Lisinopril Dosage Guide: Hypertension, Heart Failure, Post-MI (2026)

Lisinopril Dosage Guide: How Much Should You Take?

Lisinopril dosing varies significantly depending on whether you are treating hypertension, heart failure, or post-heart attack recovery. Here is a complete dosage reference for each indication.

By James Okafor, RPh, MBA

Medically reviewed by Dr. Sarah Chen, PharmD, BCPS

Published June 21, 2026

Last reviewed June 15, 2026

2 min read

Lisinopril Dosing by Indication

Lisinopril is dosed differently depending on the condition being treated. The starting dose for [hypertension](/conditions/hypertension) is much lower than the starting dose for [heart failure](/conditions/heart-failure), and the target dose for post-MI is different again. Using the wrong dose range can result in inadequate treatment or unnecessary side effects.

Hypertension (High Blood Pressure)

Parameter	Dose
Starting dose (most patients)	10 mg once daily
Starting dose (elderly, volume-depleted, or CKD)	5 mg once daily
Usual maintenance dose	20–40 mg once daily
Maximum dose	80 mg once daily (rarely needed)
Dose adjustment frequency	Every 2–4 weeks based on blood pressure response

Heart Failure with Reduced Ejection Fraction (HFrEF)

For heart failure, the target dose is much higher than for hypertension. Evidence from the ATLAS trial shows that higher doses of [lisinopril](/drugs/lisinopril) (32.5–35 mg/day) are associated with better outcomes than lower doses (2.5–5 mg/day). The key is to titrate up as tolerated.

Parameter	Dose
Starting dose	2.5–5 mg once daily
Target dose	20–40 mg once daily
Maximum dose	40 mg once daily
Titration	Double dose every 2 weeks as tolerated; hold if systolic BP <90 mmHg or creatinine rises >30%

Post-Myocardial Infarction (Post-Heart Attack)

Parameter	Dose
Starting dose (within 24 hours of MI)	5 mg, then 5 mg at 24 hours, then 10 mg at 48 hours
Maintenance dose	10 mg once daily
Duration	At least 6 weeks; indefinitely if LV dysfunction present

Diabetic Nephropathy

Parameter	Dose
Starting dose	10 mg once daily
Target dose	20–40 mg once daily
Goal	Reduce proteinuria; slow CKD progression

Renal Dosing Adjustments

eGFR (mL/min/1.73m²)	Starting Dose Adjustment
≥30	No adjustment needed
10–30	Start at 5 mg once daily
<10 (including dialysis)	Start at 2.5 mg once daily; titrate carefully

Pediatric Dosing (Hypertension, Age ≥6 Years)

Starting dose: 0.07 mg/kg once daily (up to 5 mg). Maximum dose: 0.61 mg/kg (up to 40 mg) once daily. Lisinopril is not recommended in children under 6 years or with eGFR <30 mL/min/1.73m².

Important Dosing Notes

Lisinopril can be taken with or without food
Take at the same time each day for consistent blood pressure control
Check potassium and creatinine 1–2 weeks after starting or increasing the dose
A rise in creatinine of up to 30% is acceptable; >30% warrants dose reduction or discontinuation
Do not take a double dose if you miss a dose — skip the missed dose and take the next scheduled dose

References

Packer M, et al. Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure (ATLAS). Circulation. 1999;100(23):2312-2318.
GISSI-3 Investigators. Effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction. Lancet. 1994;343(8906):1115-1122.