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The most prescribed blood pressure medicine in the U.S. is the ACE inhibitor lisinopril. At last count, more than 20 million Americans swallow this BP pill daily. We always thought we knew about lisinopril side effects such as cough, digestive upset, high potassium levels, sensitivity to sunlight, dizziness, headache, fatigue and swelling of the mouth, throat or abdomen (angioedema). A link between lisinopril and hand tremors was not on our radar scope until we received a question about it a few months ago. Since then, we have received many other reports about lisinopril and hand tremors.
Lisinopril and Hand Tremors:
Q. I recently started taking care of my own health issues. I had hand tremors that made the mouse run laps around the computer screen. After researching all my prescription medicines, I quit taking lisinopril for hypertension.
After a month being off it, the tremors are gone. They had been so bad that another nurse friend noticed it when we were out for dinner. I have many hobbies and could not imagine not being able to knit, crochet, sew or embroider again.
A. Your story took us by surprise. We have been interested in ACE inhibitors like lisinopril for decades. This blood pressure pill works well for most people, with relatively few side effects.
Some develop an uncontrollable cough, though. A few others experience something called angioedema, which can be life threatening.
In this condition, the tissues of the face, especially the lips, tongue and throat, swell and may block the ability to breathe. Angioedema can also occur in the abdomen, causing intestinal blockage. To learn more about angioedema and how serious it can be, check out this link.
Lisinopril Side Effects Can Be Lethal
Blood pressure pills like Lisinopril are perceived as generally safe medications, but mysterious lisinopril side effects called angioedema can be life threatening.
Lisinopril and Hand Tremors:
Hand tremors are not a life-threatening complication. We doubt that most health professionals are aware that it might be linked to lisinopril. We were certainly ignorant of this potential adverse reaction.
Tremor is listed in the prescribing information, but it appears to be quite rare. You are the first person who has told us about experiencing this complication.
We trust you are in touch with your doctor about other ways to control your blood pressure. We offer more information about lisinopril, other medications and nondrug approaches in our eGuide to Blood Pressure Solutions. This online resource is available in the Health eGuides section of this website.
There is a powerful lesson to be learned from this alert reader’s realization that there was a connection between lisinopril and hand tremors. Because a shaky hand is not considered a) important, b) common or c) drug related, it is easily ignored. We have learned a great deal from the readers who visit this web site. We never would have considered withdrawal itching associated with cetirizine (Zyrtec) without reader input.
More Readers Report an Association between Lisinopril and Hand Tremors:
Q. After I read on your website that lisinopril could cause hand tremors, I asked my doctor to change my blood pressure medication. I had been on HCTZ/lisinopril for at least ten years. She said she hadn’t heard of any connection between the two and suggested I see a neurologist. I said let’s try changing my medication first.
She increased my HCTZ to 25 mg. I took no other medication. Within three days, my hand tremors were essentially gone. I was able to polish my own fingernails. Thank you for bringing this information forward.
A. A dry cough is the most common complication of ACE inhibitors like lisinopril. We’re not surprised that your doctor was unaware of tremor as a side effect. Most electronic drug databases that physicians rely on don’t list this adverse reaction.
We too were unaware of it until a reader reported hand tremor associated with lisinopril. When we checked the FDA-approved prescribing information, we found that tremor is a recognized reaction, though it is considered rare.
Lisa shares this poignant story about lisinopril and hand tremors:
“I have essential tremor (thanks, Dad). By the end of my father’s life, his tremor had progressed to the point that it prevented him from signing his name, tightening a screw, eating neatly, and doing almost anything that mattered to him.
“I’ve seen my tremor steadily progress throughout my life, as well. When I began taking metoprolol, though, my tremor regressed. I’d say it was knocked back thirty years or more, and it definitely was the metoprolol at work. That was a lovely thing. I’m an artist and had feared what my future would look like.
“Then I was switched from metoprolol to lisinopril. My tremor came back with a vengeance. It is now so bad that I have trouble writing and typing, buttoning a button–any task that requires careful hand control. Drawing and painting are a joke. Now, I even have begun to have tremor in my neck and jaw (think Katherine Hepburn).
“I asked to switch back to metoprolol. Instead, my doctor wanted me to add the metoprolol back and continue taking lisinopril. I was delighted and looked forward to the improvement I expected to follow. But it didn’t.
