Lisinopril

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Generic Name: Lisinopril Brand Name(s): Generics only. No brands available.

Uses

What is Lisinopril used for?

Lisinopril is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It is also used to treat heart failure and to improve survival after a heart attack.

Lisinopril belongs to a class of drugs known as ACE inhibitors. It works by relaxing blood vessels so blood can flow more easily.

How should I take Lisinopril?

Take this medication by mouth with or without food as directed by your doctor, usually once daily.

If you are using the suspension form of this medication, shake the bottle well before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

The dosage is based on your medical condition and response to treatment. For children, the dosage is also based on weight.

To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

For the treatment of high blood pressure, it may take 2 to 4 weeks before you get the full benefit of this medication. For the treatment of heart failure, it may take weeks to months before you get the full benefit of this medication. Tell your doctor if your condition does not get better or if it gets worse (for example, your blood pressure readings remain high or increase).

How do I store Lisinopril?

Lisinopril is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Lisinopril in the bathroom or the freezer. There may be different brands of Lisinopril that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Lisinopril down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Lisinopril?

Before taking lisinopril, tell your doctor or pharmacist if you are allergic to it; or to other ACE inhibitors (such as benazepril); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: history of an allergic reaction which included swelling of the face/lips/tongue/throat (angioedema), blood filtering procedures (such as LDL apheresis, dialysis), high level of potassium in the blood.

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

Too much sweating, diarrhea, or vomiting may cause loss of too much body water (dehydration) and increase your risk of lightheadedness. Report prolonged diarrhea or vomiting to your doctor. Be sure to drink enough fluids to prevent dehydration unless your doctor directs you otherwise.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This product may increase your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist.

Older adults may be more sensitive to the side effects of this drug, especially dizziness and increases in potassium level.

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details. (See also Warning section.)

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Lisinopril during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Lisinopril. Lisinopril is pregnancy risk category N according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Lisinopril?

Dizziness, lightheadedness, tiredness, or headache may occur as your body adjusts to the medication. Dry cough may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: fainting, symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat).

Although lisinopril may be used to prevent kidney problems or treat people who have kidney problems, it may also rarely cause serious kidney problems or make them worse. Your doctor will check your kidney function while you are taking lisinopril. Tell your doctor right away if you have any signs of kidney problems such as a change in the amount of urine.

Lisinopril may rarely cause serious (possibly fatal) liver problems. Get medical help right away if you have any symptoms of liver damage, such as: nausea/vomiting that doesn’t stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Lisinopril?

Some products that may interact with this drug are: aliskiren, certain drugs that weaken the immune system/increase the risk of infection (such as everolimus, sirolimus), lithium, drugs that may increase the level of potassium in the blood (such as ARBs including losartan/valsartan, birth control pills containing drospirenone), sacubitril.

Some products have ingredients that could raise your blood pressure or worsen your heart failure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

A very serious reaction may occur if you are getting injections for bee/wasp sting allergy (desensitization) and are also taking lisinopril. Make sure all your doctors know which medicines you are using.

Lisinopril may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Lisinopril?

Lisinopril may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Lisinopril?

Lisinopril may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Lisinopril.

What is the dose of Lisinopril for an adult?

Usual Adult Dose for Hypertension

Initial dose: 10 mg orally once a day; 5 mg orally once a day

Maintenance dose: 20 to 40 mg orally once a day

Maximum dose: 80 mg orally once a day

Comments:

-The initial dose is 5 mg orally once a day in patients receiving a diuretic.

-The 80 mg dose is used but does not appear to give greater effect.

-If blood pressure is not controlled with lisinopril alone, a low dose of a diuretic may be added (e.g., hydrochlorothiazide, 12.5 mg). After the addition of a diuretic, it may be possible to reduce the dose of lisinopril.

Usual Adult Dose for Congestive Heart Failure

Initial dose: 2.5 to 5 mg orally once a day

Maintenance dose: Dosage should be increased as tolerated

Maximum dose: 40 mg orally once a day

Comments:

-The diuretic dose may need to be adjusted to help minimize hypovolemia, which may contribute to hypotension. The appearance of hypotension after the initial dose of lisinopril does not preclude subsequent careful dose titration with the drug.

Usual Adult Dose for Myocardial Infarction

Initial dose: 5 mg orally (within 24 hours of the onset of acute myocardial infarction)

Subsequent doses: 5 mg orally after 24 hours, then 10 mg orally after 48 hours.

Maintenance dose: 10 mg orally once a day. Dosing should continue for at least 6 weeks.

Comments:

-Therapy should be initiated at 2.5 mg in patients with a low systolic blood pressure (less than or equal to 120 mm Hg and greater than 100 mmHg) during the first 3 days after the infarct. If prolonged hypotension occurs (systolic blood pressure less than 90 mmHg for more than 1 hour) therapy should be withdrawn.

