Here is how I came to my own conclusions on this matter.
I started "taking" eating more dark chocolate after laying off--got tired of it--for many months. Originally I ate it because I liked it--chocoholic for centuries or more. ( Note my exaggeration, fairly typical among some chocoholics.)
Then I read about an apparently worldwide scientific search for populations that didn't get hypertension as they aged. I think the article was in Science News.
A population was discovered on an island in the Caribbean. They aged without developing hypertension. But it was found that members of this group who had moved off island to cities--none were specified, but I imagine regional cities. The off-islanders exhibited BPs typical of most populations, ie their BPs ranged higher than the on island population, as they aged. The researchers identified the practice among islanders of drinking cocoa during the day. Emigrants had dropped that practice. Not exactly following stringent rules of evidence of Robert Koch, but pretty suggestive of a research project. I am unaware of any, but I haven't looked.

Daniel18263
August 26, 2019

Suddenly I found my BP in the range of 140-160 systolic, and upper 90s diastolic, in the morning before much activity, and even in the afternoon after not particularly stressful activities. Since I do not want to be on Blood Pressure meds I decided to once more eat a bit of the ol' Valrhona. daily And within a week my BP returned to normal. Then to double check, sorta on the lines of Koch's postulates, I discontinued the chocolate. Fairly quickly my BP began to rise. I recommenced eating chocolate and again my BP returned to normal levels--around 112/70, sometimes more, sometimes less.
SO.
Now, I have not examined the scientific literature on the matter, but, Suddenly last year I began to see articles in Science News suggesting that chocolate was ONLY effective when taken simultaneously with Blood Pressure meds.
This assertion does not match my experience. Indeed it doesn't match the original scientific research. Thus, I have begun to think that perhaps the new research has been "financed" by the drug companies themselves. I do Not trust it!
SO. Now I am going to try to perform a pretty exhaustive search of the literature for the truth.
I will report back to ConsumerLab when I find satisfactory evidence either way.

Grant18232
August 21, 2019

I would also note that ACE Inhibitors are associated with higher risk of lung cancer than using ARB ( angiotensin receptor blockers ) particularly if you have a family history of lung cancer.
https://www.bmj.com/content/363/bmj.k4209

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