Lisinopril

How it works

     * Lisinopril inhibits an enzyme called angiotensin-converting enzyme
       (ACE). This enzyme is involved in the production of angiotensin II,
       a powerful vasoconstrictor (a substance that narrows the arteries),
       which also stimulates the release of the hormone, aldosterone, from
       the adrenal glands (aldosterone increases blood pressure). By
       inhibiting this enzyme, lisinopril dilates (opens up) the arteries,
       and reduces how hard the heart has to work to pump blood around the
       body which lowers blood pressure.
     * Lisinopril belongs to a group of medicines known as
       angiotensin-converting enzyme (ACE) inhibitors.

Upsides

     * May be used to treat high blood pressure in adults and in children
       over the age of six. Lowering blood pressure reduces the risk of
       fatal and nonfatal cardiovascular events (such as strokes and heart
       attacks).
     * Effective at reducing the signs and symptoms of heart failure.
     * May increase survival odds when given within 24 hours of a heart
       attack (myocardial infarction).
     * Generic lisinopril is available.

Downsides

   If you are between the ages of 18 and 60, take no other medication or
   have no other medical conditions, side effects you are more likely to
   experience include:
     * A headache and dizziness (the dizziness may be due to the blood
       pressure lowering effect of lisinopril and may be more apparent
       when going from a lying down to a sitting or standing position).
       Dizziness may also increase the risk of falls
     * A dry, persistent cough. Blurred vision, sweating, urine changes,
       and increases in creatinine and potassium may also occur
     * Rarely, lisinopril may adversely affect kidney function. Monitoring
       of kidney function and potassium levels should occur periodically
       in those receiving lisinopril.
     * Allergic reactions, including angioedema (swelling of airways and
       facial areas), are rare, but possible after lisinopril
       administration. The risk may be increased in people who have
       already experienced angioedema unrelated to ACE inhibitor
       administration, and in people of African-American descent
     * Dosages greater than 80mg may not be associated with a greater
       effect
     * The dosage of lisinopril may need adjusting in people with
       moderate-to-severe kidney disease
     * May interact with some other medications including other
       antihypertensives, medicines that also retain potassium, diuretics,
       NSAIDs, lithium, injectable sodium aurothiomalate and aliskiren.
     * Should not be given to pregnant women becasue it can cause harm to
       the fetus.

   Notes: In general, seniors or children, people with certain medical
   conditions (such as liver or kidney problems, heart disease, diabetes,
   seizures) or people who take other medications are more at risk of
   developing a wider range of side effects. For a complete list of all
   side effects, [84]click here.

Bottom Line

   Lisinopril can be used to treat high blood pressure, heart failure, and
   to increase survival following a heart attack. However, development of
   a dry, hacking cough attributable to the drug may force
   discontinuation.

Tips

     * Can be taken without regard to meals.
     * Treatments that lower blood pressure, such as lisinopril, should
       always be part of a comprehensive cardiovascular risk reduction
       plan that also targets, if appropriate, cholesterol lowering,
       diabetes risk reduction, exercise, weight loss, and smoking
       cessation.
     * Ensure adequate hydration before starting lisinopril.
     * Lisinopril may make you feel dizzy, especially in the first few
       weeks of therapy and when going from a sitting or lying down
       position to standing. Always take your time when standing up. Talk
       with your doctor if this feeling persists.
     * Call emergency services if your throat, face or lips show signs of
       swelling.
     * Your doctor should monitor your kidney function and potassium
       levels regularly.
     * For high blood pressure, continue this medication even if you feel
       well. High blood pressure does not usually have symptoms.
     * Do not use salt substitutes or potassium supplements while taking
       lisinopril, unless recommended by your doctor.
     * If you also have diabetes, you may need to monitor your blood sugar
       levels more closely during the first few weeks of lisinopril
       therapy.
     * Do not use lisinopril if you are pregnant or trying to become
       pregnant.

Response and Effectiveness

     * Starts to lower blood pressure within an hour of administration
       with peak effects seen within 6 hours.
     * Lower doses may be needed in kidney impairment.

References