Jump to: What is lisinopril? | What is Mounjaro? | Why take Mounjaro with lisinopril? | Take home message
You can take Mounjaro with lisinopril if you have high blood pressure and a BMI over 27.
No known interactions exist between the medications, so the clinical risk is considered low if patients are continually monitored.
If you’re on lisinopril but don’t have a high BMI, you won’t be prescribed Mounjaro as it could lead to unnecessary weight loss.
While you can take Mounjaro with lisinopril, caution should be applied as the medications can cause similar side effects, like headaches and tiredness, which may be worsened when they’re combined.
There’s also a potential risk of experiencing acute low blood pressure (hypotension) due to the blood pressure-lowering effect of both Mounjaro and lisinopril. Your doctor may wish to alter your lisinopril dose if you take Mounjaro.
If you start taking Mounjaro alongside lisinopril, symptoms of very low blood pressure to look out for are:
- Dizziness or lightheadedness, especially when standing up from a sitting or lying position
- Fainting or feeling like you might faint
- Blurred vision
- Confusion or difficulty concentrating
- Fatigue or weakness
- Nausea
- Rapid or irregular heartbeat (palpitations)
- Cold, clammy skin
Everyone responds differently to medications, and while some people may experience side effects, they’re typically mild, occur during dose increases, and ease after the body adjusts to the medication.
We recommend telling your doctor if you start taking Mounjaro to ensure they can monitor your medication response.
What is lisinopril?
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor prescribed to treat high blood pressure, heart failure, and improve survival after a heart attack.
It works by blocking the formation of angiotensin II, a substance that causes blood vessels to constrict.
Lisinopril helps blood vessels relax and lower blood pressure by preventing this constriction.
Research has extensively studied lisinopril’s effectiveness in managing blood pressure.
Clinical studies show that 68-89% of elderly patients respond positively to treatment after 8 weeks or more.
The ALLHAT trial, a significant long-term study with 23 years of follow-up data, showed lisinopril effectively manages blood pressure with outcomes comparable to other blood pressure medications.
What is Mounjaro?
Mounjaro is a dual-action weight-loss injection.
It supports weight loss by mimicking two hormones, GLP-1 and GIP, that communicate with the brain’s appetite control centre, the hypothalamus, to lower hunger and food-seeking behaviour.
By lowering hunger and our desire to eat, Mounjaro helps us eat fewer calories to achieve a calorie deficit.
A calorie deficit occurs when we consume fewer calories than our body needs to fuel its essential functions, such as digestion, blood flow, and brain function.
By creating a calorie deficit, our bodies will ‘burn’ the excess fat stored for energy, and we’ll lose weight.
Mounjaro also slows down the rate at which we digest food so that our stomach and gut send signals to the brain to signal the feeling of fullness.
So, Mounjaro supports weight loss by making us feel less hungry through two mechanisms:
- Communicating with the brain’s appetite control centre
- Slowing the rate that food is digested
Randomised controlled trials have shown that Mounjaro leads to an average weight loss of around 26% after one year.
Why take Mounjaro with lisinopril?
People living with obesity have an increased risk of developing high blood pressure.
Research from Framingham (a longitudinal cardiovascular study of over 5,000 adults in the U.S.) showed that people living with a BMI of over 30 had 16 mmHg higher systolic and 9 mmHg higher diastolic blood pressure compared to those with a BMI below 25.
While there’s a connection between obesity and blood pressure, it’s more likely due to the lifestyle that leads to obesity that’s causing higher blood pressure than it solely being a direct effect of having excess body fat.
Poor diet, a lack of physical activity, poor sleep, and stress can all lead to higher blood pressure, and many people living with obesity have normal blood pressure, much like many people who are a ‘healthy’ weight will be living with high blood pressure, despite lower levels of body fat.
Still, research has shown that losing weight (or the process of getting healthier to support weight loss) consistently reduces blood pressure.
Additionally, randomised controlled trials have shown that tirzepatide (the drug in Mounjaro) significantly reduces systolic and diastolic blood pressure by around 7 mmHg and 4 mmHg.
The number of participants on Mounjaro with elevated blood pressure significantly reduced during this trial, and the percentage of participants with normal blood pressure increased from 30.2% to 58% after 72 weeks of treatment.
So, if you’re currently living with obesity and high blood pressure, Mounjaro may help you lose weight and have the complimentary benefit of lowering blood pressure.
Combining the two drugs may also lead to very low blood pressure, particularly when adjusting doses.
It’s worth monitoring the response to both medications; your doctor may wish to alter your lisinopril dose if you start taking Mounjaro.
Take home message
While Mounjaro and lisinopril can be taken together, the combination requires careful monitoring to prevent excessive drops in blood pressure, particularly during dose adjustments.
Research shows that Mounjaro not only supports weight loss but can also improve blood pressure, with clinical trials demonstrating significant reductions in both systolic and diastolic readings.
Weight-loss injections like Mounjaro shouldn’t be seen as a magic pill, but a tool to kickstart weight loss and manage hunger while developing healthy habits to keep weight off in the long term.
