Lisinopril: Difference between revisions
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==General== | ==General== | ||
*Type: [[ACE inhibitor]] | *Type: [[ACE inhibitor]] | ||
*Dosage Forms: 2. | *Dosage Forms: 2.5mg, 5mg, 10mg, 20mg, 30mg, 40mg | ||
*Common Trade Names: Prinivil, Zestril | *Common Trade Names: Prinivil, Zestril | ||
General information: | General information: | ||
* Doses > | *Doses > 40mg/day rarely more effective | ||
* Decreased efficacy as mono therapy in | *Decreased efficacy as mono therapy in Black patients | ||
* Obtain Chem 10 if starting in ED to assess renal function | *Obtain Chem 10 if starting in ED to assess renal function | ||
==Adult Dosing== | ==Adult Dosing== | ||
* | *Hypertension: 10 - 40mg PO Qday, max 80mg/day | ||
*Occasionally outpatient will prescribe BID dosing of lisinopril for potential continuous BP control (or [[losartan]]) | |||
**2020 large scale Kaiser study concluded no increased efficacy | |||
**There is potential for risk for AKI and hyperkalemia with lisinopril, but not losartan -- hypotension was not investigated<ref>Derington et al. Twice-daily versus once-daily lisinopril and losartan for hypertension: Real-world effectiveness and safety. PLoS One. 2020 Dec 3;15(12):e0243371. doi: 10.1371/journal.pone.0243371</ref> | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
* 6-16 year old: 0. | *6-16 year old: 0.07mg/kg PO qday, max 40mg/day | ||
==Special Populations== | ==Special Populations== | ||
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*Lactation: Safety unknown | *Lactation: Safety unknown | ||
*Renal Dosing | *Renal Dosing | ||
**Adult: CrCl < 30, start 2. | **Adult: CrCl < 30, start 2.5mg qday, max 40mg q/day | ||
**Pediatric | **Pediatric creatinine Cl 30-50: decrease dose 50%, CrCl < 30, avoid use | ||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult: Not defined | **Adult: Not defined | ||
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==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
* | *history of angioedema | ||
* pregnancy | *pregnancy | ||
* caution if renal artery stenosis | *caution if renal artery stenosis | ||
* caution if severe CHF | *caution if severe CHF | ||
* caution if renal impairment | *caution if renal impairment | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
* angioedema | *angioedema | ||
* hypotension | *hypotension | ||
* hyperkalemia | *hyperkalemia | ||
* renal impairment | *renal impairment | ||
* hepatotoxicity | *hepatotoxicity | ||
* neutropenia | *neutropenia | ||
*pancreatitis | *pancreatitis | ||
* steven johnson syndrome | *steven johnson syndrome | ||
* fetal/neonatal harm | *fetal/neonatal harm | ||
* congenital malformations | *congenital malformations | ||
===Common=== | ===Common=== | ||
* dizziness | *dizziness | ||
* elevated Cr | *elevated Cr | ||
* headache | *headache | ||
*diarrhea | *diarrhea | ||
* hypotension | *hypotension | ||
* abdominal pain | *abdominal pain | ||
* hyperkalemia | *hyperkalemia | ||
==Pharmacology== | ==Pharmacology== | ||
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==See Also== | ==See Also== | ||
*[[Hypertension]] | |||
*[[ACE inhibitor]] | |||
== | ==References== | ||
<references/> | |||
[[Category:Pharmacology]] | |||
[[Category: | [[Category:Cardiology]] | ||
Latest revision as of 16:59, 22 April 2025
General
- Type: ACE inhibitor
- Dosage Forms: 2.5mg, 5mg, 10mg, 20mg, 30mg, 40mg
- Common Trade Names: Prinivil, Zestril
General information:
- Doses > 40mg/day rarely more effective
- Decreased efficacy as mono therapy in Black patients
- Obtain Chem 10 if starting in ED to assess renal function
Adult Dosing
- Hypertension: 10 - 40mg PO Qday, max 80mg/day
- Occasionally outpatient will prescribe BID dosing of lisinopril for potential continuous BP control (or losartan)
- 2020 large scale Kaiser study concluded no increased efficacy
- There is potential for risk for AKI and hyperkalemia with lisinopril, but not losartan -- hypotension was not investigated[1]
Pediatric Dosing
- 6-16 year old: 0.07mg/kg PO qday, max 40mg/day
Special Populations
- Pregnancy Rating: D
- Lactation: Safety unknown
- Renal Dosing
- Adult: CrCl < 30, start 2.5mg qday, max 40mg q/day
- Pediatric creatinine Cl 30-50: decrease dose 50%, CrCl < 30, avoid use
- Hepatic Dosing
- Adult: Not defined
- Pediatric: Not defined
Contraindications
- Allergy to class/drug
- history of angioedema
- pregnancy
- caution if renal artery stenosis
- caution if severe CHF
- caution if renal impairment
Adverse Reactions
Serious
- angioedema
- hypotension
- hyperkalemia
- renal impairment
- hepatotoxicity
- neutropenia
- pancreatitis
- steven johnson syndrome
- fetal/neonatal harm
- congenital malformations
Common
- dizziness
- elevated Cr
- headache
- diarrhea
- hypotension
- abdominal pain
- hyperkalemia
Pharmacology
- Half-life: 12 hours
- Metabolism: none
- Excretion: urine
- Mechanism of Action: inhibits angiotensin converting enzyme, interferes with conversion of angiotensin 1 to angiotensin 2
See Also
References
- ↑ Derington et al. Twice-daily versus once-daily lisinopril and losartan for hypertension: Real-world effectiveness and safety. PLoS One. 2020 Dec 3;15(12):e0243371. doi: 10.1371/journal.pone.0243371