Lisinopril

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Acemin, Acetan, Lisihexal, Lisinopril, Lisinostad; Belgium: Lisinopril, Zestril; Bulgaria: Diroton, Linipril, Lisigamma, Lisinopril, Lizopril, Skopryl, Vitopril; Cyprus: Albigone, Dapril, Enlisin, Zestril; Czech Republic: Dapril, Diroton, Lipribela, Lisigamma, Lisinopril, Lisipril, Prinivil; Denmark: Lisinopril, Zestril; Estonia: Diroton, Lisigamma, Lisinopril; Finland: Cardiostad, Lisinopril, Lisipril; France: Lisinopril, Prinivil, Zestril; Germany: Acerbon, Coric, Lino, Lisanuc, Lisauro, Lisi Lich, Lisi-Hennig, Lisi-Puren, Lisibeta, Lisichemia, Lisidigal, Lisidoc, Lisigamma, Lisihexal, Lisinopril, Lisip, Lisnopril, Lisodura, Lisopress, Lysimed, Zestril; Greece: Adicanil, Axelvin, Icoran, Leruze, Lisinopril, Lisinospes, Lisodinol, Mealis, Nafordyl, Perenal, Pressamea, Pressuril, Prinivil, Thriusedon, Tivirlon, Vercol, Veroxil, Z-bec, Zestril; Hungary: Linipril, Lisinopril, Lisopress, Press; Ireland: Bellisin, Byzestra, Lestace, Lisopress, Lispril, Zesger, Zestan, Zestril; Italy: Prinivil; Latvia: Dapril, Diroton, Lisigamma, Lisinopril, Tensikey; Lithuania: Dapril, Diroton, Lisinopril; Luxembourg: Novatec, Zestril; Malta: Dapril, Lisinopril, Lisopress, Lisopril, Zestril; Netherlands: Lisinopril, Zestril; Poland: Diroton, Ikapril, Lisihexal, Lisinopril, Lisinoratio, Lisiprol, Novatec, Prinivil, Ranopril; Portugal: Ecapril, Lipril, Lisinopril, Prinivil, Zestril; Romania: Lisigamma, Lisinopril, Lisiren, Medapril, Ranolip, Sinopryl, Tonolysin; Slovakia: Dapril, Diroton, Irumed, Lisinopril; Slovenia: Irumed, Lizinopril, Skopryl; Spain: Belprel, Doneka, Iricil, Kollopal, Likenil, Lisinocic, Lisinopril, Prinivil, Secubar, Tensikey, Zestril; Sweden: Lisinopril, Zestril; UK: Carace, Lisinopril, Zestril.

North America

Canada: Lisinopril, Prinivil, Zestril; USA: Lisinopril, Prinivil, Zestril.

Latin America

Argentina: Doxapril, Lisinal, Sedotensil, Tensopril, Tersif MD, Zestril; Brazil: Lisinopril, Lisopril, Listril, Lonipril, Prilcor, Prinivil, Prinopril, Vasojet, Zestril, Zinopril; Mexico: Alfaken, Dosteril, Fersivag, Linospril, Lisinopril, Noril, Priniser, Prinivil, Zestril.

Asia

Japan: Asrarn, Lisinomerck, Lisinopril, Lisitril, Lokopool, Longeril, Longes, Railtock, Zestril.

Drug combinations

Lisinopril and Amlodipine

Lisinopril and Hydrochlorothiazide

Chemistry

Lisinopril: C~21~H~31~N~3~O~5~ 2H~2~O. Mw: 441.52. (1) L-Proline, 1-[N^2^-(1-carboxy-3-phenylpropyl)-L-lysyl]-, dihydrate, (S)-; (2) 1-[N^2^-[(S)-1-Carboxy-3-phenylpropyl]-L-lysyl]-L-proline dihydrate. CAS-83915-83-7; CAS-76547-98-3 (anhydrous)(1984).

Pharmacologic Category

Angiotensin-Converting Enzyme Inhibitors. (ATC-Code: C09AA03).

Mechanism of action

Competitive inhibitor of angiotensin-converting enzyme (ACE). Prevents conversion of angiotensin I to angiotensin II, a potent vasoconstrictor.

Therapeutic use

Treatment of hypertension, either alone or in combination with other antihypertensive agents. Adjunctive therapy in treatment of heart failure. Treatment of acute MI within 24 hours in hemodynamically-stable patients to improve survival.

Pregnancy and lactiation implications

Lisinopril crosses placenta. 1^st^ trimester exposure to ACEIs may cause major congenital malformations. 2^nd^ and 3^rd^ trimester use of an ACEI associated with oligohydramnios. ACEIs not recommended during pregnancy to treat maternal hypertension or heart failure. Use not recommended while breast-feeding.

Unlabeled use

Contraindications

Hypersensitivity to lisinopril or any component of the formulation. Angioedema related to previous treatment with ACEI. Idiopathic or hereditary angioedema.

Warnings and precautions

Angioedema might occur rarely with ACEIs; may involve head and neck (potentially compromising airway) or intestine (presenting with abdominal pain). African-Americans may be at increased risk. Use in idiopathic or hereditary angioedema or previous angioedema associated with ACEI therapy contraindicated. A rare toxicity associated with ACEIs includes cholestatic jaundice, which may progress to fulminant hepatic necrosis. Might produce a dry, hacking, nonproductive cough. Hyperkalemia might occur (risk factors include renal dysfunction, diabetes mellitus, concomitant use of potassium-sparing diuretics, potassium supplements and/or potassium containing salts). Anaphylactic/anaphylactoid reactions can occur with ACEIs. Symptomatic hypotension with or without syncope can occur with ACEIs. Patients with renal impairment at high risk of developing neutropenia. Patients with both renal impairment and collagen vascular disease (e.g. systemic lupus erythematosus) at even higher risk of developing neutropenia. Possible deterioration of renal function and/or increases in serum creatinine. Use with caution in severe aortic stenosis (might reduce coronary perfusion resulting in ischemia). Initiation of therapy in ischemic heart disease or cerebrovascular disease warrants close observation due to potential consequences posed by falling blood pressure (e.g. MI, stroke). Fluid replacement, if needed, may restore blood pressure. Discontinue therapy in patients whose hypotension recurs. Use with caution in collagen vascular disease, especially with concomitant renal impairment (might be at increased risk for hematologic toxicity). Use with caution in hypertrophic cardiomyopathy and outflow tract obstruction (reduction in afterload may worsen symptoms). Use with caution in unstented unilateral/bilateral renal artery stenosis, or in pre-existing renal insufficiency. ACEIs can cause injury and death to developing fetus when used in 2^nd^ and 3^rd^ trimesters. Use of ACEIs perioperatively will blunt angiotensin II formation and may result in hypotension.

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