Lisinopril

width = Lizinopril is an inhibitor of the angiotensin-converting enzyme. Possesses properties to lower arterial pressure, corrects functions of a myocardium, expands vessels and deduces from an organism of salt of sodium.

With prolonged admission in patients, there is a decrease in the hypertrophy of the walls of blood vessels and myocardium, and the circulatory system is being adjusted.

The drug improves the quality and life expectancy of patients with chronic heart disease, and also prevents the progression of ventricular dysfunction after myocardial infarction.

Clinical and pharmacological group

ACE inhibitor.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does lisinopril cost? The average price in pharmacies is at the level of30 rubles.

Form of issue and composition

Lizinopril is released in the form of tablets by; 5; 10 and 20 milligrams. In the blister is 15 tablets. 2 blisters are placed in the package together with instructions for use.

The main active substance of the drug is lisinopril, its content in 1 tablet is 5, 10 or 20 mg. Also the composition of the preparation includes auxiliary components, which include:

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Magnesium stearate.
Dye.
Chloride of methylene.
Corn starch.
Talc.
Povidone.
Lactose monohydrate.

The tablet is yellow with a risk only on one side.

Pharmacological effect

This drug belongs to the cardiovascular group, it is a white powder that it is very difficult to dissolve in methanol, does not dissolve in ethanol, but can be used for the preparation of aqueous solution.

Lizinopril acts "sightingly" - it widens the arteries, supports the work of the myocardium in patients with diagnosed and progressive chronic cardiac insufficiency, stabilizes the pressure in the arterial capillaries and normalizes the flow of blood into the myocardium after the transferred or existing ischemic disease heart.

Begins to "work" the drug in question within an hour after ingestion, the maximum concentration of the main active substance (a it is lisinopril) in the blood is determined on average after 5 hours (at the same time, the maximum effectiveness appears), and the drug is 24 hours.

Indications for use

What helps? Lizinopril is indicated when:

Arterial hypertension (persistent increase in blood pressure) as in combination with other antihypertensive drugs, and in the form of monotherapy;
Chronic heart failure (with concurrent administration of digitalis preparations and diuretics);
Acute myocardial infarction (in the post-infarction period, with a stable condition).

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Contraindications

Absolute:

Age to 18 years;
Pregnancy;
Lactation;
Hereditary idiopathic edema or angioedema of Quincke;
Angioedema in history, incl. as a result of the use of ACE inhibitors;
Lactose intolerance, glucose-galactose malabsorption, lactase deficiency;
Hypersensitivity to the components of the drug or other ACE inhibitors.

Relative (special care is required):

Elderly age;
Diabetes;
Hyperkalemia;
Hyponatremia;
Hypovolemic conditions (including diarrhea and vomiting);
Hypertrophic obstructive cardiomyopathy;
Stenosis of the aortic estuary;
Arterial hypotension;
Severe chronic heart failure;
Cardiac ischemia;
Cerebrovascular diseases (including cerebral circulatory insufficiency);
Oppression of bone marrow hematopoiesis;
Primary hyperaldosteronism;
Systemic diseases of connective tissue (including scleroderma and systemic lupus erythematosus);
Two-sided stenosis of the renal arteries or stenosis of the single kidney artery, severe renal failure (creatinine clearance less than 30 ml / minute), condition after kidney transplantation;
Hemodialysis, which involves the use of high-flow dialysis membranes (AN69).

Dosage and route of administration

In the instructions for use indicated: Lizinopril taken inside, 1 time / day, in the morning, regardless of food intake, preferably at the same time.

Arterial hypertension:

The initial dose is 10 mg / day, the maintenance dose is 20 mg / day. The maximum daily dose is 40 mg. To fully develop the effect may take 2-4 weeks, which should be taken into account when increasing the dose. If the use of the drug at the maximum dose does not produce a sufficient therapeutic effect, it is possible to prescribe another antihypertensive drug.
Patients who received pre-diuretics, they must be canceled 2-3 days before the start of the drug. If diuretics can not be canceled, the initial dose of lisinopril should not exceed 5 mg / day.
Renascapillary hypertension or other conditions with increased activity of renin-angiotensin-aldosterone system: the initial dose is 2.5-5 mg / day under the control of blood pressure, kidney function, serum potassium concentration blood. The maintenance dose is set depending on the amount of blood pressure.

