LISINOPRIL

Angiotensin converting enzyme inhibitor antihypertensive

Dosage Forms

Tablet

10 mg

Uses

  • Moderate and severe hypertension (stage 2 and 3)
  • Symptomatic heart failure
  • Renal disease in hypertensive patients with type II diabetes mellitus
  • Prophylaxis after myocardial infarction

Dose and Duration

Stage 2 hypertension (with another antihypertensive)

Adult: 10 mg once daily (2.5–5 mg in cardiac decompensation or volume depletion). Usual maintenance dose is 20 mg once daily (max 80 mg once daily)

Child 12–18 years: 5 mg once daily increased to usual maintenance dose of 10–20 mg once daily (max 80mg once daily)

Child 6–12 years: 0.07 mg/kg (max 5 mg) once daily increased at intervals of 1–2 weeks up to a maximum of 0.6 mg/kg (max 40 mg once daily)

Heart failure

Adult and child > 12 years: 2.5 mg once daily increased by not more than 10 mg at intervals of 2 weeks or more, up to a maximum of 35 mg once daily if tolerated

Renal disease in hypertensive patients with type II diabetes mellitus

Adult and child > 12 years: 2.5–5 mg once daily; increased as required up to maintenance dose of 10–20 mg once daily

Prophylaxis after myocardial infarction (see caution)

Adult: Systolic blood pressure ≥120 mmHg; 5 mg within 24 hours of onset, followed by 5 mg after 24 hours, then 10 mg after another 24 hours and then 10 mg once daily for 6 weeks. Systolic blood pressure 100–120 mmHg; 2.5 mg daily increased to maintenance dose of 5 mg once daily for 6 weeks

Contraindications

  • Hypersensitivity to lisinopril or other ACE inhibitors
  • Hereditary or idiopathic angioedema
  • History of angioedema associated with previous ACE inhibitor therapy

Side Effects

  • Dizziness, headache
  • Orthostatic hypotension
  • Dry cough
  • Diarrhoea, vomiting
  • Renal dysfunction

Interactions

  • Ciclosporin (increased risk of hyperkalaemia)
  • Diuretics (increased hypotensive effect)
  • Potassium sparing diuretics, aldosterone antagonists (increased risk of severe hyperkalaemia)
  • Potassium salts (increased risk of severe hyperkalaemia)

Patient Instructions

  • Take your medication at approximately the same time each day

Pregnancy

  • Do not use

Breast-feeding

  • Do not use

⚠️ Caution

  • Do not use in myocardial infarction if systolic BP is below 100 mmHg. If systolic BP drops below 100 mmHg during treatment, reduce dose or withdraw in case of prolonged hypotension (systolic BP less than 90 mmHg for > 1 hour)
  • Side effects more likely to occur in renal failure. Reduce dose if creatinine clearance ˂80 ml/minute
  • Use with caution in patients who have volume depletion due to risk of hypotension
  • Increased risk of anaphylactoid reactions in patients undergoing haemodialysis