“Now I’m thinking, maybe it’s the lisinopril…”
Helen solved her problem with lisinopril and hand tremors without even realizing it:
“I took lisinopril for several years and changed because of a persistent cough. I also was beginning to have tremors but did not then connect them. Now I realize I have had none since stopping the lisinopril.”
Share Your Lisinopril Experience:
Have you ever suffered ACE inhibitor side effects? What about lisinopril and hand tremors? Please add your story in the comment section below. Never stop any medicine without discussing it with the health professional who prescribed it!
Ruth
I have spells that mimic hypoglycemia–my hands begin to tremble. I have had all the tests for diabetes but they come back normal. when I first started taking Lisinopril 10mg for my hypertension I had a dry cough that has gone away but now I’m dealing with these trembling episodes not all the time but sometimes.
Dawn
I’m diabetic and have been for over 50 years. I am on an insulin pump now. For my diabetes, I was prescribed lisinopril and HCTZ about 30 years ago as routine meds. I really made no correlation between lisinopril and essential tremor until my sister was recently placed on lisinopril and started having weird side effects. I have suffered essential tremor for about 30 years now. Hmmm, that’s when I started taking lisinopril. It has progressed to the point of recently having a DAT scan, thinking I was developing Parkinson’s disease. The neurologist prescribed Propanol. Today, when my sister told me about this possible link between tremors and lisinopril I was blown away. It was actually the first time I had ever heard about it. I will definitely be checking into this possibility.
Mila
I have been taking lisinopril for the last six months and started having hand tremors mostly noticeable when I pick up something like a cup of coffee or a glass of water. It’s very uncomfortable and annoying. I mentioned this to my doctor, but they completely ignored the fact that this was happening. I also have been having back pains often on since starting with lisinopril.
John
I am 64 and have taken lisinopril for 10+ years. My hand tremors have been horrible since. I can barely write my name. I ran out of them while traveling, and my prescription is being refilled as I type this comment. I have been off the lisinopril for only a week, and my tremors are nearly gone. I have a Doctor’s appointment soon and plan to look for an alternative.
Lauri
I stopped lisinopril due to the persistent cough. Before stopping I was having some mild hand tremors and some mild balance issues. I’m about two weeks past lisinopril and suddenly realized these other symptoms were gone. I was beginning to think I had a scary neurological issue but I guess they were all side effects.
Rhonda
I started taking Lisinopril 1 year ago, with a gradual dose increase to 40mg daily. I too started getting hand tremors. It was very disturbing, as it affected my computer work. I haven’t yet stopped the medication but plan to discuss it soon with my physician. Now I feel awful that I dismissed my mother’s complaints of hand tremors, never once considering it was her lisinopril. It helps to know I am not the only one experiencing this!
Chris
I too had to check to see if Lisinopril HCTZ caused hand tremors. I found this article and feel a little more at ease.
My BP spiked last February, and the emergency doctor put me on Nadolol 40mg. and 12.5 Lisinopril HCTZ. I started noticing I was having vivid bizarre nightmares and insomnia. I found a new doctor, and he increased my Lisinopril to 25. mg and took me off the Nadolol.
Well, the nightmares are still there, and now I have hand tremors that affect using my hands fo eating and other uses.
Plus a feeling of loss of energy and tiredness.
Diane
I just came across this article, and I’m praying that lisinopril is my problem. I’ve been having internal resting tremors. I’m going to have an MRI done this Monday because they think I have MS or something to that matter. I will be mentioning this to my doctor. I pray this is my problem.
Mike
It never dawned on me that Lisinopril might have been the root cause of my not feeling well until my physician upped my dosage. Side effects came on with a vengeance including the tremors in my hands. I have since been taken off this med and put onto a ARB. Tremors have subsided, BP has stabilized as well as the other symptoms.
David
During the many years of treatment by my cardiologist for cholesterol problems, my systolic blood pressure ran into the high 130s. Out of an abundance of caution, I received a scrip for 2.5 mg of Lisinopril, something that I thought was an insignificant amount for any drug. Over time, I began to notice that I was developing hand tremors. My father had somewhat moderate hand tremors, so I figured it was hereditary.