In chronic renal failure (CRF)the dose is determined depending on the creatinine clearance:

At the clearance of creatinine 30-70 ml / min - 5-10 mg / day, with creatinine clearance - 10-30 ml / min - 2.5-5 mg / day, less than 10 ml / min, incl. patients on hemodialysis - 2.5 mg / day. The maintenance dose is determined depending on blood pressure (under the control of kidney function, the concentration of potassium and sodium in the blood).
Chronic heart failure (CHF) (concurrent with diuretics and / or cardiac glycosides): an initial dose of 2.5 mg / day (it is possible to use tablets of another manufacturer with doses of 2.5 mg), with a gradual increase of 2.5 mg in 3-5 days to 5-10 mg / day. The maximum daily dose is 20 mg. If possible, the dose of diuretic should be reduced before the start of lisinopril.

Early treatment of acute myocardial infarction (as part of combination therapy in the first 24 hours with stable indicators hemodynamics): in the first 24 hours - 5 mg, then - 5 mg after 1 day, 10 mg - after two days and then - 10 mg 1 time per day. The course of treatment - at least 6 weeks.

At the beginning of treatment or within the first 3 days after an acute myocardial infarction in patients with low systolic blood pressure (120 mm Hg. or lower), a smaller dose of 2.5 mg is prescribed. In the case of a decrease in blood pressure (systolic blood pressure is below or equal to 100 mm Hg), the daily dose of 5 mg, if necessary, is temporarily reduced to 2.5 mg. In the case of a long pronounced decrease in blood pressure (systolic AD is below 90 mm Hg. more than 1 hour) treatment with the drug is stopped.

Diabetic nephropathy: the initial dose is 10 mg / day, which, if necessary, is increased to 20 mg / day in order to achieve diastolic blood pressure values below 75 mm Hg. in the "sitting" position for patients with type 2 diabetes and below 90 mm Hg. in the "sitting" position in patients with type 1 diabetes mellitus

Side effects

After using lisinopril, there may be adverse reactions of the body to the drug. These include: a decrease in patients' blood pressure, arrhythmia, severe chest pain. In rare cases, hypotension occurs, tachycardia.

According to reviews, lisinopril can cause dizziness, headache, create increased fatigue, drowsiness. In some cases, there is a twitching of the muscles of the limbs, as well as lips, dyspepsia, lability of mood, confusion.

With the use of lisinopril, there may be a change in taste, pain in the abdomen, diarrhea, dry mouth, increased activity of "liver" transaminases, impaired fetal kidney development, fever, myalgia, arthralgia, swelling lips, and tongue.

According to the instructions, lisinopril can cause thrombocytopenia, neutropenia, agranulocytosis, skin rashes, itching.

Overdose

Symptoms: patients may experience tachycardia, excessive peripheral vasodilation, and a marked decrease in blood pressure.

Treatment of an overdose (elimination of symptoms):

if we take into account the slow absorption of amlodipine, the patient needs gastric lavage and intake of absorbent activated carbon,
conduct symptomatic therapy (for example, with a pronounced decrease in blood pressure intravenously enter dopamine or calcium), control diuresis and blood pressure, as well as control water-electrolyte balance,
in this case, hemodialysis will be ineffective, because the active substance is not removed by hemodialysis.

special instructions

Before you start using the drug, read the special instructions:

