What it's for (Indications)
- Lisinopril is indicated for the treatment of hypertension, heart failure, and acute myocardial infarction.
- It is also used for the prevention of heart attack and stroke.
Dosage Information
| Type | Guideline |
|---|---|
| Standard | **Hypertension (Adults)**: The recommended initial dose is 10 mg orally once daily. Dosage should be adjusted according to blood pressure response, with the usual maintenance dose ranging up to 40 mg daily. For patients concomitantly receiving diuretics, the initial dose should be 5 mg once daily. **Hypertension (Pediatric patients 6 years of age and older with glomerular filtration rate > 30 mL/min/1.73m²)**: The initial dose is 0.07 mg per kg (up to a maximum of 5 mg total) once daily. **Heart Failure**: Initiate with 5 mg orally once daily, increasing the dose as tolerated up to a maximum of 40 mg daily. **Acute Myocardial Infarction (MI)**: Administer 5 mg orally within 24 hours of the onset of MI symptoms, followed by 5 mg after 24 hours, and then 10 mg once daily. **Renal Impairment**: For patients with creatinine clearance (CrCl) ≥ 10 mL/min and ≤ 30 mL/min, the usual initial dose should be halved. For patients with CrCl < 10 mL/min or those on hemodialysis, the recommended initial dose is 2.5 mg. |
Safety & Warnings
Common Side Effects
- Common side effects may include headache, dizziness, lightheadedness, tiredness, dry cough, low blood pressure (hypotension), chest pain, nausea, diarrhea, and runny nose.
Serious Warnings
- Black Box Warning: WARNING: FETAL TOXICITY. When pregnancy is detected, discontinue Lisinopril as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.
- Before using lisinopril, inform your doctor about your complete medical history, especially concerning heart or kidney diseases, diabetes, and a history of angioedema.
- Do not discontinue this medicine without consulting your doctor.
- Inform your doctor about all current medications you are taking and if you are scheduled for surgery.
- **Pregnancy**: Lisinopril is contraindicated in pregnancy and carries a Boxed Warning due to fetal toxicity.
- Discontinue lisinopril as soon as pregnancy is detected, as drugs acting directly on the renin-angiotensin system can cause injury and death to the developing fetus.
- **Lactation**: The safety and effectiveness of lisinopril in nursing females are undetermined; consult a doctor for more information.
- **Driving**: Lisinopril may cause dizziness; avoid driving or operating heavy machinery until you know how this medicine affects you.
- **Liver Impairment**: Use with caution in patients with liver conditions; dose adjustment may be required.
- Consult your doctor for more information.
- **Kidney Impairment**: Use with caution in patients with kidney conditions; dose adjustment may be required.
- Consult your doctor for more information.
- **Alcohol Consumption**: Avoid alcohol consumption when using this medicine, as it may increase the severity of side effects.
How it Works (Mechanism of Action)
Lisinopril is an angiotensin-converting enzyme inhibitor (ACEI) that acts by inhibiting the angiotensin-converting enzyme (ACE), a peptidyl dipeptidase. ACE catalyzes the conversion of angiotensin I to the potent vasoconstrictor, angiotensin II. Angiotensin II also stimulates aldosterone secretion by the adrenal cortex. The beneficial effects of lisinopril primarily result from the suppression of the renin-angiotensin-aldosterone system (RAAS), leading to decreased plasma angiotensin II, reduced vasopressor activity, and decreased aldosterone secretion. This decrease in aldosterone may result in a small increase in serum potassium. Unlike some other ACEIs, lisinopril is not a prodrug.