The hand tremors slowly increased in intensity and bothered me to the point where I saw my neurologist. Diagnosis: Essential Tremor. Over time, the tremors continued to worsened, and I found that I couldn’t fill in a form with spaces designated for each individual character. I also was not forming the letters of my block printing correctly. Add to that a complete inability to text anything of substance on my phone. With a follow-up appointment, the neurologist gave me Propranolol 60 mg ER, as a substitute for Lisinopril.
I’ve been on it a week today and cannot believe the improvement. The tremor is dramatically reduced, and I marvel at how I’ve recaptured my handwriting from many decades ago. My appetite has increased as a result of the change in medication, strangely enough, which I didn’t need. I hope that is only about discipline with what I consume. The big question is why my Chiropractor, whom I saw today, immediately was aware of the Lisinopril connection and not my Neurologist.
I believe the medical community doesn’t see a connection with Lisinopril causing the tremors and only see that drugs like Propranolol as having anti-tremor assistance. I am optimistic that once the Lisinopril completely cycles out of my body, the tremors will completely disappear.
Fran
I took Lisinopril for awhile until I started having terrible heartburn. Nothing seemed to get rid of it, and I couldn’t lie down to sleep. For some reason, I suspected the lisinopril and stopped taking it, and the heartburn went away. After some time, I started it again, and after a few weeks the heartburn started again. I stopped taking it again, and I was okay. I tried taking it again and again. I always had the heartburn so I finally stopped it completely and told my doctor.
Jim
I take 20mg lisinopril daily. I have noticed very slight tremors lately. This info is enlightening as I can possible pinpoint the tremors cause if it gets worse. Thanks.
Linda
I was switched from atenolol to lisinopril a few years ago but was told to discontinue the lisinopril after developing kidney failure in July of this year. After ceasing the lisinopril, I have also noted that the mild tremor I had in my hands occasionally has disappeared. I had not connected the tremors with lisinopril until reading this article.
Christina
I have never taken lisinopril for high blood pressure but one of the “sartans”; valsartan, losartan etc. About 3 years ago I started having a mild tremor in my right hand. I pointed it out to my doctor, but she seemed unconcerned. I’m now wondering if this could be a possible side effect of the losartan. The tremor gets worse at times and then a bit better, but it’s always there. Are any of these ACE inhibitors really safe to take? There always seems to be a trade off in that if the drug helps one thing it causes another!
Jessica
My husband was prescribed lisinopril after coronary by-pass surgery and was on it, and a myriad of other drugs, for over 20 years, until his death in 2017. Over those 27 years, his health went steadily downhill. Doctors blamed it all on his heart condition, but he had never had a heart attack. He had the cough, mild tremors, etc., but after reading this article, I now realize he also had undiagnosed angioedema. None of his doctors ever considered side effects from his meds. When something new developed, they just added another pill to treat the new side effects.
At the time of his death he was taking over 16 different prescription meds, some more than once a day! This is not quality health care…this is pill pushing for profit. Keeping the patient coming back more often to “monitor” his progress (downhill), and milking Medicare for more and more money. In my experience, doctors are not willing to listen to patients complaints regarding side effects. They just brush you off as a hypochondriac, saying it’s just the power of suggestion, because you read the leaflet that came with the meds.
Charles
I take both lisinopril and metoprolol. Recently I have noticed a slight tremor while eating. Today I had a difficult time using my screwdriver. I intended to discuss this with my heart specialist during my visit next week. Very pleased to come across your related article on this matter.
Lisabdot
I have essential tremor (thanks, Dad). By the end of my father’s life, his tremor had progressed to the point that it prevented him from signing his name, tightening a screw, eating neatly, and doing almost anything that mattered to him.
I’ve seen my tremor steadily progress throughout my life, as well. When I began taking Metoprolol, though, my tremor regressed. I’d say it was knocked back thirty years or more, and it definitely was the Metoprolol at work. That was a lovely thing. I’m an artist and had feared what my future would look like.
Then I was switched from Metoprolol to Lisinopril. My tremor came back with a vengeance. It is now so bad that I have trouble writing and typing, buttoning a button–any task that requires careful hand control. Drawing and painting are a joke. Now, I even have begun to have tremor in my neck and jaw (think Katherine Hepburn).
I asked to switch back to Metoprolol. Instead, my doctor wanted me to add the Metoprolol back and continue taking Lisinopril. I was delighted and looked forward to the improvement I expected to follow. But it didn’t.
