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Lisinopril: Brands, Price & Uses in Bangladesh
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor with the following evidence-based indications: Hypertension (established/FDA-approved): Treatment of high blood pressure in adults and…
About Lisinopril
Indications of Lisinopril
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor with the following evidence-based indications:
- Hypertension (established/FDA-approved): Treatment of high blood pressure in adults and pediatric patients 6 years of age and older, alone or in combination with other antihypertensive agents.
- Heart Failure (established/FDA-approved): Used as adjunct therapy (with diuretics and, where appropriate, digitalis) to reduce the signs and symptoms of symptomatic systolic (congestive) heart failure.
- Acute Myocardial Infarction (established/FDA-approved): To improve survival in hemodynamically stable patients within 24 hours of an acute myocardial infarction.
- Diabetic nephropathy / proteinuric chronic kidney disease (guideline-supported, often off-label): ACE inhibitors including Lisinopril are widely used per clinical practice guidelines to slow progression of proteinuric kidney disease, particularly in patients with diabetes.
Use of Lisinopril for any indication should be individualized and directed by a physician based on clinical assessment.
Dosage & Administration of Lisinopril
Dosage of Lisinopril must be individualized by a physician based on the indication, blood pressure response, and renal function.
Hypertension
| Population | Dose |
|---|---|
| Adults (not on diuretic) | Initial 10 mg once daily; usual maintenance 20-40 mg once daily; maximum 80 mg/day |
| Adults on diuretic | Initial 5 mg once daily to reduce risk of symptomatic hypotension |
| Pediatric ≥6 years | Initial 0.07 mg/kg (up to 5 mg) once daily; titrated per response up to a maximum of 0.61 mg/kg or 40 mg/day |
Heart Failure
Initial dose 5 mg once daily (2.5 mg once daily if serum sodium is low or the patient is hypotensive), titrated as tolerated toward a target dose of 20-40 mg once daily.
Acute Myocardial Infarction
2.5-5 mg within 24 hours of symptom onset, followed by 5 mg at 24 hours, 10 mg at 48 hours, and 10 mg once daily thereafter for at least 6 weeks; lower starting doses are used if systolic blood pressure is low.
Renal Impairment
Dose reduction of Lisinopril is required based on creatinine clearance; see Use in Special Populations for details.
Side Effects of Lisinopril
Common side effects of Lisinopril include:
- Dry, persistent, non-productive cough (a well-known class effect of ACE inhibitors)
- Dizziness or lightheadedness, especially after the first dose
- Headache
- Fatigue
- Nausea
- Hyperkalemia (elevated blood potassium)
- Hypotension
Less common but serious effects include angioedema (swelling of the face, lips, tongue, or throat — see Precautions and Warnings), acute renal failure, neutropenia/agranulocytosis (rare), hepatic dysfunction, and severe skin reactions such as Stevens-Johnson syndrome. Any signs of facial or throat swelling, or difficulty breathing or swallowing, while taking Lisinopril require immediate emergency medical attention.
Contraindications of Lisinopril
Lisinopril is contraindicated in:
- Patients with known hypersensitivity to Lisinopril or any other ACE inhibitor.
- Patients with a history of angioedema related to previous treatment with an ACE inhibitor.
- Patients with hereditary or idiopathic angioedema.
- Pregnancy — Lisinopril can cause fetal injury and death when used during pregnancy (see boxed warning under Pregnancy and Lactation).
- Concomitant use with aliskiren in patients with diabetes mellitus.
Frequently Asked Questions about Lisinopril
What is Lisinopril used for?
Lisinopril is mainly used to treat high blood pressure (hypertension), manage heart failure alongside other medicines, and improve survival after a heart attack. It may also be used off-label to help protect kidney function in certain patients with diabetes.
How should I take Lisinopril?
Lisinopril is usually taken once daily, by mouth, with or without food, at the same time each day. Do not stop or change your dose without talking to your doctor, even if you feel well, since blood pressure control needs consistent daily dosing.
Can I take Lisinopril during pregnancy?
No. Lisinopril carries a boxed warning because it can cause serious injury or death to an unborn baby, especially if used during the second or third trimester. If you become pregnant while taking Lisinopril, contact your doctor immediately so treatment can be reviewed. Women who may become pregnant should discuss safer alternatives with their doctor.
Why do I have a dry cough since starting Lisinopril?
A persistent, dry, tickling cough is a well-known side effect of Lisinopril and other ACE inhibitors, thought to be related to increased bradykinin levels. It is not dangerous but can be bothersome; if troublesome, talk to your doctor, who may consider switching you to a different class of medicine.
What should I do if my face or throat starts swelling while on Lisinopril?
Facial, lip, tongue, or throat swelling (angioedema) is a rare but potentially life-threatening reaction to Lisinopril. Stop taking Lisinopril immediately and seek emergency medical care right away if you notice any swelling, difficulty breathing, or difficulty swallowing.
What happens if I take too much Lisinopril?
An overdose of Lisinopril can cause a significant drop in blood pressure, dizziness, and weakness. If you or someone else has taken more than the prescribed amount of Lisinopril, seek immediate medical attention or contact a poison control center; do not try to treat an overdose at home.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.