Generic
Lisinopril
13 brands available in the market
At a glance
Lisinopril is an ACE inhibitor used for high blood pressure, heart failure, and after a heart attack. It relaxes blood vessels, reduces the heart's workload, and lowers the risk of heart attack and stroke.
Description
Lisinopril competitively inhibits ACE from converting angiotensin I to angiotensin II (a potent vasoconstrictor), resulting in increased plasma renin activity and reduced aldosterone secretion, promoting vasodilation and BP reduction.
Indications
- Essential hypertension and renovascular hypertension
- Heart failure - as adjunctive therapy
- Post-myocardial infarction - started within 24 hours of symptom onset
- Diabetic nephropathy - hypertensive type 2 diabetics with microalbuminuria
Therapeutic class
Angiotensin-Converting Enzyme (ACE) Inhibitors
Pharmacological class
ACE Inhibitor
Pharmacology
Lisinopril competitively inhibits ACE, reducing angiotensin II production, leading to vasodilation, decreased aldosterone secretion, and blood pressure reduction.
Mechanism of action
Relaxes blood vessels, lowers blood pressure, and reduces the heart's workload.
Dosage
Hypertension (Adult):
- Initial: 10 mg/day (first dose at bedtime)
- Maintenance: 20 mg/day; max 80 mg/day
- Renovascular HTN, volume depletion, severe HTN: 2.5-5 mg/day
- On diuretics: 5 mg/day
Heart Failure: 2.5-5 mg/day start, titrate up to 40 mg/day
Post-MI: 5 mg/day (2 days), then 10 mg/day; low SBP: 2.5 mg/day
Children (>6 years): 0.07 mg/kg, max 5 mg/day
Administration
- Swallow tablet whole; do not chew, crush or break
- May be taken with or without food, but at a fixed time is preferable
- Take at the same time each day
Missed dose
If you miss a dose, skip it and continue with your normal schedule. Do not double the dose.
Side effects
Common Side Effects:
- Decreased blood pressure
- Cough
- Increased potassium level in blood
- Fatigue
- Weakness
- Dizziness
Precautions & warnings
- May cause dizziness for the first few days; rise slowly from sitting or lying positions
- Inform your doctor about any cough or throat irritation that does not go away
- Avoid potassium supplements and potassium-rich foods (banana, broccoli)
- Do not use in second or third trimester of pregnancy
Contraindications
- History of angioedema related to previous ACE inhibitor treatment
- Hereditary or idiopathic angioedema
- Bilateral renal artery stenosis
- Pregnancy (2nd or 3rd trimester)
Drug interactions
- May enhance hypotensive effect with diuretics
- May increase risk of renal function deterioration and decrease antihypertensive effect with NSAIDs
- May increase serum levels and toxicity of lithium
- Increased risk of hyperkalemia with potassium-sparing diuretics and potassium supplements
Food interactions
Alcohol consumption with Lisinopril is unsafe.
Use in pregnancy
Use in Pregnancy: Lisinopril is unsafe during pregnancy (Category D); definite evidence of risk to the fetus. Use only in life-threatening situations with doctor's advice.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Lisinopril is probably safe during breastfeeding; limited human data suggests no significant risk to the baby.
Pediatric use
Dose established for children over 6 years.
Geriatric use
Elderly may require dose adjustment (based on renal function).
Renal / hepatic impairment
Renal Impairment: Caution in kidney disease; dose adjustment based on CrCl; regular blood pressure monitoring recommended.
Hepatic Impairment: Caution in liver disease; inform doctor if signs of jaundice occur.
Overdose effects
No specific overdose information available; symptomatic and supportive treatment.
Storage conditions
Store below 30°C, away from light and moisture; keep out of reach of children.
Chemical structure
Lisinopril