Quick answer

Ask your pharmacist or doctor before combining. The lisinopril label lists potassium supplements and potassium-containing salt substitutes as risk factors for high blood potassium, and its patient advice warns that heavy sweating, dehydration, vomiting and diarrhea can pull blood pressure too low. NIH says most potassium-only supplements contain no more than 99 mg a serving.^1,2

Key facts

The lisinopril label says risk factors for high blood potassium include kidney problems, diabetes, and taking potassium-sparing diuretics, potassium supplements or potassium-containing salt substitutes.¹
NIH says ACE inhibitors, the group lisinopril belongs to, reduce the potassium lost in urine and can lead to high potassium, and that experts recommend monitoring potassium in people who take them.²
The label tells patients that excessive perspiration and dehydration may lead to an excessive fall in blood pressure, and that vomiting or diarrhea may do the same.¹
MedlinePlus lists potassium supplements among the nonprescription products that may interact with lisinopril, and says to talk to your doctor before using salt substitutes that contain potassium.³
In the label's study of people with high blood pressure and normal kidney function, average blood potassium rose about 0.1 mEq/L over up to 24 weeks, and about 15% of people had a rise above 0.5 mEq/L.¹

Ask your pharmacist or doctor first

Lisinopril and other ACE inhibitors can raise blood potassium. The lisinopril label lists potassium supplements and potassium-containing salt substitutes as risk factors, and tells patients not to use such salt substitutes without asking their physician.^1,2

On the medicine's label

Which two risks does the lisinopril label raise?

MedlinePlus describes lisinopril as an ACE inhibitor used for high blood pressure and heart failure.³

The first risk is potassium. The label says drugs that inhibit the renin angiotensin system can cause high blood potassium, asks for potassium to be monitored periodically, and names the risk factors: kidney problems, diabetes, and the use of potassium-sparing diuretics, potassium supplements or potassium-containing salt substitutes. In its patient counseling section it tells people not to use salt substitutes that contain potassium without consulting their physician.¹

The second risk is blood pressure falling too far when the body loses fluid and salt. The label lists severe volume or salt depletion among the situations that put people at risk of excessive low blood pressure, and tells patients that excessive perspiration, dehydration, vomiting and diarrhea may lead to a fall in blood pressure.¹

An electrolyte product can touch both: its potassium relates to the first risk, and its sodium and fluid relate to the second. The label does not name electrolyte drinks or mixes, so reading a product against these two lists is a job for your pharmacist.¹

How much potassium do supplements and salt substitutes contain?

NIH says multivitamin and mineral supplements that include potassium typically provide about 80 mg, and potassium-only supplements mostly contain up to 99 mg. Salt substitutes can be far higher: NIH gives a range of about 440 mg to 2,800 mg of potassium per teaspoon and says people taking certain medicines should consult their provider before using them. The sources read for this page do not give the potassium content of electrolyte drink mixes in general, so the label on yours is the place to look.²

Too much potassium from supplements or salt substitutes can raise blood potassium (hyperkalemia), especially with kidney disease or medicines that keep potassium in the body. It often causes no symptoms, but severe cases can cause dangerous heart rhythms.^2,4

NIH adds that people whose kidneys pass less potassium, because of kidney disease or medicines such as ACE inhibitors, can develop high potassium at intakes that would be ordinary for other people. The label's own study, above, shows why it asks for potassium to be monitored periodically.^1,2

What about sweat, vomiting and diarrhea on lisinopril?

MedlinePlus says diarrhea, vomiting, not drinking enough fluids and sweating a lot can cause blood pressure to drop on lisinopril, which may cause lightheadedness and fainting. The label also tells patients to report light-headedness, especially during the first few days of treatment.^1,3

That is also why a salty drink is not a simple swap. MedlinePlus says that if your doctor prescribes a low-salt or low-sodium diet, you should follow those directions carefully, and the sodium in an electrolyte mix counts toward that.³

Does a water pill change the picture?

The label says that starting lisinopril in a person already taking a diuretic may result in an excessive fall in blood pressure, and that potassium-sparing diuretics can increase the risk of high potassium, so potassium should be monitored frequently if the two are used together. If you take a water pill as well, ask about both medicines and your electrolyte product in one conversation.¹

What to ask your pharmacist about electrolytes and lisinopril

Does my electrolyte drink, powder or tablet list potassium, and how much?
Do I use a salt substitute, and does it contain potassium chloride?
On a day of heavy sweating, vomiting or diarrhea, what should I do about my lisinopril and my fluids?
Do I need a blood test for potassium or kidney function after adding a new product?

Bring the label of every drink mix, tablet and salt substitute you use. NIH says a Supplement Facts panel lists the amount of the mineral itself, such as elemental potassium, so amounts can be compared directly.²

Questions people ask

Can you take electrolytes with lisinopril?

Ask your pharmacist or doctor first. The lisinopril label lists potassium supplements and potassium-containing salt substitutes as risk factors for high blood potassium, and low blood pressure can follow fluid loss.¹

Do the sodium and fluid in electrolyte drinks matter on lisinopril?

MedlinePlus says to follow a low-salt diet carefully if your doctor prescribes one, and that sweating a lot or not drinking enough can lower blood pressure. Ask your pharmacist how the sodium and fluid in your drink fit.³

Does lisinopril change potassium levels?

It can. In the label's study of people with normal kidney function, average potassium rose about 0.1 mEq/L, and about 15% had a rise above 0.5 mEq/L. That is why the label asks for periodic monitoring.¹

Does a salt substitute count as an electrolyte product?

The label treats potassium-containing salt substitutes as a risk factor of their own and tells patients not to use them without consulting their physician. Many contain potassium chloride, so read the label.^1,2

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Sources

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.