Products
Lisinopril is commercially available in tablet form as a monopreparation (Zestril, generic) and as a fixed combination with hydrochlorothiazide (Zestoretic, generic). It has been approved in many countries since 1989.
Structure and properties
Lisinopril (C21H31N3O5, Mr = 405.49 g/mol) is present in drugs as lisinopril dihydrate, a white crystalline powder that is soluble in water. It is not a prodrug and is a peptidomimetic and has approximately the structure of the tripeptide phenylalanine-lysine-proline.
Effects
Lisinopril (ATC C09AA03) has antihypertensive properties and unloads the heart (preload and afterload). The effects are due to inhibition of the formation of angiotensin II from angiotensin I by inhibition of angiotensin converting enzyme (ACE). Lisinopril thus abolishes the effects of antiogensin II.
Indications
- Hypertension
- Congestive heart failure
- Acute myocardial infarction
- Diabetes mellitus with microalbuminuria
Dosage
According to the SmPC. Lisinopril is administered once daily and independently of meals. It should always be taken at the same time of day.
Contraindications
- Hypersensitivity
- Previous angioedema while taking ACE inhibitors or sartans.
- Pregnancy
- Concurrent use of aliskiren in patients with diabetes mellitus or impaired renal function.
For complete precautions, see the drug label.
Adverse effects
Possible adverse effects include diarrhea, vomiting, irritable cough, renal impairment, dizziness, headache, orthostatic discomfort, low blood pressure, and arrhythmias. Lisinopril may occasionally cause hyperkalemia because it retains potassium in the body.
