Lipril 10mg

Indications

Hypertension: Lisinopril is used to treat hypertension in adults and children aged 6 and up. It lowers blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, such as strokes and myocardial infarctions. Antihypertensive medicines from a wide range of pharmacologic classes have shown these advantages in controlled studies.

High blood pressure control should be part of a complete cardiovascular risk management strategy that includes, when needed, cholesterol control, diabetes management, antithrombotic medication, smoking cessation, exercise, and salt restriction. To reach blood pressure objectives, many individuals will require more than one medication. See published recommendations, such as those of the National High Blood Pressure Education Program's Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, for detailed guidance on objectives and treatment (JNC).

In randomized controlled trials, a variety of antihypertensive drugs from various pharmacologic classes and with various mechanisms of action have been shown to reduce cardiovascular morbidity and mortality, and it can be concluded that blood pressure reduction, not some other pharmacologic property of the drugs, is largely responsible for those benefits. The reduction in the risk of stroke has been the most significant and persistent cardiovascular outcome benefit, although reductions in myocardial infarction and cardiovascular mortality have also been shown on a regular basis.

Elevated systolic or diastolic pressure raises cardiovascular risk, and the absolute risk increase per mmHg is larger at higher blood pressures, thus even small decreases in severe hypertension can be beneficial. Because the absolute benefit of blood pressure reduction is similar across populations with varying absolute risks (for example, patients with diabetes or hyperlipidemia), patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia) would benefit from more aggressive treatment to a lower blood pressure goal.

Many antihypertensive medications have extra authorized uses and effects in black individuals, while some antihypertensive drugs have lesser blood pressure effects (as monotherapy) (e.g., on angina, heart failure, or diabetic kidney disease). These considerations might help you decide on a treatment plan.

Lisinopril can be used alone or in combination with other antihypertensive medications.

Lisinopril is used to treat heart failure symptoms in people who aren't responding well to diuretics or digitalis.

Acute Myocardial Infarction: Lisinopril is used to reduce mortality in hemodynamically stable individuals who have had an acute myocardial infarction within the first 24 hours. Standard prescribed therapies such as thrombolytics, aspirin, and beta-blockers should be given to patients as needed.

Pharmacology

Lisinopril prevents ACE from converting angiotensin I to angiotensin II (a strong vasoconstrictor), resulting in higher plasma renin activity and lower aldosterone production (a hormone that promotes water and sodium retention). This causes vasodilation and lowers blood pressure.

Dosage 

Oral (Adult)-

Hypertension: Initially, 10 mg/day, 1st dose given preferably at bedtime to avoid precipitous fall in BP. Patient with renovascular HTN, volume depletion, severe HTN: Initially, 2.5-5 mg once daily. Patient on diuretic: Initially, 5 mg once daily. Maintenance: 20 mg once daily, up to 80 mg/day may be given if needed.

Diabetic nephropathy: Hypertensive type 2 diabetics with microalbuminuria: 10 mg once daily, may increase to 20 mg once daily to achieve a sitting diastolic BP

Heart failure: As adjunct: Initially, 2.5 or 5 mg/day, increased by increments of ≤10 mg at intervals of at least 2 wk to max maintenance dose of 40 mg/day.Post-myocardial infarction: 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 (Child)-

Hypertension: ≥6 yr Initially, 0.07 mg/kg, up to 5 mg once daily.

Administration

May be taken with or without food.

Interaction

Diuretics may exacerbate the hypotensive impact. With NSAIDs, it may raise the risk of renal function deterioration and reduce the antihypertensive impact. Lithium toxicity and serum levels may be affected. Hyperkalemia is a concern with K-sparing diuretics and K supplements. Gold Na thiomalate nitrite reactions may be boosted.

Contraindications

Previous ACE inhibitor treatment-related angioedema, inherited or idiopathic angioedema. In individuals with diabetes or renal impairment, aliskiren should be used together. Pregnancy. Children with a GFR of less than 30 mL/min/1.73 m2

Side Effects

Headache, tiredness, chest and abdominal discomfort, dizziness, nausea, vomiting, diarrhea, upper respiratory tract infection, asthenia, rash, orthostatic effects, hypotension, renal failure, hyperkalemia, intestinal angioedema; elevated BUN and serum creatinine levels.

Pregnancy & Lactation

Category D: Although there is evidence of human fetal risk, the advantages of usage in pregnant women may outweigh the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Precautions & Warnings

Bilateral renal artery stenosis or unilateral renal artery stenosis in a single kidney. Patients with collagen vascular disease, acute MI at risk of worsening hemodynamics, angioedema not linked to ACE inhibitor treatment, aortic stenosis, and hypertrophic cardiomyopathy. Angioedema risk is higher in black patients. Renal insufficiency. Lactation. 6 years. old child.

Storage Conditions

Store at below 25° C.