Lisinopril

General

  • Type: ACE inhibitor
  • Dosage Forms: 2.5, 5, 10, 20, 30, 40
  • 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

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