Medication Identification

Lisinopril is an oral medication classified as an angiotensin-converting enzyme (ACE) inhibitor. This drug belongs to the cardiovascular therapeutic class, primarily prescribed to treat hypertension and heart failure. Its chemical structure includes a lysine derivative, contributing to its antihypertensive properties. It is typically available in tablet form.

Mechanism of Action

Lisinopril functions by inhibiting the angiotensin-converting enzyme, which reduces the synthesis of angiotensin II, a potent vasoconstrictor. This action facilitates blood vessel relaxation, leading to lower blood pressure. Moreover, it decreases the secretion of aldosterone, resulting in sodium and water excretion, which aids in reducing blood volume.

Prescribed Indications

The primary indications for Lisinopril include management of hypertension to decrease the risk of cardiovascular events. It is also prescribed for heart failure as it improves survival rates and reduces hospitalizations. Additionally, Lisinopril is utilized post-myocardial infarction to enhance heart function and delay the progression of left ventricular dysfunction.

Dosage and Administration

Lisinopril is administered orally, usually once daily, with or without food. The initial dose for hypertension is often 10 mg daily, adjustable according to patient response. In heart failure, the starting dose is typically 2.5 mg daily, gradually increased under medical supervision. Post-myocardial infarction dosing begins at 5 mg, tailored to individual needs for optimal outcomes.

Pharmacokinetics Profile

Lisinopril exhibits a bioavailability of roughly 25%. Absorption is not significantly affected by food intake. The medication reaches peak plasma concentrations within 6-8 hours post-administration. It is not metabolized by the liver, and the drug is excreted unchanged primarily through the kidneys, with an elimination half-life of approximately 12 hours.

Potential Drug Interactions

Concomitant use with diuretics can enhance the antihypertensive effects of Lisinopril. Nonsteroidal anti-inflammatory drugs may reduce its efficacy. Potassium supplements or potassium-sparing diuretics can lead to hyperkalemia, necessitating careful monitoring. Co-administration with lithium could increase serum lithium levels, indicating the need for dose adjustment.

Common Side Effects

Patients may experience dizziness, headache, fatigue, or cough while taking Lisinopril. These symptoms generally subside as the body adjusts to the medication. Gastrointestinal disturbances such as nausea or diarrhea can also occur. Tachycardia is rare but possible during therapy with this medication.

Severe Adverse Reactions

Angioedema, a potentially life-threatening condition, is an uncommon but serious side effect. Patients may exhibit facial swelling or difficulty breathing. Hyperkalemia, characterized by elevated potassium levels in the blood, can also arise, requiring immediate medical intervention. Severe renal impairment has been reported in those with pre-existing kidney issues.

Monitoring and Laboratory Tests

Patients on Lisinopril require periodic monitoring of blood pressure to ensure effective management of hypertension. Renal function tests, including serum creatinine and blood urea nitrogen levels, are crucial to detect any drug-induced nephropathy. Electrolyte levels, especially potassium, should be checked regularly to prevent hyperkalemia.

Considerations for Special Populations

Elderly patients may exhibit increased sensitivity to the blood pressure-lowering effects. In individuals with renal impairment, dose adjustments are necessary to avoid drug accumulation and toxicity. Providing extra caution while prescribing to those with a history of angioedema related to ACE inhibitors is crucial.

Pregnancy and Lactation

Lisinopril is contraindicated during pregnancy, particularly in the second and third trimesters, due to risks of fetal toxicity. In breastfeeding mothers, caution is advised, as minimal amounts may be excreted in breast milk, although the effects on infants remain unclear. Discuss potential risks and benefits with healthcare providers.

Patient Counselling Information

Educate patients on the importance of adherence to prescribed dosages to achieve desired therapeutic effects. Advise reporting any unusual symptoms, such as persistent cough or swelling, immediately. Recommend lifestyle modifications alongside drug therapy, such as a low-sodium diet and regular exercise, to enhance treatment outcomes.

Storage and Handling Instructions

Store Lisinopril tablets at room temperature, away from excessive moisture and heat. Keep securely closed in their original packaging to maintain stability. Ensure the medication is out of reach of children and pets. Dispose of expired or unused tablets following local regulations or pharmacy guidelines.