Lisinopril
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Lisinopril
Zestril, Prinivil, Qbrelis
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Summary
Classes
Common uses
Hypertension0, Heart failure0, Post-myocardial infarction0, Diabetic nephropathy0
Pharmacy
Starting dose
5-10 mg PO once daily (2.5 mg in heart failure, hyponatremia, or volume depletion)
Preparations
2.5, 5, 10, 20, 30, 40 mg tablets; 1 mg/mL oral solution
US FDA Max
80 mg/d
Pharmacology
Routes
Oral
Onset
BP lowering within 1 hour; max effect at 6 hours
Duration
24 hours
Half-life
~12 hours (effective); terminal half-life is biphasic[1]
Bioavailability
~25% (oral; food does not affect absorption)[1]
Pregnancy
Contraindicated in pregnancy (all trimesters); fetal renal injury, oligohydramnios, skull hypoplasia, hypotension. Stop on detection[1]
Legal status
Rx-only in US
Purported mechanism
Lisinopril is a long-acting ACE inhibitor that blocks conversion of angiotensin I to angiotensin II, reducing vasoconstriction, aldosterone secretion, and renal sodium retention.0 Also raises bradykinin, contributing to vasodilation and the characteristic dry cough. Renally cleared, unmetabolized; dose-adjust by eGFR[1].
References
- ↑ 1.0 1.1 1.2 1.3 FDA Prescribing Information, Zestril (lisinopril), AstraZeneca, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019777s056lbl.pdf