Special care is required in appointing patients with bilateral stenosis of the renal arteries or stenosis of the artery of a single kidney (possibly increasing the concentration urea and creatinine in the blood), patients with IHD or cerebrovascular disease, with decompensated CHF (possibly lowering blood pressure, myocardial infarction, stroke). In patients with CHF, a decrease in blood pressure can lead to impaired renal function.
Treatment with lisinopril with acute myocardial infarction is carried out against a background of standard therapy (thrombolytics, acetylsalicylic acid, beta-blockers). Compatible with intravenous administration of nitroglycerin or with a transdermal patch containing nitroglycerin.
The marked decrease in blood pressure on the background of treatment most often occurs with a decrease in BCC caused by diuretic therapy, restriction of consumption of table salt, dialysis, diarrhea or vomiting.
Patients with diabetes require careful monitoring of glycemia, especially during the first month of therapy with lisinopril. Before beginning treatment, it is necessary to compensate for the loss of fluid and salts.
When using drugs that reduce blood pressure in patients with extensive surgery or during Anesthesia Lysinopril can block the formation of angiotensin II, secondary to the compensatory secretion renin. Before surgery (including dental surgery), the surgeon / anesthesiologist should be informed of the use of an ACE inhibitor.
In patients taking lisinopril during desensitization to the hymenoptera, it is extremely rare, there may be life-threatening anaphylactoid reaction. It is necessary to temporarily stop the treatment with lisinopril before starting the course of desensitization.
Risk factors for the development of hyperkalemia include chronic renal failure, diabetes mellitus, and simultaneous the use of potassium-sparing diuretics (spironolactone, triamterene or amiloride), potassium or salt substitutes, containing potassium. Periodic monitoring of the potassium content in blood plasma is recommended.
With the development of angioedema, adequate emergency therapy (adrenaline administration, glucocorticoid drugs (GCS), antihistamines) is necessary.
Possible occurrence of anaphylactoid reactions with simultaneous hemodialysis using high-flow membranes (including AN 69). Consider using another type of membrane for dialysis or another antihypertensive drug.
It is possible to develop a dry cough when taking lisinopril.
Safety and efficacy of lisinopril in children is not established.
In elderly patients, the same dose leads to a higher concentration of the drug in the blood, therefore special caution is required when determining the dose.
During apheresis of low-density lipoproteins using dextran sulfate, concomitant therapy with lisinopril may lead to life-threatening anaphylactic reactions (eg, lowering blood pressure, shortness of breath, vomiting, skin allergies reaction). With the use of lisinopril, it is possible to develop an angioedema of the face, extremities, lips, tongue and nasopharynx. Edema can develop at any stage of therapy, which in such cases should be immediately stopped and monitor the patient's condition.

Care should be taken when driving vehicles and performing work that requires an increased concentration of attention and speed of psychomotor reactions.

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Drug Interactions

When using the drug, it is necessary to take into account the interaction with other drugs:

Lizinopril strengthens the action of ethanol.
Non-steroidal anti-inflammatory drugs, estrogens and acetylsalicylic acid reduce the antihypertensive effect of the drug.
The use of lisinopril in combination with insulin can provoke hypoglycemia.
In combination with preparations containing lithium, the excretion of the latter from the body is disturbed. With this combination, continuous monitoring of the concentration of lithium in the blood is required.
Strengthen antihypertensive effect of the drug beta-adrenoblockers, slow calcium channel blockers, diuretics and other antihypertensive drugs.
The complex reception with potassium-sparing diuretics and potassium preparations can provoke the development of hyperkalemia. This combination is used with extreme caution.
Complex application with allopurinol, procainamide, cytostatics can lead to leukopenia.

Reviews

We picked up some reviews of people taking the drug LISINOPRIL:

Catherine. On the appointment of a doctor for high blood pressure, I take Lysinopril for some time. The intake is convenient, once a day for 10 mg. The drug well normalized the pressure, stabilized and sustained it during the day. I do not have any side effects, the price is affordable. I fully trust the drug.
Olga. After three years of taking lisinopril, they began to vylize all the pills, crises often began to happen. The pressure does not hold constantly. Arthralgia, neuralgia, chest pain from neuralgia, anemia, increased soy, conjunctivitis, swelling, face hyperemia appeared. Our Russian drug was drunk, but I should probably drink a diroton. Maybe fewer side effects and it would be... go to the cardiologist to change to another.
Alexander. To normalize my pressure, the cardiologist prescribed me 5 mg lisinopril. I am relatively young, 36 years old, taking a large dose, the doctor said, there is no urgent need. I drank 1 "fagot" a day - in the morning. The main condition was to use tablets at the same time! The pills are cumulative, the pressure is not sharply reduced, but over time the result is obvious. After a month of use, the pressure became on average 130-140 / 90 after the previous 150-160 / 100. Their price is available to the average Russian, therefore - I recommend !!!

Analogues

Analogues of lisinopril are all medicines that have a similar composition, indications for the use of the drug, as well as contraindications and probable side effects.

These drugs include:

Equator - Hungarian means, whose value in Russia - from 400 to 450 rubles, in Ukraine - from 105 to 137 hryvnia,
Dapril - the production of Cyprus, the cost of the funds - in Russia - from 220 to 300 rubles, and in Ukraine - from 62 to 75 hryvnia,
Diroton is an analog of Lysinopril, the cost of medicine in Russia is from 160 to 410 rubles, in Ukraine - from 39 to 103 hryvnia,
Lizitar - the cost of such a drug in Russia from 50 to 146 rubles, and in Ukraine - from 11 to 25 hryvnia.

Before using analogues, consult your doctor.

Storage conditions and shelf life

The shelf life of Lizinopril tablets is 3 years from the date of their manufacture. The drug should be stored in a dry place inaccessible to children at an air temperature of no more than + 25ºC.