Uses: Reduction of mortality in acute myocardial infarction

Usual Adult Dose for Diabetic Nephropathy

Initial dose: 10 to 20 mg orally once a day

Maintenance dose: 20 to 40 mg orally once a day

Dosage may be titrated upward every 3 days

Comments:

-Not an approved indication.

Usual Geriatric Dose for Hypertension

Initial dose: 2.5 to 5 mg orally once a day

Maintenance dose: Dosages should be increased at 2.5 mg to 5 mg per day at 1 to 2 week intervals.

Maximum dose: 40 mg orally once a day

Renal Dose Adjustments

CrCl greater than 30 mL/min: No adjustment recommended

CrCl 10 mL/min to less than or equal to 30 mL/min: Recommended initial dose is half of the usual recommended dose (i.e., hypertension, 5 mg; systolic heart failure, 2.5 mg, and acute MI, 2.5 mg. Up titrate as tolerated to a maximum of 40 mg daily)

CrCl less than 10 mL/min or on hemodialysis: Recommended initial dose is 2.5 mg orally once a day

Liver Dose Adjustments

Patients who develop jaundice or marked elevations of hepatic enzymes should discontinue therapy and receive appropriate medical treatment.

Dose Adjustments

-The antihypertensive effect may diminish toward the end of the dosing interval regardless of the administered dose, but most commonly with a dose of 10 mg or less daily. This can be evaluated by measuring blood pressure just prior to dosing to determine whether satisfactory control is being maintained for 24 hours. If it is not, an increase in dose should be considered. If blood pressure is not adequately controlled with lisinopril alone, a diuretic may be added. After the addition of a diuretic, it may be possible to reduce the dose of lisinopril.

-In all high risk patients, such as patients with ischemic heart or cerebrovascular disease, in whom excessive falls in blood pressure may lead to myocardial infarction or cerebrovascular accident the manufacturer advises treatment initiation at lower dosages.

-Dosage adjustments in the elderly should be made with particular caution.

-In patients who are currently being treated with a diuretic, symptomatic hypotension occasionally can occur following the initial dose. To reduce the likelihood of hypotension, the diuretic should, if possible, be discontinued 2 to 3 days prior to beginning therapy. Then, if blood pressure is not controlled with lisinopril alone, diuretic therapy should be resumed. If diuretic therapy cannot be discontinued, an initial dose of 5 mg should be used with careful medical supervision for several hours and until blood pressure has stabilized.Dialysis

This drug can be removed by hemodialysis.

Other Comments

Administration advice:

-Should be given as a single daily dose.

-May be given with or without food.

-In some patients with heart failure who have normal or low blood pressure, additional lowering of systemic blood pressure may occur with this drug. This effect is anticipated and is not usually a reason to discontinue treatment. If hypotension becomes symptomatic, a reduction of dose or discontinuation of may be necessary.

General:

-This drug is indicated as adjunctive therapy with diuretics and digitalis for treating heart failure.

-Following first time MI, all ACE inhibitors, at comparable appropriate dosages, appear to be equally effective for reducing mortality and recurrent MI rates.

-Prior to therapy, patients at high risk of symptomatic hypotension such as patients with salt depletion with or without hyponatremia, hypovolemia or those receiving vigorous diuretic therapy should have these conditions corrected. Renal function and serum potassium should be monitored.

-If it is not feasible to discontinue diuretic therapy prior to starting lisinopril, the patient should be closely monitored for several hours following the initial dose of this drug, and until the blood pressure has stabilized. The antihypertensive effects of lisinopril and diuretics used in combination are approximately additive.

-Achievement of optimal blood pressure reduction may require 2 to 4 weeks of therapy.

-Acute myocardial infarction: in addition to this drug, patients should receive, if appropriate, standard treatments, such as thrombolytics, aspirin, and a beta-blocker.

-Antihypertensive effects of this drug are maintained during long-term therapy. Abrupt withdrawal has not been associated with a rapid increase in blood pressure, or a significant increase in blood pressure compared to pretreatment levels.

Patient advice:

-This drug may be taken with or without food, but should be taken at the same time each day.

-This drug may impair your ability to drive or operate machinery.

What is the dose of Lisinopril for a child?

Usual Pediatric Dose for Hypertension

Pediatric patients greater than or equal to 6 years of age:

Initial dose: 0.07 mg/kg orally once a day (Maximum initial dose is 5 mg once a day)

Maintenance dose: Dosage should be adjusted according to blood pressure response at 1 to 2 week intervals.

Maximum dose: Doses above 0.61 mg/kg or greater than 40 mg have not been studied in pediatric patients

Comments:

-This drug is not recommended in pediatric patients less than 6 years old or in pediatric patients with glomerular filtration rate less than 30 mL/min.

Precautions

Safety and efficacy have not been established in patients younger than 6 years.

How is Lisinopril available?

Lisinopril is available in the following dosage forms and strengths:

  • Oral Tablet
  • Oral Solution

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Lisinopril, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: March 17, 2018 | Last Modified: March 17, 2018

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