Lisinopril

Lisinopril Medication Overview

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used in the treatment of hypertension, congestive heart failure, and to improve survival after a heart attack. It functions by relaxing blood vessels, which allows blood to flow more easily and the heart to pump more efficiently.

Indications and Usage

This medication is prescribed for managing high blood pressure either alone or in combination with other antihypertensive agents. It’s also indicated for the treatment of heart failure as an adjunct therapy when used with diuretics and digitalis. Additionally, Lisinopril is used in patients who have suffered from a recent myocardial infarction to improve survival rates.

Dosage Information

The initial dose for Lisinopril in patients with hypertension is typically 10 mg once daily. The maintenance dose ranges from 20 to 40 mg daily. In heart failure, it starts at 2.5 mg and may be gradually increased. Following a myocardial infarction, Lisinopril administration should commence within 24 hours, starting at 5 mg and adjusted based on tolerability. Dosage modification may be necessary for patients with renal impairment or in those who are on diuretics.

Lisinopril Administration

Lisinopril is taken orally, with or without food, usually once per day. The tablet should be swallowed whole with a sufficient amount of liquid. Consistency in the time of day it is taken is recommended to maintain even levels of medication in the blood.

Pharmacological Mechanism

Lisinopril inhibits the angiotensin-converting enzyme, which leads to decreased levels of angiotensin II. As a result, blood vessel dilation (vasodilation) occurs, and aldosterone secretion is reduced, causing a decrease in water retention. This ultimately lowers blood pressure and reduces the workload on the heart.

Side Effects Profile

Common side effects include cough, dizziness, headache, extreme tiredness, nausea, diarrhea, weakness, and sneezing. Serious side effects can occur and should be reported immediately to a healthcare provider. These include swelling, difficulty breathing or swallowing, fever, fainting, and chest pain.

Drug Interactions

Lisinopril can interact with other medications such as diuretics, potassium supplements, lithium, insulin, nonsteroidal anti-inflammatory drugs (NSAIDs), and other drugs that may increase serum potassium. Careful monitoring and possible dose adjustments are needed when these agents are used concomitantly.

Monitoring Parameters

Regular monitoring of blood pressure, renal function, and electrolyte levels is important in patients taking Lisinopril. Periodic assessment of white blood cell counts is recommended for patients with collagen vascular disease and renal disease.

Special Populations Considerations

Pregnant women should not use Lisinopril as it can cause harm or death to the unborn baby. Caution should be employed in pediatric and geriatric patients, who may be more sensitive to its effects. In patients with impaired renal function or those undergoing renal dialysis, Lisinopril dosage adjustments may be warranted.

Storage and Handling Instructions

Lisinopril should be stored at controlled room temperature, away from moisture and heat. Keep the container tightly closed when not in use. Medication should be kept out of reach of children and disposed of properly when it is expired or no longer needed.

Missed Dose Protocol

If a dose is missed, it should be taken as soon as remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling up on doses to make up for a missed one is not recommended.

Overdose Management

In the event of an overdose, supportive treatment should be initiated. This may include the administration of intravenous fluids to promote urine production and maintain blood pressure. If hypotension occurs, the patient should be placed in the supine position and, if necessary, receive an infusion of normal saline. Lisinopril can be removed by hemodialysis.