Lisinopril Stada

Lisinopril

Arterial HTN; cardiac insufficiency, as an additional treatment when non-K sparing diuretics are not sufficient or, if necessary, w/ digitalis; MI in patients w/ stable cardiocirculatory situation, as an additional treatment to standard MI treatment, preferably w/ nitrates.

Arterial HTN Initially 5 mg once daily. Titrate dose at intervals of ≥3 wk until optimal BP attained. Maintenance: 10-20 mg once daily. Max: 40 mg once daily. Cardiac insufficiency 2.5 mg once daily. Titrate dose in steps of 2.5 mg at intervals of at least 2-4 wk. Max: 35 mg daily. Acute MI Initially 5 mg, followed by 5 mg after 24 hr & 10 mg after 48 hr. After that, 10 mg daily. Continue for 6 wk at a min maintenance dose of 5 mg once daily. Renal impairment (CrCl 30-70 mL/min) & elderly Initially 2.5 mg once daily. Maintenance: 5-10 mg daily. Max: 20 mg daily.

May be taken with or without food.

Hypersensitivity to lisinopril or other ACE inhibitors. Renal artery stenosis (bilateral, or unilateral in a single functioning kidney); hereditary or idiopathic angioneurotic oedema due to ACE inhibitors; post-renal transplantation; severe renal impairment (CrCl <30 mL/min); during haemodialysis; aortic or mitral stenosis or other interruption of outflow from the left heart chamber eg, hypertrophic myocardiopathy; haemodynamically unstable patients post-acute MI; systolic BP ≤100 mmHg; cardiogenic shock. Concomitant use w/ poly(acrylonitrile, sodium-2-methylallyl-sulfonate) high-flux membrane (eg, AN 69) in an emergency dialysis. Concomitant use w/ aliskiren-containing products in patients w/ DM or renal impairment (GFR <60 mL/min/1.73 m²). Pregnancy & lactation.

Initiate therapy under hospital setting in case of concomitant high dose therapy w/ diuretics (eg, >80 mg furosemide); hypovolemia or hyponatremia; pre-existing hypotension; unstable cardiac insufficiency; reduced kidney function; undergoing high dose therapy w/ vasodilators; elderly ≥70 yr. Dual blockade of the renin-angiotensin-aldosterone system (RAAS) through combined use of ACE inhibitors, angiotensin II receptor blockers or aliskiren. May cause severe drop of BP, especially after the 1st administration. Higher risk for severe hypotension & renal insufficiency in patients w/ renovascular HTN & existing bilateral or unilateral artery stenosis. Risk of hyperkalemia. Use in primary hyperaldosteronism is not advisable. Reports of proteinuria; angioneurotic edema; neutropenia/agranulocytosis. Patients w/ obstruction in the left ventricular emission tract. Concomitant LDL apheresis w/ dextran sulfate; desensitisation therapy against insect stings. Patients undergoing major operation or anaesth. May affect ability to drive & use machines. Patients w/ renal impairment. Childn. Elderly.

Excessive BP reduction, dizziness, weakness, impaired vision, syncope; renal insufficiency; dry cough, sore throat, hoarseness, bronchitis; nausea, abdominal pain & indigestion; allergic skin reactions; headache, tiredness; decreased Hb, haematocrit, leucocyte or platelet counts.

Higher frequency of adverse events w/ ACE inhibitors, angiotensin II receptor blockers or aliskiren. Enhanced antihypertensive effect w/ diuretic & other antihypertensives; alcohol. Increased serum K conc w/ K-sparing diuretics or K prep. Reduced BP-lowering effect w/ NaCl; NSAIDs; sympathomimetics. Increased serum conc of lithium. Enhanced effect of alcohol. Increased BP fall w/ anaesth, narcotics, hypnotics. Increased risk for leucopenia w/ allopurinol, immune response-suppressing drugs, procainamide. Enhanced blood glucose lowering effect of oral antidiabetics (eg, sulphonylurea drugs, biguanides), insulin. Reduced bioavailability w/ antacids.

ACE Inhibitors/Direct Renin Inhibitors

C09AA03 - lisinopril ; Belongs to the class of ACE inhibitors. Used in the treatment of cardiovascular disease.

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