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Lisinopril

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Lisinopril, Prinivil, Zestril, Qbrelis

  • See Also
  1. ACE Inhibitor
  • Indications
  1. See ACE Inhibitor
  • Mechanism
  1. See ACE Inhibitor
  2. Synthetic Lysine derivative of Enalaprilat (active form of Enalapril)
  3. Angiotensin Converting Enzyme (ACE) inhibitor
    1. Long acting ACE Inhibitor that may be dosed daily
    2. Other ACE Inhibitors (other than Enalapril) often are best dosed more than once daily
  • Dosing
  • Adults
  1. Hypertension
    1. Start 10 mg orally daily
    2. Target 20 to 40 mg/day
    3. Maximum 40 mg/day
  2. Congestive Heart Failure (CHF)
    1. Start 2.5 to 5 mg orally daily
    2. Target 5 to 20 mg/day
    3. Maximum 40 mg/day
  3. Acute MI
    1. Start 5 mg orally daily for 2 days then increase to 10 mg orally daily
  4. Diabetic Nephropathy
    1. Take 10 to 20 mg orally daily
  5. Renal Dosing
    1. GFR 10-30
      1. Start 2.5 to 5 mg orally daily
    2. GFR <10 or on Hemodialysis
      1. Start 2.5 mg orally daily to start
  6. Maximum 80 mg/day (but no added benefit above 40 mg/day)
  • Dosing
  • Children (age >=6 years)
  1. Contraindicated under age 6 years or GFR <30 ml/min
  2. Hypertension
    1. Give 0.07 mg/kg up to 5 mg/day orally daily
  • Supplied
  1. Available as generic/Prinivil scored tablets (10, 20 and 40 mg)
  2. Available as generic/Zestril unscored tabs (2.5, 5, 10, 20, 30 and 40 mg)
  3. Available as oral solution 1 mg/ml (Qbrelis)
  • Metabolism
  1. Primarily renal excretion
  • Adverse Effects
  1. See ACE Inhibitor
  • Safety
  1. See ACE Inhibitor
  2. Pregnancy Category X
  3. Avoid in Lactation
  • Resources
  1. Lisinopril (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7d6c31e2-b5a4-4279-8013-a8dad37ea73b
  • References
  1. (2016) Presc Lett, Resource #321151, ACE Inhibitor Antihypertensive Dose Comparison
  2. (2020) Med Lett Drugs Ther 62(1598): 73-80
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 68-9
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia