Indications |
Oral Hypertension Adult: Initially, 5-10 mg daily given at bedtime to avoid precipitous fall in BP. Patient with renovascular hypertension, volume depletion, severe hypertension: Initially, 2.5-5 mg once daily. Patient on diuretic: Initially, 5 mg once daily. Maintenance: 20 mg once daily, up to 80 mg daily may be used if needed. Child: ≥6 yr: Initially, 0.07 mg/kg (up to 5 mg once daily). Adjust dose until desired BP goal is achieved. Renal impairment: Adult: Dialysis: Initially 2.5 mg once daily. Max dose: 40 mg once daily. Child: Do not give if GFR <30 ml/min/1.73 m2.
Oral Heart failure Adult: As adjunctive therapy: Initially, 2.5 mg daily. Maintenance: 5-40 mg daily as a single dose. Oral Post myocardial infarction Adult: Initially, 5 mg once daily for 2 days started within 24 hr of the onset of symptoms. Increase to 10 mg once daily. Patients with low systolic BP: Initially, 2.5 mg once daily. Oral Diabetic nephropathy Adult: For hypertensive type 2 diabetics with microalbuminuria: 10 mg once daily, may increase to 20 mg once daily to achieve a sitting diastolic BP <90 mmHg. |
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Contraindications |
History of angioedema related to previous treatment with ACE inhibitors, hereditary or idiopathic angioedema. Bilateral renal artery stenosis. Pregnancy (2nd or 3rd trimester), lactation. | ||||||||
Warnings / Precautions |
Hypovolaemia, hyperkalaemia, collagen vascular disease, valvular stenosis; before, during or immediately after anaesthesia, preexisting renal insufficiency, unilateral renal artery stenosis. Children <6 yr. Assess renal function. May impair ability to drive or operate machinery. | ||||||||
Adverse Reactions |
Dizziness, headache, fatigue; cough, upper respiratory tract infection; rash; diarrhoea, nausea, vomiting, abdominal pain; chest pain, weakness; orthostatic effects; hypotension; hyperkalaemia; impotence; decreased haemoglobin; increased serum creatinine. Potentially Fatal: Severe hypotension, angioedema. |
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Overdose Reactions |
Symptom: Most likely hypotension. Treatment: Normal saline IV infusion may be used. | ||||||||
Drug Interactions |
Increased hypersensitivity reactions with allopurinol. Decreased serum levels with antacids. Reduced antihypertensive effect with aprotinin, NSAIDs, salicylates. May enhance the neutropenic effect of azathioprine. May enhance the nephrotoxic effect of ciclosporin. Increased risk of hyperkalaemia with eplerenone, potassium-sparing diuretics, trimethoprim. May enhance the adverse effects of ferric gluconate, gold sodium thiomalate. Increased risk of hypoglycaemia with insulin. Increased risk of neutropenia with mercaptopurine. Increased hypotensive effect and/or the nephrotoxic effect with thiazide diuretics. Potentially Fatal: May increase serum level of lithium. Increased risk of adverse renal effects with NSAIDs, salicylates. Increased risk of acute hypotensive events or acute renal failure with loop diuretics. See Below for More lisinopril Drug Interactions |
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Lab Interactions |
False-positive urine acetone determination results with sodium nitroprusside. Increases serum potassium and BUN/serum creatinine. | ||||||||
Food Interactions |
Avoid dong quai; ephedra, yohimbe, ginseng (may worsen hypertension). | ||||||||
Mechanism of Actions |
Lisinopril competitively inhibits angiotensin-converting enzyme (ACE) from converting angiotensin I to angiotensin II resulting in decreased levels of angiotensin II (a potent vasoconstrictor). This increases plasma renin activity and reduces aldosterone secretion. It also increases bradykinin levels. Onset: 1-2 hr. Duration: 24 hr (once daily dosing). Absorption: Absorbed slowly and incompletely from the GI tract (oral); peak plasma concentrations after 7 hr. Distribution: Protein-binding: Not significantly bound (25%). Excretion: Via urine (as unchanged drug); 12 hr (elimination half-life). |
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Administration |
May be taken with or without food. |
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Storage Conditions |
Oral: Store at 15-30°C (59-86°F). | ||||||||
ATC Classification |
C09AA03 - lisinopril ; Belongs to the class of ACE inhibitors. Used in the treatment of cardiovascular disease. | ||||||||
Storage |
Oral: Store at 15-30°C (59-86°F). | ||||||||
Available As |
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Lisinopril
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Lisinopril Containing Brands
Lisinopril is used in following diseases
Drug - Drug Interactions of Lisinopril
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