Lisinopril (Lisinopril)
Overview of Lisinopril
Lisinopril is an oral angiotensin-converting enzyme (ACE) inhibitor used in the treatment of hypertension and congestive heart failure (CHF). Chemically, Lisinopril is the lysine ester of enalaprilat, the active moiety of enalapril. ACE inhibitors prevent conversion of certain enzymes in the body and prevents constriction of blood vessels and lower the blood pressure and makes the heart beat stronger. Lisinopril is active without metabolism and its (S) epimer is used clinicaly. Lisinopril is a lysine derivative of enalaprilat. Lisinopril is administered orally. It has a slower onset and a longer duration of action than either captopril or enalapril and can be dosed once daily.it was originally approved by the FDA in December 1987 for use in the treatment of hypertension. In July 1993, it was also approved for use in the treatment of CHF. Finally, in November 1995, it was approved to improve survival in hemodynamically stable patients within 24 hours post-myocardial infarction.it competes with angiotensin I for its binding site on the angiotensin-converting enzyme (ACE). As a result, the drug blocks the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor and a negative feedback mediator for renin activity. Thus, when it lowers angiotensin II plasma levels, blood pressure decreases and plasma renin activity increases.
Indication of Lisinopril
Lisinopril is primarily indicated in conditions like Acute myocardial infarction, Congestive heart failure (adjunct), Diabetic nephropathy, Diabetic retinopathy, Gastric acid reduction during anaesthesia, Heart failure, Heart failure (adjunct), Hypertension, Iron deficiency anaemia, and can also be given in adjunctive therapy as an alternative drug of choice in Essential and renovascular hypertension.
Contraindication of Lisinopril
Lisinopril is contraindicated in conditions like Salt depletion,Renal artery stenosis,Hypotension,Angioneurotic edema,Renal impairment,Hypersensitivity.
Side Effects of Lisinopril
The severe or irreversible adverse effects of Lisinopril, which give rise to further complications include Angioedema, Angioedema, Airway obstruction.,Lisinopril produces potentially life-threatening effects which include Renal failure, Hypotension. which are responsible for the discontinuation of Lisinopril therapy.,The signs and symptoms that are produced after the acute overdosage of Lisinopril include Hypotension.,The symptomatic adverse reactions produced by Lisinopril are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Headache, Nausea, Vomiting, Alopecia, Diarrhea, Palpitation, Photosensitivity, Skin rash, Impotence, Cough, Asthenia, Alopecia, dizziness.
Precautions of Lisinopril
W.B.Cs counts and urinary protein estimation should be done before and after therapy. Lisinopril therapy can cause neutropenia or agranulocytosis. Patients with renal disease, patients with immunosuppression or receiving immunosuppressives, and patients with collagen vascular disease or autoimmune disease are at a greater risk for developing these complications. It should be used with caution in patients with pre-existing bone marrow depression. The dose should be adjusted in patients with renal impairment. It should be used cautiously in patients with congestive heart failure. Initial doses should be lower than in the treatment of hypertension because of a greater risk of developing hypotension. It should not be administered to patients with pre-existing renal artery stenosis. Renal function should be monitored closely during the first 2 weeks after initiating therapy. It should be discontinued if renal function worsens acutely. Other types of renal disease can actually improve during lisinopril therapy. The dose should be adjusted in patients with renal impairment. It should be used with caution in patients with hyperkalemia. It should be used during pregnancy only if clearly needed. Lisinopril is not for use in the children.