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Does CBD Interact With Lisinopril (Prinivil)?

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Daily CBD , last updated on April 15, 2022

Lisinopril is a drug belonging to the class called angiotensin-converting enzyme inhibitor (ACE inhibitor). It is an antihypertensive drug used in treating high blood pressure, congestive heart failure, and post-myocardial infarction treatment.

Cannabidiol (CBD) and lisinopril can have an agonistic interaction when consumed together.

This could cause a rapid decrease in blood pressure, leading to an increased risk of side effects.

Lisinopril illustration

Does CBD Interact With Lisinopril (Prinivil)?

Yes. CBD can interact with lisinopril. They can have a mild to mostly moderate level of interaction.

Lisinopril and CBD can interact with each other and bring blood pressure down to levels that may be abnormally low. This could cause symptoms like dizziness, fainting, weakness, etc.

CBD can interact with lisinopril in two ways.

A. Increased Effects (Agonistic Interaction)

Lisinopril and CBD can have an agonistic interaction.

Agonistic interactions occur when two substances have a similar effect on the body, resulting in a heightened effect of one or both substances.

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor. Angiotensin enzyme is an essential component of the renin angiotensin system (RAAS). This system allows the conversion of angiotensin I (AT) to angiotensin II (ATII). Lisinopril acts on this system, causing vasodilation, leading to a decrease in blood pressure in the vessels.

On the other hand, CBD acts on the endocannabinoid system and can cause vasodilation and a reduction in blood pressure.

Taking them together has double the effect and can cause a rapid drop in blood pressure. As a result, many symptoms can occur, such as fainting, dizziness, hypotension, headache, etc.

Lisinopril is not metabolized by the liver and gets excreted out completely unchanged in the urine. So while other ACE inhibitors may show some metabolic inhibition when consumed with CBD, it is very unlikely in the case of lisinopril.

Similar Medications: CBD & ACE inhibitors

Lisinopril is an angiotensin-converting enzyme inhibitor. CBD and ACE inhibitors all have the same risks and concerns.

Here’s a list of similar medications that share this level of risk when combined with CBD:

Is It Safe to Take CBD & Lisinopril (Prinivil) Together?

When CBD and lisinopril are used together, they can have a moderate amount of interaction. With large doses and long-term use of both drugs, this could get worse.

Because both medications have antihypertensive qualities, they may produce blood pressure levels that are too low.

If you intend to take these two drugs together, always check with your prescribing physician first. If you have any unusual side effects, do not delay in seeking medical help.

Hemp leaves side to side with a CBD oil dropper over white background

Is CBD a Viable Alternative to Lisinopril (Prinivil)?

CBD is not a perfect substitute for stronger antihypertensive medications like lisinopril. This is because, while it has antihypertensive qualities, it may not be effective in extreme situations.

CBD lowers blood pressure by increasing the amount of nitric oxide in the body. It accomplishes this by acting on CB1 receptors in the endothelium, producing artery dilatation and reducing blood pressure [1]. It can also help users with tachycardia and high blood pressure [2].

CBD also has antioxidative and anti-inflammatory characteristics, which can aid in the treatment of inflammatory diseases that can lead to or be caused by high blood pressure [3].

Hence, while CBD may act on some mild forms of hypertension or as an adjunct for other antihypertensives, it cannot be used for more severe cases.

What is Lisinopril (Prinivil)?

Lisinopril is an antihypertensive belonging to the class called angiotensin-converting enzyme (ACE) inhibitor. It is used for the treatment of hypertension, congestive heart failure, and treatment following myocardial infarction. It is a gold standard in the treatment of high blood pressure. Prinivil is one of its commonly used brand names.

It is FDA-approved and available as a prescription drug.

Lisinopril (Prinivil) Specs:

Drug Name  Lisinopril
Trade Name Prinivil, Cipril, Hipril, Lipril, Lisinace, Lisoril, Listril
Classification Angiotensin-converting enzyme (ACE) inhibitor
CYP Metabolism Not metabolised by CYP enzymes  
Interaction With CBD Agonistic
Risk of Interaction Moderate

Other Names For Lisinopril (Prinivil)

Lisinopril is sold under many other brand names. All share the same risk and potential interactions.

