CBD and lisinopril (e.g. Zestril, Prinivil, Lisodura)
David ReichUpdated:Key points at a glance:
CBD and lisinopril are generally considered compatible for many people. Metabolic interactions via CYP enzymes are regarded as unlikely, as lisinopril is largely excreted unchanged by the kidneys. More relevant is the pharmacodynamic aspect: CBD has been discussed in relation to slight blood pressure lowering effects. Used together, some individuals may experience dizziness or light-headedness, especially at the beginning. It may be advisable to start with a low dose of CBD and monitor blood pressure for 1 to 2 weeks. Extra caution is often recommended for people with low baseline blood pressure, older adults, those with kidney issues, or those taking diuretics. Consulting a doctor or pharmacist is advisable before combining the two.
- CYP450 interactions between CBD and lisinopril are unlikely – lisinopril is largely excreted unchanged via the kidneys.
- The more relevant aspect is the pharmacodynamic interaction: CBD is sometimes associated with a slight lowering of blood pressure. Together with lisinopril, dizziness and light-headedness may occur.
- Introduce CBD slowly, check blood pressure regularly during the first 1–2 weeks and watch out for dizziness – especially when standing up.
- Particular caution: low baseline blood pressure, higher age, impaired kidney function, diuretics, risk of hyperkalaemia.
- For people who are new to CBD and taking lisinopril, THC-free products (isolate/broad spectrum) are often considered a sensible option. Prior consultation with a doctor is recommended.
What are CBD and lisinopril?
CBD is a naturally occurring compound found in the cannabis plant. It interacts with the endocannabinoid system (ECS), which is involved in various regulatory processes in the body such as sleep, mood, pain perception and the stress response. CBD does not bind strongly and directly to CB1/CB2 receptors, but modulates the system indirectly. Initial data indicate that CBD may, in certain situations, help blood vessels to relax and in this way be associated with a mild reduction in blood pressure.
Read our article on how CBD works in the body.
CBD interacts with the body’s endocannabinoid system and may in some cases be associated with a mild lowering of blood pressure, which is relevant when it is used alongside blood pressure medicines such as lisinopril.
Lisinopril in brief
Lisinopril (e.g. Zestril, Prinivil, Lisodura) is an ACE inhibitor used to treat high blood pressure and certain heart conditions. It inhibits the formation of angiotensin II, leads to dilation of blood vessels and in this way lowers blood pressure. For assessing a potential CBD–lisinopril interaction, it is important that lisinopril is not significantly broken down via CYP450 enzymes in the liver. It is largely excreted unchanged via the kidneys, so CYP-mediated interactions with CBD are regarded as unlikely.
Do CBD and lisinopril interact?
Pharmacodynamics: additive blood pressure lowering and dizziness
The available data on CBD and lisinopril are limited. From a practical point of view, the main consideration is a possible additive effect on blood pressure: CBD may, in some individuals, be associated with a slight reduction in blood pressure and dizziness. Together with lisinopril, this could lead to more pronounced dizziness, light-headedness or a drop in blood pressure – particularly in the first few days of combining them, when CBD doses are increased, or in situations of fluid loss/heat.
Pharmacokinetics: CYP450 is barely relevant for lisinopril
CBD can inhibit various CYP450 enzymes involved in drug metabolism. For lisinopril, however, this is of little practical relevance, because it is not significantly metabolised via CYP450, but is mainly eliminated unchanged by the kidneys. CYP-related increases in lisinopril levels due to CBD are therefore considered unlikely.
Read our article on CBD interactions
For CBD and lisinopril, the main concern is an additive blood pressure‑lowering effect with possible dizziness. CYP450‑related drug interactions are considered unlikely because lisinopril is eliminated largely unchanged via the kidneys.
