Lisinopril, classified as an angiotensin-converting enzyme (ACE) inhibitor, is a medication designed to address conditions such as high blood pressure, heart failure, and the prevention of kidney failure associated with hypertension and diabetes. Other ACE inhibitors in the same class include enalapril, quinapril, captopril, fosinopril, benazepril, ramipril, moexipril, and trandolapril. The primary function of ACE inhibitors is to regulate blood pressure by inhibiting the production of angiotensin II, a chemical that causes arterial muscles, including those in the heart, to contract and elevate blood pressure.
Brand Names and Generic Availability
Lisinopril is available under brand names such as Zestril, Prinivil, and Qbrelis. Additionally, it is accessible in generic form.
Prescription Requirement
Yes, lisinopril requires a prescription for use.
Side Effects of Lisinopril
Common side effects of lisinopril include dizziness, cough, nausea, headaches, anxiety, chest pain, diarrhea, and fluctuations in blood pressure and potassium levels. Less common effects involve insomnia, drowsiness, nasal congestion, psoriasis, rash, and sexual dysfunction. Like all ACE inhibitors, lisinopril may induce a nonproductive cough, which typically ceases upon discontinuation. Allergic reactions, such as facial swelling, are rare but require immediate cessation of the medication. Infrequent complications include decreases in red blood cells, white blood cells, and platelets.
Cough Induction by Lisinopril
Lisinopril, like other ACE inhibitors, may induce a nonproductive cough, which subsides upon discontinuation of the drug.
Dosage and Administration
For heart failure, the initial lisinopril dose is 5 mg daily, with an effective range of 5-40 mg daily. Dosage adjustments can be made every two weeks, increasing by 10 mg, to achieve maximum efficacy. In treating high blood pressure, the starting dose is 10 mg daily, typically ranging from 20-40 mg daily, with minimal additional efficacy seen at 80 mg. Treatment for a heart attack involves initial doses of 5 mg, followed by 5 mg after 24 hours, 10 mg after 48 hours, and a continuation of 10 mg daily for 6 weeks.
Interactions with Other Drugs or Supplements
Lisinopril should not be combined with potassium supplements or potassium-conserving diuretics, as it may lead to dangerous increases in blood potassium levels. Reports suggest potential interactions with lithium, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs), which may reduce the effectiveness of ACE inhibitors. Nitritoid reactions may occur when lisinopril is combined with injectable gold sodium aurothiomalate used in rheumatoid arthritis treatment.
Pregnancy and Breastfeeding
Lisinopril should not be taken during pregnancy due to potential harm to fetuses and neonates. Its excretion in breast milk is unknown.
Storage Information
Lisinopril tablets should be stored in a dry place within the temperature range of 15°C to 30°C (59°F to 86°F).
Summary
Lisinopril, an ACE inhibitor, proves effective in managing high blood pressure, heart failure, and preventing kidney failure associated with hypertension. While exhibiting potential side effects and drug interactions, careful adherence to prescribed dosages and regular medical oversight ensures optimal therapeutic outcomes. Understanding lisinopril’s mechanisms, precautions, and storage requirements enhances its safe and efficacious use in various cardiovascular conditions.