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Lisinopril

Medical and Pharmacy Editor:

Brand Name: Zestoretic

Generic Name: Lisinopril

Drug Class: ACEI/Diuretic Combos; ACEI/HCTZ Combos

What Is Lisinopril and How Does It Work?

Lisinopril is a prescription medication used to treat high blood pressure (hypertension) in both adults and children 6 years of age and older.

By medical definition, high blood pressure is a condition that is defined as a repeatedly elevated blood pressure.

Lisinopril belongs to a class of medications called ACE inhibitors. ACE is short for angiotensin converting enzyme. Lisinopril is considered and antihypertensive drug. In general, antihypertensive drugs are used as a treatment for high blood pressure.

Some people taking this drug have reported light-headedness during the first few days of treatment. If you faint while taking this medication stop taking the drug and talk to the doctor who prescribed this drug for you.

Lisinopril is available under the following different brand names: Zestoretic.

Dosages of Lisinopril:

Tablet

  • 10 mg/12.5 mg
  • 20 mg/12.5 mg
  • 20 mg/25 mg

Dosage Considerations – Should be Given as Follows:

Adult dosage only. Safety and efficacy not established in pediatric dosages.

Hypertension

  • 10-80 mg Lisinopril/6.25-50 mg hydrochlorothiazide orally each day.
High Blood Pressure: Learn About Hypertension

What Are Side Effects Associated with Using Lisinopril?

Common side effects include:

Side effects of Hydrochlorothiazide

This document does not contain all possible side effects and others may occur. Check with your doctor or other medical professional for additional information about side effects or other concerns about conditions related to your health.

What Other Drugs Interact with Lisinopril?

If your doctor has directed you to use this NSAID, your medical doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first for more health information.

Severe Interactions of Lisinopril include:

Lisinopril has serious interactions with at least 49 different drugs.

Lisinopril has moderate interactions with at least 224 different drugs.

Lisinopril has mild interactions with at least 168 different drugs.

This information does not contain all possible interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the medications you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions, concerns, or more health information.

High Blood Pressure: Learn About Hypertension

What Are Warnings and Precautions for Lisinopril?

Warnings

  • Discontinue as soon as possible when pregnancy is detected; affects renin-angiotensis system causing oligohydramnios, which may result in fetal injury and/or death
  • This medication contains lisinopril. Do not take Zestoretic if you are allergic to lisinopril or any ingredients contained in this drug
  • Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately

Contraindications

Do not take Lisinopril if

Do not co-administer with aliskiren in patients with diabetes mellitus or with kidney impairment (GFR greater than 60 ml/min/1.73 m2).

Effects of Drug Abuse

  • None

Short-Term Effects

  • Rapid swelling of the face, extremities, lips, tongue, glottis, and larynx has been reported in patients treated with angiotensin-converting enzyme inhibitors. If laryngeal stridor or rapid swelling of the face, tongue, or glottis occurs discontinue therapy and institute appropriate therapy immediately.
  • See "What Are Side Effects Associated with Using Lisinopril?”

Long-Term Effects

  • See "What Are Side Effects Associated with Using Lisinopril?”

Cautions

  • Begin combination therapy only after failed monotherapy
  • Severe renal impairment or hepatic impairment
  • Risk of hypotension, especially with chronic heart failure
  • Rapid swelling of the face, extremities, lips, tongue, glottis, and larynx has been reported in patients treated with angiotensin-converting enzyme inhibitors. If laryngeal stridor or rapid swelling of the face, tongue, or glottis occurs discontinue therapy and institute appropriate therapy immediately
  • Patients receiving co-administration of angiotensin converting enzyme inhibitors and mammalian target of rapamycin inhibitor (temsirolimus, sirolimus, or everolimus) therapy may be at increased risk for rapid swelling. Intestinal rapids swelling has been reported in patients treated with angiotensin converting enzyme inhibitors
  • Decrease in bile flow and jaundice may occur, which may progress to severe impairment of liver function; discontinue is symptoms occur
  • Dry hacking nonproductive cough may occur within few months of treatment; consider other causes of cough prior to discontinuation
  • Elevated potassium levels may occur with angiotensin converting enzyme inhibitors; risk factors include kidney dysfunction, diabetes mellitus, and simultaneous use of potassium sparing diuretics and potassium supplements; use cautiously if at all with these agents
  • Thiazide diuretics may cause low potassium levels, electrolyte disturbance due to low chloride ion in the blood, low levels of magnesium, and low levels of sodium
  • Hydrochlorothiazide may precipitate gout in patients with familial predisposition to gout or chronic kidney failure
  • Symptomatic low blood pressure with or without fainting can occur with angiotensin converting enzyme inhibitors; mostly observed in volume depleted patients, correct volume depletion prior to initiation; monitor closely when initiating and increasing dosing
  • Deficiency of granulocytes in the blood, abnormally few neutrophils in the blood, or reduction of white cells in the blood with abnormal proliferation of bone marrow cells reported with other angiotensin converting enzyme inhibitors; patients with renal impairment are at high risk; monitor CBC with differential in these patients
  • Photosensitization may occur
  • Hydrochlorothiazide may cause acute transient nearsightedness and acute angle-closure glaucoma that may occur within hours of initiating therapy; discontinue therapy immediately in patients with acute decreases in visual acuity or ocular pain; additional treatment may be needed if uncontrolled intraocular pressure persists
  • Use caution in patients with severe aortic stenosis; may reduce coronary perfusion resulting in an inadequate blood supply
  • Use hydrochlorothiazide with caution in patients with diabetes or at risk of diabetes; may see increase in glucose
  • Use caution in patient's collagen vascular disease, especially in patients with simultaneous kidney impairment
  • Thiazide diuretics may decrease kidney calcium excretion; consider avoiding use in patients with elevated levels of calcium in the blood
  • Increased cholesterol and triglyceride levels reported with thiazides; use caution in patients with moderate to high cholesterol concentrations
  • Pathologic changes in parathyroid glands with elevated levels of calcium in the blood and too low levels of phosphor levels in the blood reported with prolonged use; discontinue prior to testing for parathyroid function
  • Dual blockade of the renin-angiotensin-aldosterone system (ARB plus an angiotensin converting enzyme inhibitors or aliskiren) in patients with established atherosclerotic disease or heart failure or with diabetes with end organ damage is associated with a higher frequency of low blood pressure, fainting, hyperkalemia, and changes in kidney function (including acute kidney failure), as compared with the use of a single renin-angiotensin-aldosterone system agent; limit dual blockade to individually defined cases, with close monitoring of kidney function
  • Neonates with history of in utero exposure: If oliguria or low blood pressure occurs, support of blood pressure and kidney perfusion; exchange transfusions or dialysis may be required

Pregnancy and Lactation

  • Use lisinopril in pregnancy only in LIFE THREATING emergencies when no safer drug is available. There is evidence of human fetal risk.
  • If breastfeeding, discontinue lisinopril or do not nurse
Reviewed on 4/14/2017


SOURCE:
Medscape. Lisinopril.
https://reference.medscape.com/drug/zestoretic-lisinopril-hydrochlorothiazide-342333

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