Uses and Administration of Lisinopril Lisinopril is an Angiotensin-Converting Enzyme inhibitor. It is used in the treatment of hypertension and heart failure in Kenya, prophylactically after myocardial infarction, and in diabetic nephropathy. This specific formulation contains doses of Hydrochlorothiazide, for side effects and precautions please search for Hydrochlorothiazide on the mainstore as a single drug formulation and read about it.
In the treatment of hypertension, the usual initial dose of Lisinopril is 10 mg daily. Since there may be a precipitous fall in blood pressure in some patients when starting therapy with an ACE inhibitors, the first dose should preferably be given at bedtime. Hypotension is particularly likely in patients with renovascular hypertension, volume depletion, heart failure, or severe hypertension and such patients should be given a lower initial dose of 2.5 to 5 mg once daily. Patients taking diuretics should have the diuretic withdrawn 2 or 3 days before lisinopril is started and resumed later if required; if this is not possible, an initial dose of 5 mg once daily should be given. The usual maintenance dose is 20 mg given once daily, though up to 80 mg daily may be given if necessary.
In the management of heart failure, severe first-dose hypotension on introduction of an ACE inhibitor is common in patients on loop diuretics, but their temporary withdrawal may cause rebound pulmonary oedema. Thus treatment should be initiated with a low dose under close medical supervision. Lisinopril is given in an initial dose of 2.5 mg daily. In the USA an initial dose of 5 mg daily is suggested. Usual maintenance doses range from 5 to 40 mg daily.
Following myocardial infarction, treatment with lisinopril may be started within 24 hours of the onset of symptoms in an initial dose of 5 mg once daily for two days, then increased to 10 mg once daily. An initial dose of 2.5 mg once daily is recommended for patients with a low systolic blood pressure.
In diabetic nephropathy, the initial dose is 2.5 mg once daily. In normotensive type 1 diabetics the maintenance dose is 10 mg daily, increased to 20 mg daily if necessary to achieve a sitting diastolic blood pressure below 75 mmHg. In hypertensive type 2 diabetics, the dose should be adjusted to achieve a sitting diastolic blood pressure below 90 mmHg.
Adverse Effects and Side Effects of Lisinopril
Many of the adverse effects of ACE inhibitors including Lisinopril are relate to their pharmacological action and all therefore have a similar spectrum of adverse effects. The most common adverse effects of Lisinopril are due to the vascular effects of ACE inhibitors and include hypotension, dizziness, fatigue, headache, and nausea and other gastrointestinal disturbances.