Now I’m thinking, maybe it’s the Lisinopril…
Mary
After reading the article about lisinopril causing hand tremors, I asked my doctor to change my blood pressure medication. I had been on hctz/lisinopril for at least ten years. She said she hadn’t heard of any connection between the two and suggested I see a neurologist. I said let’s try changing my medication first. She increased my hctz to 25 mg and no other med. Within 3 days my hand tremors were essentially gone. I was able to polish my own fingernails. Thank you so much for bringing this information forward.
Judy
My husband has been on Lisinopril for many years for his blood pressure. He has been experiencing hand tremors. Now we have something to present to the doctor at next visit.
Helen
I took Lisinopril for several years and changed because of a persistent cough. I also was beginning to have tremors but did not then connect them. Now realize I have had none since stopping the Lisinopril.
Julie
I have been taking Lisinopril for about ten years and noticed hand tremors in the morning when trying to write. I had no idea that Lisinopril could cause tremors but it is the only medicine I take.
Frances
I had been taking lisinopril 2 years ago and started having severe heart burn. I stopped taking it, and the heartburn was gone. After a few weeks I started taking it again, and a few weeks later the heartburn returned. I stopped it a second time, and no more heartburn. After some time, I took it again, and the same thing happened. I didn’t take it anymore.
I haven’t seen this issue addressed but it was definitely causing my heartburn.
Sandy
After reading those accounts, I’m wondering if all blood pressure meds can give you tremors? I’m taking the beta blocker, Metoprolol. When I try to LOWER the dosage…I get really noticable tremors! My Doc said, “See, your body must need it” Yeah, there’s some irony in there someplace!
Connie
My husband takes 20 mg of Lisinopril daily and has taken it for over 15 years to help with blood pressure. He’ll be 70 this year. I’ve noticed his hand tremors worsening in the last couple of years (fingers tremble while trying to grasp a screw driver, for example), and we’ve never associated this symtom with the Lisinopril. I thought it might be Parkinsons, too. Now, we wonder, and we’ll check with our doctor. Thank you for posting this article.
Robin
My dear mother passed at age 90. She took Lisinopril probably for 15-20 yrs. Parkinson’s was ruled out. Doctors called it ‘essential tremors’ & said it was hereditary. It slowly got so bad she could no longer play cards, hold a fork or cup, or even read a book. The shaking was so bad, her hand tore the page right out of the book!
To think this might have been prevented by changing medicine is so upsetting. I have warned my siblings that if they should get the hand tremors to check their medicines first. It may not be hereditary after all! Sharing this to let you know this may not be so rare as is thought.
Melanie
I also take Lisinopril and have for about 10 years now. I do get dizzy from time to time and wonder if it’s the medication. On the topic of Lisinopril, but not it’s side effects, I do have a question: Since Covid 19 began I’ve read several articles stating that ACE inhibitors are an invitation to let the virus in, and then I’ve read just the opposite, that ACE Inhibitors and ARBS prevent the Covid 19 virus.I am so confused, I’m wondering if the Pharmacists can weigh in on this?
Chris E
Saw the article on hand tremors and lisinopril in the 23 Jul 2020 Houston Chronicle.
My bp was under control with benazepril for years until the VA switched me to lisinopril because benazepril was not in the formulary.
About the same time the stratum corneum on the palms of both hands began growing rapidly and itching like crazy. Two dermatologists were no help. My wife at the time would not let me touch her. When I had a computer keyboard problem I opened the case and shook out an amazing amount of skin flakes. Disgusting. After about six or seven years of this a chance comment led me to suspect a drug interaction, and my new doctor put me back on benazepril. The palm problem went away and after a month or so my nails on fingers and toes were no longer crossed with ridges.
Last year I ran out of benazepril and switched back to lisinopril. Within a week I saw those flaky patches on my hands again.
I haven’t heard of a similar interaction with lisinopril, and I didn’t have hand tremors nor the cough.
Cate
I have been taking monopril since the late 1990’s. About 8 years after I started taking the monopril, when I needed a renewed Rx, someone in the doctor’s office switched me to lisinopril once, and I had to leave the same day on a trip, with no time to object and get the stuff replaced by my monopril. I was sick as a dog with coughing and upper respiratory issues, starting the next day. When I was able to get off the lisinopril, the illness went away as abruptly as it had begun. Both are ACE inhibitors, but something is very different between the two.
