Lisinopril

GENERIC NAME: lisinopril

BRAND NAME: Zestril, Prinivil

DRUG CLASS AND MECHANISM: Lisinopril is an angiotensin converting enzyme(ACE) inhibitor. Angiotensin is a chemical that is made by the body continuously. It narrows blood vessels and thereby maintains (elevates) blood pressure. When the enzyme is blocked by lisinopril, angiotensin cannot be converted into its active form. As a result, blood vessels dilate and blood pressure falls.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: 2.5, 5, 10, 20, and 40 mg oral tablets.

STORAGE: Lisinopril should be stored in a dry place at 15-30°C (59-86 °F).

PRESCRIBED FOR: Lisinopril is used to treat elevated blood pressure, heart failureand to improve survival after a heart attack (myocardial infarction).

DOSING: Lisinopril should be taken at doses specifically directed by the physician. Lisinopril can be taken with or without food. Lisinopril should be taken at the same time each day to maintain consistent blood levels of lisinopril. Lisinopril should not be taken within two hours of taking an antacid since the antacid binds lisinopril and prevents its absorption. The dose of lisinopril is often lowered slowly when discontinuing.

The starting dose of lisinopril is 5 mg daily, and the effective dose range for treating heart failure is 5-40 mg daily. The dose can be increased by 10 mg every 2 weeks to achieve the maximum effect. The maximum dose is 40 mg daily.

The starting dose of lisinopril for treating high blood pressure is 10 mg daily. The usual dose range is 20-40 mg daily. A dose of 80 mg is not much more effective than 40 mg.

Treatment of heart attack (myocardial infarction) is started with 5 mg followed by 5 mg after 24 hours, 10 mg after 48 hours and then 10 mg daily. Treatment is continued for 6 weeks.

DRUG INTERACTIONS: In general, lisinopril should not be taken with potassium supplements or diuretics that conserve potassium [for example,hydrochlorothiazide/triamterene (Dyazide)], since blood potassium levels may rise to dangerous levels.

Nitritoid reactions (symptoms includie facial flushing, nausea, vomiting and hypotension) may occur when injectable gold (sodium aurothiomalate), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including lisinopril.

PREGNANCY: Lisinopril should not be taken during pregnancy because fetuses and neonates have died when lisinopril was administered during pregnancy.

NURSING MOTHERS: It is not known whether lisinopril is excreted in breast milk.

SIDE EFFECTS: First doses of lisinopril can cause dizziness due to a drop in blood pressure. Lisinopril can cause nausea, headaches, anxiety, insomnia, drowsiness, nasal congestion and sexual dysfunction. Lisinopril should be stopped if there are symptoms or signs of an allergic reaction including feelings of swelling of the face, lips, tongue or throat. Severe allergic reactions (anaphylaxis) and hivesoccasionally occur. Rarely, lisinopril may cause a drop in red blood cells, white blood cells, and platelets.

Lisinopril can impair the function of the kidneys, and every person taking this medication should have their kidney function checked.

WARNING: This drug can cause serious (possibly fatal) harm to an unborn baby if used during pregnancy. Therefore, it is important to prevent pregnancy while taking this medication. Consult your doctor for more details and to discuss the use of reliable forms of birth control while taking this medication. If you are planning pregnancy, become pregnant, or think you may be pregnant, contact your doctor immediately.

USES: This drug belongs to a group of medications called ACE inhibitors. It is used to treat high blood pressure (hypertension) in adults and in children 6 years of age and older. It works by relaxing blood vessels, causing them to widen. High blood pressure reduction helps prevent strokes, heart attacks and kidney problems.This medication is also used after an acute heart attack to improve survival, and is used with other drugs (e.g., "water pills"/diuretics, digoxin) to treat congestive heart failure.OTHER This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.This medication may also be used to help protect the kidneys from damage due to diabetes.

HOW TO USE: Take this medication by mouth, usually once a day or as directed by your doctor. You may take this drug with or without food. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time each day.If you are taking this drug in the liquid suspension form, shake the bottle well before each use. Measure the dose out carefully.Do not take potassium supplements or salt substitutes containing potassium without talking to your doctor or pharmacist first. This medicine can raise your potassium levels, which rarely can cause serious side effects such as muscle weakness or very slow heartbeats. Tell your doctor immediately if these effects occur.The dosage is based on your medical condition and response to therapy. For the treatment of high blood pressure, it may take 2 to 4 weeks before the full benefit of this drug occurs. It may take several weeks or months to see the full benefit when this drug is used for congestive heart failure.It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.