Description

Simple

A medication used to lower blood pressure, slow the progression of heart failure, and treat heart attacks.

Clinical

An ACE inhibitor used to treat hypertension, heart failure, and acute myocardial infarction.

Overview

Lisinopril is an angiotensin converting enzyme inhibitor (ACEI) used to treat hypertension, heart failure, and myocardial infarction.[8,9,10] Lisinopril and [captopril] are the only ACEIs that are not prodrugs.[7] It functions by inhibition of angiotensin converting enzyme as well as the renin angiotensin aldosterone system.[3,4,Read more

Pharmacology

Indication

Lisinopril is indicated for the treatment of acute myocardial infarction, hypertension in patients ≥6 years, and as an adjunct therapy for heart failure.[8, Read more

Pharmacodynamic

Lisinopril is an angiotensin converting enzyme inhibitor used to treat hypertension, heart failure, and myocardial infarction.[8, Read more

Mechanism of action

Angiotensin II constricts coronary blood vessels and is positively inotropic, which under normal circumstances, would increase vascular resistance and oxygen consumption.[ Read more

Absorption

Lisinopril is 6-60% orally bioavailable with an average of 25% bioavailability.[2, Read more

Protein binding

Lisinopril has not been demonstrated to bind to serum proteins.[8,9, Read more

Volume of distribution

The apparent volume of distribution of lisinopril is 124L.[ Read more

Clearance

A 30kg child has a typical clearance of 10L/h, which increases with renal function.[8, Read more

Half life

Lisinopril has an effective half life of accumulation of 12.6h[2, Read more

Route of elimination

Lisinopril is entirely eliminated exclusively in the urine.[8,9, Read more

Toxicity

The oral and subcutaneous LD50 in rats is >8500mg/kg and in mice is >9100mg/kg.[11] The oral LDLO in women is 1200µg/kg/16D and in men is 43mg/kg/43W.[ Read more

Adverse Effects

Contraindications

  • Recommended Actions:
    • Avoid
  • Regions: US
  • With Categories:
      • Name: Neprilysin, antagonists & inhibitors
      • Drugbank Id: DBCAT001007
  • Regions: US
  • Patient Conditions:
      • Name: Hereditary or idiopathic angioedema
      • Drugbank Id: DBCOND0107806
  • Regions: US
  • Patient Conditions:
      • Name: Angioedema
      • Drugbank Id: DBCOND0013604
  • Hypersensitivity:
    • Angiotensin-Converting Enzyme Inhibitors
  • Regions: US
  • Regions: US
  • Patient Conditions:
      • Name: Diabetes
      • Drugbank Id: DBCOND0022048
  • With Drugs Coadmin:
      • Name: Aliskiren
      • Drugbank Id: DB09026

Food Interactions

  • Herbs that may attenuate the antihypertensive effect of lisinopril include: bayberry, blue cohash, cayenne, ephedra, ginger, ginseng (American), kola and licorice.
  • High salt intake may attenuate the antihypertensive effect of lisinopril.
  • Lisinopril decreases the excretion of potassium. Salt substitutes containing potassium increase the risk of hyperkalemia.
  • Take without regard to meals.

Interactions

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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
1-(3-Mercapto-2-Methyl-Propionyl)-Pyrrolidine-2-Carboxylic Acid
1-(3-Mercapto-2-Methyl-Propionyl)-Pyrrolidine-2-Carboxylic Acid may decrease the antihypertensive activities of Lisinopril.
1-benzylimidazole
1-benzylimidazole may decrease the antihypertensive activities of Lisinopril.
2,5-Dimethoxy-4-ethylamphetamine
2,5-Dimethoxy-4-ethylamphetamine may decrease the antihypertensive activities of Lisinopril.
2,5-Dimethoxy-4-ethylthioamphetamine
2,5-Dimethoxy-4-ethylthioamphetamine may decrease the antihypertensive activities of Lisinopril.
4-Bromo-2,5-dimethoxyamphetamine
4-Bromo-2,5-dimethoxyamphetamine may decrease the antihypertensive activities of Lisinopril.
4-Methoxyamphetamine
4-Methoxyamphetamine may decrease the antihypertensive activities of Lisinopril.
5-methoxy-N,N-dimethyltryptamine
5-methoxy-N,N-dimethyltryptamine may decrease the antihypertensive activities of Lisinopril.
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline may increase the hypotensive activities of Lisinopril.
Abacavir
Lisinopril may decrease the excretion rate of Abacavir which could result in a higher serum level.
Abediterol
Abediterol may decrease the antihypertensive activities of Lisinopril.
Acarbose
Acarbose may decrease the excretion rate of Lisinopril which could result in a higher serum level.
Acebutolol
The risk or severity of hyperkalemia can be increased when Lisinopril is combined with Acebutolol.
Aceclofenac
The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Aceclofenac is combined with Lisinopril.
Acemetacin
The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Acemetacin is combined with Lisinopril.
Acepromazine
Acepromazine may decrease the antihypertensive activities of Lisinopril.
Acetaminophen
Acetaminophen may decrease the excretion rate of Lisinopril which could result in a higher serum level.
Acetazolamide
Acetazolamide may increase the excretion rate of Lisinopril which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acid
The therapeutic efficacy of Lisinopril can be decreased when used in combination with Acetylsalicylic acid.
Aclidinium
Lisinopril may decrease the excretion rate of Aclidinium which could result in a higher serum level.
Acrivastine
Lisinopril may decrease the excretion rate of Acrivastine which could result in a higher serum level.
11 References
  1. 1 . Thomson AH, Kelly JG, Whiting B: Lisinopril population pharmacokinetics in elderly and renal disease patients with hypertension. Br J Clin Pharmacol. 1989 Jan;27(1):57-65. doi: 10.1111/j.1365-2125.1989.tb05335.x.PubMed: 2539850
  2. 2 . Beermann B: Pharmacokinetics of lisinopril. Am J Med. 1988 Sep 23;85(3B):25-30. doi: 10.1016/0002-9343(88)90346-4.PubMed: 2844083
  3. 3 . Goa KL, Balfour JA, Zuanetti G: Lisinopril. A review of its pharmacology and clinical efficacy in the early management of acute myocardial infarction. Drugs. 1996 Oct;52(4):564-88. doi: 10.2165/00003495-199652040-00011.PubMed: 8891468
  4. 4 . Laurent S: Antihypertensive drugs. Pharmacol Res. 2017 Oct;124:116-125. doi: 10.1016/j.phrs.2017.07.026. Epub 2017 Aug 2.PubMed: 28780421
  5. 5 . Te Riet L, van Esch JH, Roks AJ, van den Meiracker AH, Danser AH: Hypertension: renin-angiotensin-aldosterone system alterations. Circ Res. 2015 Mar 13;116(6):960-75. doi: 10.1161/CIRCRESAHA.116.303587.PubMed: 25767283
  6. 6 . Wright JM, Musini VM, Gill R: First-line drugs for hypertension. Cochrane Database Syst Rev. 2018 Apr 18;4:CD001841. doi: 10.1002/14651858.CD001841.pub3.PubMed: 29667175
  7. 7 . Herman LL, Bashir K: Angiotensin Converting Enzyme Inhibitors (ACEI) .PubMed: 28613705
  8. 8 . FDA Approved Drug Products: Lisinopril Oral Tablet Link
  9. 9 . FDA Approved Drug Products: Lisinopril Oral Solution Link
  10. 10 . FDA Approved Drug Products: Lisinopril and Hydrochlorothiazide Oral Tablet Link
  11. 11 . Cayman Chemicals: Lisinopril MSDS Link