CBD and lisinopril interaction at a glance
| Mechanism | Relevance | What does this mean? | What to do? |
|---|---|---|---|
| Pharmacodynamics | Moderate | Possible additional drop in blood pressure → dizziness/light-headedness | Introduce CBD slowly, monitor blood pressure, stand up carefully, inform your doctor if you have symptoms |
| Pharmacokinetics (CYP) | Low | Lisinopril hardly depends on CYP metabolism | Not the main focus; still review other medicines for CBD interactions and involve your doctor |
What does this mean in practice if I take lisinopril and want to use CBD?
If you are considering using CBD in addition to lisinopril, a gradual approach, monitoring your blood pressure and paying attention to dizziness is advisable – especially during the first 1–2 weeks or after changes to the dose.
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- Discuss CBD use with your doctor before starting.
- Measure your blood pressure at home in the first 1–2 weeks (morning and evening).
- Watch out for dizziness, light-headedness, visual disturbances or feeling faint – especially when standing up quickly.
- If symptoms are persistent or pronounced, pause CBD and seek medical advice.
Who should be particularly cautious with CBD and lisinopril?
- People with rather low baseline blood pressure or marked blood pressure fluctuations
- Older adults
- Patients with impaired kidney function
- Those with electrolyte imbalances (especially risk of hyperkalaemia with ACE inhibitors)
- People who are dehydrated (e.g. due to diarrhoea, vomiting, heavy sweating)
- Those on diuretic therapy or other blood pressure-lowering medicines
Checklist before starting CBD while on lisinopril
- Review current blood pressure values and trend (blood pressure diary if available).
- Check concomitant medication: diuretics, ARBs, beta-blockers, other antihypertensives or prescription medicines.
- Confirm current kidney function and potassium levels (as per your doctor’s routine monitoring).
- Consider fitness to drive and operate machinery during the adjustment phase (dizziness/sedation may occur).
- Plan CBD dosing and introduce it slowly.
What should I look out for in the first 14 days of combining CBD and lisinopril?
- Symptoms: dizziness, light-headedness, tiredness, visual disturbances, especially on standing up
- Blood pressure: measure 1–2 times daily (at similar times) and record the values
- If values are noticeably low or symptoms occur: do not increase the CBD dose, consider pausing and seek medical advice.
Product aspects: CBD full spectrum vs THC-free with lisinopril
- THC may also be associated with lowering blood pressure and increasing sedation.
- For people taking lisinopril and new to CBD, CBD isolates or broad-spectrum products without THC are often considered a reasonable option.
- The choice of product and dosing is best discussed with a doctor.
- Severe or persistent dizziness, fainting, very low blood pressure readings
- Ongoing, troublesome cough
- Racing heart, chest pain, shortness of breath
- Swollen legs, unusual weight gain
- Possible signs of electrolyte or kidney problems (e.g. muscle cramps, weakness, reduced urine output)
Side effects – relevant for the CBD and lisinopril combination
CBD: key points in this context
For use alongside lisinopril, dizziness, light-headedness/sedation and a mild drop in blood pressure are particularly relevant. These effects are more likely at the beginning or when the dose is increased and often appear to be dose-dependent. Starting with a low amount and increasing gradually can help you assess how well you tolerate it.
More about CBD drug interactions.
Lisinopril: what matters in the combination
With lisinopril, dizziness and low blood pressure episodes can occur – this may be additively influenced by CBD. The typical dry cough associated with ACE inhibitors is not directly affected by CBD, but is important to distinguish. There is also a risk of hyperkalaemia and impaired kidney function; CBD is not considered a direct driver here, but routine monitoring (kidney function/potassium) should still be followed.
When CBD and lisinopril are used together, dizziness and low blood pressure are the main things to watch for. Cough, changes in kidney function and electrolyte imbalances are typical ACE inhibitor considerations and are regarded as independent of CBD.
CBD can affect liver enzymes (CYP450), but lisinopril is largely excreted unchanged via the kidneys. For this specific combination, the interaction is mainly pharmacodynamic (blood pressure and dizziness), while CYP-mediated effects are considered of low relevance.
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Disclaimer: This article is for information purposes only and does not replace medical advice. Do not change medicines or dosages without consulting your doctor. No claims are made regarding the treatment or cure of illnesses.