Other names for lisinopril (Prinivil) include:

  • Cipril
  • Hipril
  • Lipril
  • Lisinace
  • Lisoril
  • Listril

What Does Lisinopril (Prinivil) Do?

Lisinopril is an antihypertensive that can block the angiotensin-converting enzyme (ACE).

Angiotensin I (ATI) can be converted to angiotensin II (ATII) with the help of ACE. The ATII is a critical component of the renin-angiotensin-aldosterone system that helps to regulate blood pressure (RAAS).

This process regulates and controls the flow of blood, water, and electrolytes in the body. Renin is released from the kidneys when certain events occur, such as sympathetic activation, lower blood pressure, or reduced blood supply to the kidneys.

This renin release aids in converting circulating angiotensinogen into ATI, which is then transformed into ATII by ACE.

The adrenal cortex secretion of aldosterone is also stimulated by ATII. Aldosterone promotes sodium and water reabsorption by increasing the number of sodium channels and sodium-potassium ATPases on cell membranes in the distal convoluted tubule (DCT) and collecting tubules of nephrons. Blood pressure rises as a result of this.

The posterior pituitary gland can secrete vasopressin or antidiuretic hormone (ADH) in response to ATII. Through the action of aquaporin-2 channels on the apical surface of DCT and collecting tubule cells, ADH encourages additional water reabsorption from the kidneys. ATII also causes a rise in blood pressure by constricting the arteries.

By competing with angiotensin I for binding at the angiotensin-converting enzyme, lisinopril can block the RAAS system from working. This will prevent angiotensin I from converting to angiotensin II, lowering blood pressure.

Angiotensin II constricts coronary blood arteries and is positively inotropic, which increases vascular resistance and oxygen consumption in normal circumstances. Myocyte enlargement and vascular smooth muscle cell proliferation may result from this activity.

Lisinopril’s ACE inhibiting actions prevent myocyte hypertrophy and vascular smooth muscle cell proliferation.

It has a half-life of 12.6 hours and can last in the body for up to 48 hours.

Side Effects of Lisinopril (Prinivil)

Lisinopril is not recommended during pregnancy since it can disrupt the renin-angiotensin system in the fetus, resulting in oligohydramnios and even fetal mortality.

The medicine must be stopped immediately and an alternative prescribed if the patient becomes pregnant.

It should not be taken alongside neprilysin inhibitors like sacubitril.

It should not be used by anyone who has a history of hereditary or idiopathic angioedema.

Side effects of Lisinopril (Prinivil)

  • Abdominal pain
  • Asthenia
  • Chest pain
  • Cough
  • Diarrhea
  • Dizziness
  • Dyspnea
  • Hyperkalemia
  • Hypersensitivity
  • Hypotension
  • Increase in creatinine
  • Infection
  • Nausea
  • Pruritus
  • Rash
  • Syncope

Key Takeaways: Is it Safe to Take Lisinopril (Prinivil) With CBD?

There is a moderate possibility of interaction when CBD and lisinopril are taken together. When both medicines are taken simultaneously, side effects such as a sudden drop in blood pressure, dizziness, and other issues can occur.

This is especially true when both medicines are used for a long time. A low dose of both treatments for a short period and with enough spacing in between may lessen the likelihood of an interaction.

However, you should never take both of these medications without consulting your prescribing physician.

CBD may be used to treat milder forms of hypertension or as a supplement to existing antihypertensive medications.


References

  1. Stanley, C. P., Hind, W. H., Tufarelli, C., & O’Sullivan, S. E. (2015). Cannabidiol causes endothelium-dependent vasorelaxation of human mesenteric arteries via CB1 activation. Cardiovascular Research, 107(4), 568-578.
  2. Jadoon, K. A., Tan, G. D., & O’Sullivan, S. E. (2017). A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study. JCI insight, 2(12).
  3.  Atalay, S., Jarocka-Karpowicz, I., & Skrzydlewska, E. (2020). Antioxidative and anti-inflammatory properties of cannabidiol. Antioxidants, 9(1), 21.

Learn More About CBD-Drug Interactionds

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