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CARDIOVASCULAR SYSTEM › AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM › ACE INHIBITORS, PLAIN › ACE inhibitors, plain
lisinopril
C09AA03
Forms & Strengths
- Tablets: 2.5mg, 5mg, 10mg, 20mg, 30mg, 40mg
- Oral solution: 1mg/mL
Adult Dosing
- Hypertension: 10mg orally once daily, titrate to 20-40mg/day
- Heart failure: 5mg orally once daily, titrate to 20-40mg/day
- Myocardial infarction: 5mg orally once daily, titrate to 10mg/day
Pediatric Dosing
- Hypertension (ages 6-16): 0.07mg/kg orally once daily, titrate to 0.6mg/kg/day
- Newborns (ages 0-1 month): contraindicated
- Infants (ages 1-6 months): not recommended
Indications
- Treatment of hypertension
- Treatment of heart failure
- Reduction of mortality in acute myocardial infarction
- Treatment of diabetic nephropathy
Mechanism of Action
- Competitive inhibition of angiotensin-converting enzyme (ACE)
- Decreases conversion of angiotensin I to angiotensin II
- Increases bradykinin and decreases aldosterone levels
Contraindications
- Hypersensitivity to lisinopril or other ACE inhibitors
- History of angioedema related to previous ACE inhibitor use
- Bilateral renal artery stenosis
- Unilateral renal artery stenosis in a solitary kidney
Adverse Reactions
- Cough (up to 12% of patients)
- Dizziness (up to 5% of patients)
- Headache (up to 5% of patients)
- Fatigue (up to 4% of patients)
- Nausea and vomiting (up to 3% of patients)
- Angioedema (rare, but potentially life-threatening)
Drug Interactions
- Potassium-sparing diuretics: increased risk of hyperkalemia
- Potassium supplements: increased risk of hyperkalemia
- Lithium: increased risk of lithium toxicity
- Non-steroidal anti-inflammatory drugs (NSAIDs): decreased antihypertensive effect
Curated Content: Needs Vetting Before Put to Clinical Use