Lisinopril


Description

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

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Pharmacology

Indication

Lisinopril is indicated for the treatment of acute myocardial infarction, hypertension in patients ≥... Read more

Pharmacodynamic

Lisinopril is an angiotensin converting enzyme inhibitor used to treat hypertension, heart failure,... Read more

Mechanism of action

Angiotensin II constricts coronary blood vessels and is positively inotropic, which under normal cir... Read more

Absorption

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

Protein binding

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

Half life

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

Route of elimination

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

Toxicity

The oral and subcutaneous LD50 in rats is >8500mg/kg and in mice is >9100mg/kg.[ Read more


Adverse Effects

Effect Regions Age Groups Incidences Evidence Type
Dizziness US
  • Kind: experimental
    • Percent: 12-19%
  • Clinical Trial
    Hypotension US
  • Kind: experimental
    • Percent: 7-11%
  • Clinical Trial
    Creatinine increased US
  • Kind: experimental
    • Percent: 7-10%
  • Clinical Trial
    Dizziness US
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Syncope US
  • Kind: experimental
    • Percent: 5-7%
  • Clinical Trial
    Hyperkalemia US
  • Kind: experimental
    • Percent: 4-6%
  • Clinical Trial
    Hypotension US
  • Kind: experimental
    • Percent: 5%
  • Clinical Trial
    Headache US
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Dizziness US
  • Kind: experimental
    • Percent: 4%
  • Clinical Trial
    Headache US
  • Kind: experimental
    • Percent: 4%
  • Clinical Trial
    Fatigue US
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Cough US
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Cough US
  • Kind: experimental
    • Percent: 3%
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Orthostatic effects US
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Asthenia US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Paresthesia US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Muscle Cramps US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Upper Respiratory Infection US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 2%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Pancreatitis US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Constipation US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Orthostatic effects US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Pancreatitis US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Flatulence US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Dry Mouth US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Constipation US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Flatulence US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Renal Dysfunction US
  • Kind: experimental
    • Percent: 1%
  • Clinical Trial
    Fatigue US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Asthenia US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Orthostatic effects US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Fatigue US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Asthenia US
  • Kind: experimental
    • Percent: ≥1%
  • Clinical Trial
    Cutaneous pseudolymphoma US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Diaphoresis US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Skin Inflammation US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Pruritus US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Flushing US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Angioedema of the face US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Urinary Tract Infection US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Otalgia US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Tinnitus US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Blurred vision US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Angioedema of larynx US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Angioedema of glottis US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Angioedema of tongue US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Angioedema of extremities US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Angioedema of lips US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial
    Pulmonary Congestion US
  • Kind: experimental
    • Percent: 0.3-1%
  • Clinical Trial

    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

    Type in a drug name to check for interaction with Lisinopril

    1-(3-Mercapto-2-Methyl-Propionyl)-Pyrrolidine-2-Carboxylic Acid may decrease the antihypertensive activities of Lisinopril.
    1-benzylimidazole may decrease the antihypertensive activities of Lisinopril.
    2,5-Dimethoxy-4-ethylamphetamine may decrease the antihypertensive activities of Lisinopril.
    2,5-Dimethoxy-4-ethylthioamphetamine may decrease the antihypertensive activities of Lisinopril.
    4-Bromo-2,5-dimethoxyamphetamine may decrease the antihypertensive activities of Lisinopril.
    4-Methoxyamphetamine may decrease the antihypertensive activities of Lisinopril.
    5-methoxy-N,N-dimethyltryptamine may decrease the antihypertensive activities of Lisinopril.
    7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline may increase the hypotensive activities of Lisinopril.
    Lisinopril may decrease the excretion rate of Abacavir which could result in a higher serum level.
    Abediterol may decrease the antihypertensive activities of Lisinopril.
    Acarbose may decrease the excretion rate of Lisinopril which could result in a higher serum level.
    The risk or severity of hyperkalemia can be increased when Lisinopril is combined with Acebutolol.
    The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Aceclofenac is combined with Lisinopril.
    The risk or severity of renal failure, hyperkalemia, and hypertension can be increased when Acemetacin is combined with Lisinopril.
    Acepromazine may decrease the antihypertensive activities of Lisinopril.
    Acetaminophen may decrease the excretion rate of Lisinopril which could result in a higher serum level.
    Acetazolamide may increase the excretion rate of Lisinopril which could result in a lower serum level and potentially a reduction in efficacy.
    The therapeutic efficacy of Lisinopril can be decreased when used in combination with Acetylsalicylic acid.
    Lisinopril may decrease the excretion rate of Aclidinium which could result in a higher serum level.
    Lisinopril may decrease the excretion rate of Acrivastine which could result in a higher serum level.

    References

    • 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 . 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 . 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 . 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 . 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 . 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 . Herman LL, Bashir K: Angiotensin Converting Enzyme Inhibitors (ACEI) . [PubMed: 28613705]
    • 8 . FDA Approved Drug Products: Lisinopril Oral Tablet [Link]
    • 9 . FDA Approved Drug Products: Lisinopril Oral Solution [Link]
    • 10 . FDA Approved Drug Products: Lisinopril and Hydrochlorothiazide Oral Tablet [Link]
    • 11 . Cayman Chemicals: Lisinopril MSDS [Link]

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