* 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
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