Christina
I have been taking either Valsartan or Losartan for at least 10 years. About 6 years ago I started experiencing tremors in my right hand. My doctor wasn’t sure what was causing it but didn’t seem concerned. The tremors come and go and can be quite annoying at times. I have also experienced other side effects such as those listed with Lisinopril, such as coughing, stomach upset and dizziness. Of course I was unaware of the nature of these symptoms until reading your newsletter. Thank you for keeping the public informed, as the drug companies only seem to put profit over peoples’ health and well being.
Robert A
What about ACE Inhibitors affecting smell and taste? I have this problem and have been taking Enalapril for over 15 years. Please advise.
Terry Graedon
Thank you for the question. We did not know before tackling the answer that ARBs affect taste: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884926/
Apparently, ACE inhibitors also affect smell and taste: https://www.bmj.com/content/368/bmj.m406/rr-27
Anonymous
Anonymous: Will Ramipril also cause hand tremors?
Lorraine
I’ve been on lisinopril for more than 5 yrs. I have had the tremors show up within this time. I have been to neurologist to find the reason. It was not Parkinson’s. But, they still put me on Premadone to control the tremors. Even with premadone I still have the tremors. Some days are worse than others. It causes me to drop things and knock over things. This is the 1st I’ve heard that lisinopril maybe the issue. I have high blood pressure & cannot take the chance of having a stroke over hand tremors.
Anne
I took Ramipril for several years. During that time, I had several problems that I didn’t associate with Ramipril until I was able to get off of it for 3 months.
Unfortunately, my blood pressure went back up, and I went on Lisinopril. All the problems started back. I didn’t have hand tremors but I had a skipping heartbeat, a loss of good balance, and it affected my strength. Also, I was having problems with my left eye twitching, vertigo, and actually temporarily lost my eyesight while driving. It only lasted a minute, and I didn’t have an accident. I also lost all the cartilage in my knees. Six months after I started taking Ramipril, I had knee pain so bad that I avoided walking. I don’t know if I can totally blame that on the Ramipril, but it sure got worse after I started taking it. Now I am on an ARB. I felt so much better off of BP medicine for those 3 weeks, I would love to get off of it again. The ARB seems to be causing some unwanted hair growth and some hair loss.
Christa
I’m in my sixties and I have been taking lisinopril for years now. Maybe 4 or 5 years ago, I started having a tremor in my right hand. It initially manifested when my arm was tired, such as when I traveled with a rollaboard suitcase and a boarding bag on top. Over time, the tremor has gotten worse, showing up when my hand hangs relaxed. When I asked my doctor about it a couple of years ago, he called it an essential tremor, nothing to worry about, and left it at that. Now I’m wondering….
Patricia K
My son was on Lisinopril for years. His hands shook so bad I wondered if it was Parkinson’s. My husband was given 40 mg of Lisinopril and and developed kidney problems. I have a friend who was having psychological problems that cleared up when she came off Lisinopril. I took 5 mg of Lisinopril and was told to stop when I felt like I was going to pass out every time I stood up (no matter how slowly). I think there should be more studies on Lisinopril.
Carolyn
I was put on Lisinopril by my Dr . Over year ago as a 2nd BP Med. along with Triamterine /HCTZ (Diuretic). I took them faithfully and did notice my BP decreased but also found out by reading, that Lisinopril also acted as a diuretic. I lived in the Bathroom. Then I developed a hacking, dry Cough which would not go away. After a year or more of coughing, it subsided. It was only after I recently read Article on dangerous side effects of Lisinopril, this Article included, that I stopped taking this Med. on my own. I knew to confer with my Doctor first before stopping any medication abruptly, but I didn’t. My Coughing subsided and I had a sense of feeling better, not as lethargic, I moved around more and had more energy for an 81 year old Woman. My Blood Pressure is staying within normal range because with my new sense of well being, I am more active, which helps lower BP.
Brenda
I have taken Quinipril for years. I have the shakes! Always wondered why. I’ve started biking again and have noticed that the shakes are minimal on my biking days. Plus with biking I’ve been able to reduce the dosage.