ACINOPRIL
LISINOPRIL · by NOVAMED
Composition
Tab5 mg/10 mg/20 mg/40 mg: Lisinopril 5 mg/10 mg/20 mg/40 mg.
Indications & Dosage
Hypertension: Adult: Initially 10 mg once daily; usual maintenance 20 mg once daily; max. 80 mg per day. Hypertension (in addition to diuretic) in cardiac decompensation or in volume depletion: Adult: Initially 2.5-5 mg once daily; usual maintenance 20 mg once daily; max. 80 mg per day. Short-term treatment following myocardial infarction in haemodynamically stable patients (systolic blood pressure over 120mmHg): Adult: Initially 5 mg, taken within 24 hours of myocardial infarction, followed by 5 mg and then 10 mg, to be taken at 24 hours intervals, then 10 mg once daily for 6 weeks (or continued if heart failure), temporarily reduce maintenance dose to 5mg and if necessary 2.5mg daily if systolic blood pressure 100mmHg or less during treatment; withdraw if prolonged hypotension occurs during treatment (systolic blood pressure less than 90mmHg for more than 1 hour). Short-term treatment following myocardial infarction in haemodynamically stable patients (systolic blood pressure 100-120mmHg): Adult: Initially 2.5 mg once daily, maintenance 5 mg once daily, increase to maintenance dose only after at least 3 days of the initial dose, should not be started after myocardial infarction if systolic blood pressure less than 100 mmHg. Renal complications of diabetes mellitus: Adult: Initially 2.5-5 mg once daily, adjusted according to response; usual dose 10-20 mg once daily. Heart failure (adjunct): Adult: Initially 2.5 mg once daily; increased in steps of up to 10 mg at least every 2 weeks; max. 35 mg per day.
Contraindications
Aortic stenosis, outflow obstruction, cor pulmonale. Angioneurotic oedema related to previous ACE-inhibitor therapy, renal dysfunction, Systolic BP <100 mmHg in acute MI
Precautions
Renovascular hypertension, severe congestive heart failure, low systolic BP in acute MI, haemodialysis, renal impairment; monitor renal function before and during treatment, anaesthesia.
Interactions
K+-sparing diuretics, K+ supplement, lithium, NSAIDs, antidiabetic agents, neuroleptics, tricyclic, antihypertensives.
Pregnancy
Contraindicated in pregnancy.
Lactation
Caution advised
Side Effects
Hypotension, renal failure, angioedema, rash, dizziness, headache GI upset, cough, fatigue, palpi-tations, asthenia, Raynauds syndrome, vertigo, asthenia, cerebrovascular accident, confusion, impotence, mood changes, myocardial infarction,palpitation, sleep disturbances, tachycardia. Rare: Alopecia, dry mouth, gynaecomastia, psoriasis