LISISTAD 10 Tablet

- Hypertension: Lisinopril is used alone or in combination with other classes of antihypertensive agents (e.g. thiazide diuretics) in the management of hypertension.

- Congestive heart failure: Lisinopril is also used in conjunction with cardiac glycosides and diuretics in the management of symptomatic congestive heart failure resistant to or inadequately controlled by cardiac glycosides and diuretics.

- Acute myocardial infarction: Lisinopril may be used in conjunction with thrombolytic agents, aspirin, and/or beta-adrenergic blocking agents to improve survival in patients with acute myocardial infarction who are haemodynamically stable.

- Diabetic nephropathy.

Dosage and administration

Orally

Adults

- Hypertension

In patients no receiving a diuretic: The usual initial dosage is 5-10mg once daily. Dosage of the drug should be adjusted according to the patient’s peak and trough blood pressure responses. The usual maintenance dosage in adults is 20-40mg daily, given as a single dose.

In patients already receiving a diuretic: It is recommended that diuretic therapy be discontinued, if possible, 2-3 days before initiating lisinopril. If diuretic therapy cannot be discontinued, sodium intake can be increased prior to initiating lisinopril to minimize the risk of hypotension and lisinopril should be initiated in adults at a dosage of 5mg daily under close medical supervision for at least 2 hours and until blood pressure has stabilized.

- Congestive heart failure: The usual initial dosage for the management of congestive heart failure in adults with normal renal function and serum sodium concentration is 2.5-5mg daily. The usual effective dosage in adults is 5-40mg daily, given as a single dose.

- Acute myocardial infarction: A 5mg dose should be given within 24 hours of onset of symptoms of myocardial infarction for 2 days. Thereafter, a maintenance dosage of 10mg daily should be used; lisinopril therapy should be continued for 6 weeks. An initial dose of 2.5mg once daily is recommended for patients with a low systolic blood pressure.

- Diabetic nephropathy: The initial dose is 2.5mg once daily. In normotensive type 1 diabetics the maintenance dose is 10mg daily, increased to 20mg daily if necessary to achieve a sitting diastolic blood pressure below 75mmHg.In hypertensive type 2 diabetics, the dose should be adjusted to achieve a sitting diastolic blood pressure below 90mmHg.

Children

- Children aged 6-12 years: A starting dose of 70mcg/kg (up to 5mg) once daily. This dose may be increased at intervals of 1-2 weeks to a maximum of 600mcg/kg or 40mg once daily.

- Children aged 12-18 years: An initial dose of 2.5mg daily increased as necessary to a maximum of 40mg daily.

See the package insert about the details below:

- Renal impairment

- Patients with a history of angioedema related to previous treatment with an angiotensin converting enzyme inhibitor.

- Patients with hereditary or idiopathic angioedema.

- Known hypersensitivity to lisinopril, other ACE inhibitors, or any ingredient in the formulation.

- Adverse effects reported in patients receiving lisinopril or lisinopril in fixed combination with hydrochlorothiazide for the management of hypertension include headache, dizziness, cough, fatigue, diarrhea, upper respiratory tract infection, nausea, asthenia, rash, orthostatic effects, hypotension, vomiting, hyperkalemia, or minor increases in BUN and serum creatinine concentrations.

- Additional adverse effects reported in patients receiving lisinopril in fixed combination with hydrochlorothiazide include dyspepsia, muscle cramps, paresthesia, decreased libido, vertigo, nasal congestion, influenza, or impotence.

- Adverse effects reported in patients receiving lisinopril for the management of heart failure include dizziness, hypotension, headache, diarrhoea, chest pain, nausea, abdominal pain, rash, and upper respiratory tract infection.

- In a large trial in patients with acute myocardial infarction, hypotension and renal dysfunction occurred more frequency in patients receiving lisinopril than in those not receiving the drug.

See the package insert about the details below:

- Diuretics

- NSAIDs

- Agents increasing serum potassium

- Lithium

- Other agents: nitrates and/or digoxin

See the package insert about the details below:

Pregnancy

Contraindicated

Lactation

A decision should be made whether to discontinue nursing or lisinopril, taking into account the importance of the drug to the woman.

See the package insert about the details below:

- Aortic stenosis/hypertrophic cardiomyopathy: Like other vasodilators, lisinopril should be administered with caution in patients with obstruction in the outflow tract of the left ventricle (e.g. aortic stenosis, hypertrophic cardiomyopathy).

- Renal effects

- Effects on potassium

- Hypoglycemia

- Cough

- Surgery/anesthesia

Lisinopril is an angiotensin converting enzyme (ACE) inhibitor. ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensinⅠto the vasoconstrictor substance, angiotensinⅡ. AngiotensinⅡalso stimulates aldosterone secretion by the adrenal cortex. The beneficial effects of lisinopril in hypertension and heart failure appear to result primarily from suppression of the renin-angiotensin-aldosterone system. Inhibition of ACE results in decreased plasma angiotensinⅡwhich leads to decreased vasopressor activity and to decreased aldosterone secretion.