There are a wide variety of medications used for the prevention of Migraine and headache, most of which are prescribed off-label. If lisinopril has been prescribed for you, or if you and your doctor have been considering it, here's some information that may be helpful.

BLACK BOX WARNING:

Pregnancy

fetal/neonatal morbidity/mortality may occur when drugs that act directly on the renin-angiotensin system are used in pregnancy; D/C drug as soon as possible once pregnancy detected
 

Type of medication:

Lisinopril, brand name Prinivail or Zestril, is in a class of drugs called angiotensin converting enzyme, or ACE inhibitors. This type of medication is used to treat hypertension, diabetic nephropathy, and congestive heart failure.  It can help increase the chances of survival after a heart attack. It is also prescribed off-label for Migraine and headache prevention. 

Precautions:

• Your blood pressure will need to be monitored regularly while taking lisinopril.
• If you are pregnant, tell your doctor and stop using lisinopril right away. Lisinopril can harm a fetus.
• Avoid alcohol; it may increase some of the side effects and your blood pressure could become dangerously low.
• Using salt substitutes while using lisinopril, except under doctors orders, is not recommended.
• Taking potassium supplements while using lisinopril, except under doctors orders, is not recommended.
• Heavy sweating, vomiting and/or diarrhea can cause dehydration and may increase the chances of your blood pressure lowering.  This could lead to an electrolyte disorder and/or kidney failure. Be sure to drink plenty of water while taking lisinopril.
• If you are allergic to any ACE inhibitor such as Lotensin, Capoten Momopril, Vasotec, Univasc, Aceon, Accupril, Altace or Mavik do not use lisinopril.
• If you have a history of angioedema (the swelling of hands, face, lips, throat, eyes and tongue) or have had trouble swallowing or breathing, do not use lisinopril.
• Do not use lisinopril if you are a pediatric patient with serious kidney issues.
• Do not use lisinopril if you take aliskiren.
• If you are having surgery or dental work done, make sure to tell the doctor you are taking lisinopril. You may need to discontinue it for a short while.
• Even if you feel well when taking lisinopril for high blood pressure, you must continue to take this medication. High blood pressure may not have any symptoms and this is a medication you may need to take for the rest of your life. 
• Make sure your doctor knows about any prescription, over-the-counter medications, herbal and/or dietary supplements you take.

Pregnancy and Breastfeeding:

• Lisinopril is FDA pregnancy category D during the second and third trimester and category C during the first trimester. Both animal and human information show that ACE inhibitors are connected with fetal death and malformation.
• Using lisinopril during pregnancy could cause harm to a fetus and therefore should not be used.
• There is not enough information available to know if lisinopril passes through breast milk or will harm a nursing baby. Therefore it is advised a nursing mother not take lisinopril without discussing it with her doctor if she plans on breastfeeding.
• Because lisinopril may have severe harmful effects in nursing babies, mothers who take this medication should either stop it or stop nursing - whichever is better for the mother's health.