Lisinopril
General
- Type: ACE inhibitor
- Dosage Forms: 2.5mg, 5mg, 10mg, 20mg, 30mg, 40mg
- 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
- Occasionally outpatient will prescribe BID dosing of lisinopril for potential continuous BP control (or losartan)
- 2020 large scale Kaiser study concluded no increased efficacy
- There is potential for risk for AKI and hyperkalemia with lisinopril, but not losartan -- hypotension was not investigated[1]
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
- ↑ Derington et al. Twice-daily versus once-daily lisinopril and losartan for hypertension: Real-world effectiveness and safety. PLoS One. 2020 Dec 3;15(12):e0243371. doi: 10.1371/journal.pone.0243371