Lisinopril 10mg pills №28

Latin name

Lisinopril

Dosage Form

Pills

Composition

1 pill contains lisinopril dihydrate (corresponds to lisinopril) 10 mg.

Packaging

28 pcs.

Mechanism of action

Lisinopril has a hypotensive, vasodilating, cardioprotective, natriuretic effect.

Indications

Arterial hypertension (mono- and combination therapy), incl. renovascular; chronic heart failure (as part of combination therapy for the treatment of patients taking digitalis and / or diuretics); acute myocardial infarction (in the first 24 hours with stable hemodynamic parameters to maintain these indicators, as well as to prevent dysfunction of the left heart chamber and heart failure); diabetic nephropathy (to reduce albuminuria in insulin-dependent patients with normal blood pressure and insulin-independent patients with arterial hypertension).

Contraindications

Hypersensitivity to lisinopril or other ACE inhibitors; angioedema in history, including and from the use of ACE inhibitors, hereditary angioedema, or idiopathic edema; pregnancy, breastfeeding, age up to 18 years (safety and efficacy have not been determined).

Use during pregnancy and lactation

The use of lisinopril during pregnancy is contraindicated. When establishing pregnancy, the drug should be stopped as soon as possible. Acceptance of ACE inhibitors in the II and III trimester of pregnancy has an adverse effect on the fetus (pronounced decrease in blood pressure, renal failure, hyperkalemia, hypoplasia of the skull, fetal death) are possible. Data on the negative effects of the drug on the fetus in the case of use during the first trimester is not. For newborns and infants who have been exposed to intrauterine effects of ACE inhibitors, it is recommended to conduct careful monitoring to timely detect a pronounced decrease in blood pressure, oliguria, hyperkalemia. Lisinopril penetrates through the placenta. No data on the penetration of lysinopril into breast milk. For the period of drug treatment, it is necessary to cancel breastfeeding.

Dosage and administration

Lisinopril is taken orally, regardless of the meal. In hypertension patients who do not receive other antihypertensive drugs, 5 mg 1 time per day. In the absence of effect, the dose of Lisinopril is increased by 5 mg to the average therapeutic dose - 20-40 mg / day every 2-3 days (increasing the dose over 40 mg / day usually does not lead to a further decrease in blood pressure). The usual daily maintenance dose is 20 mg, the maximum daily dose is 40 mg. The full effect usually develops within 2-4 weeks from the start of treatment, which should be considered when increasing the dose.With insufficient clinical effect, it is possible to combine Lisinopril with other antihypertensive drugs.

Side effects

The most common side effects are dizziness, headache (in 5-6% of patients), weakness, diarrhea, dry cough (3%), nausea, vomiting, orthostatic hypotension, skin rash, chest pain (1-3%).

Other side effects (frequency

Immune system:(0.1%) angioedema (face, lips, tongue, larynx or epiglottis, upper and lower extremities).

Cardiovascular:pronounced decrease in blood pressure, orthostatic hypotension, renal dysfunction, cardiac arrhythmias, rapid heartbeat.

with side of the central nervous system:fatigue, drowsiness, jerky muscles of the limbs and lips.

Hemic and lymphatic:possible leukopenia, neutropenia, agranulocytosis, thrombocytopenia, with long-term treatment - a slight decrease in the concentration of hemoglobin and hematocrit, erythrocytopenia.

Laboratory values:hyperkalemia, azotemia, hyperuricemia, hyperbilirubinemia, increased activity of “liver” enzymes, especially in the presence of a history of kidney disease, diabetes mellitus and renovascular hypertension.

Rare side effects (less than 1%):

Cardiovascular:heartbeat; tachycardia; myocardial infarction; cerebrovascular stroke in patients with an increased risk of disease, due to a pronounced decrease in blood pressure.

From the digestive tract:dry mouth, anorexia, dyspepsia, changes in taste, abdominal pain, pancreatitis, hepatocellular or cholestatic jaundice, hepatitis.

From the skin:urticaria, increased sweating, pruritus, alopecia.

Urogenital:renal failure, oliguria, anuria, acute renal failure, uremia, proteinuria.

Immune system:syndrome, which includes the acceleration of erythrocyte sedimentation rate (ESR), arthralgia and the appearance of antinuclear antibodies.

From the side of the central nervous system:asthenic syndrome, mood lability, confusion, decrease in potency.

Other:myalgia, fever, impaired fetal development.

Special notes

Most often, a pronounced decrease in blood pressure occurs when a decrease in the volume of fluid caused by diuretic therapy, a decrease in the amount of salt in food, dialysis, diarrhea or vomiting. In patients with chronic heart failure with simultaneous renal failure or without it, a pronounced decrease in blood pressure is possible. It is more often detected in patients with severe stage of chronic heart failure, as a result of the use of large doses of diuretics, hyponatremia or impaired renal function. In such patients, treatment with Lisinopril should begin under the strict supervision of a physician (with careful selection of the dose of the drug and diuretics). Similar rules should be followed when prescribing patients with coronary heart disease,cerebrovascular insufficiency, in which there is a sharp: decrease in blood pressure can lead to myocardial infarction or stroke. Transient hypotensive reaction is not a contraindication for taking the next dose of the drug. When Lisinopril is used in some patients with chronic heart failure, but with normal or lowered BP, there may be a decrease in BP, which is usually not a reason to stop treatment. Before starting treatment with Lisinopril, if possible, normalize the concentration of sodium and / or fill up the lost volume of fluid, carefully monitor the effect of the initial dose of Lisinopril on the patient. In case of stenosis of the renal artery (especially in bilateral stenosis, or in the presence of stenosis of the artery of a single kidney), as well as circulatory failure due to lack of sodium and / or fluid, the use of Lisinopril can lead to impaired renal function, acute renal failure, which is usually turns out to be irreversible after drug withdrawal. In acute myocardial infarction, the use of standard therapy (thrombolytics, Acetylsalicylic acid, beta-blockers) is indicated. Lisinopril may be used in conjunction with intravenous administration or with the use of therapeutic transdermal systems Nitroglycerin. With extensive surgical interventions, as well as the use of other drugs that cause a decrease in blood pressure, Lisinopril, blocking the formation of angiotensin II, can cause a pronounced unpredictable decrease in blood pressure.In elderly patients, the same dose leads to a higher concentration of the drug in the blood, so special care is required when determining the dose. Since the potential risk of agranulocytosis cannot be excluded, periodic monitoring of the blood picture is required. When using the drug in dialysis conditions with a polyacryl-nitrile membrane, anaphylactic shock may occur, therefore either a different type of dialysis membrane or the appointment of other antihypertensive agents is recommended.

Interaction

Lisinopril reduces the excretion of potassium from the body during treatment with diuretics. Special care is required when using the drug simultaneously with: potassium-sparing diuretics (spironolactone, triamterene, amiloride), potassium, potassium containing salt substitutes (the risk of hyperkalemia increases, especially if renal function is impaired), so they can only be co-administered on the basis of an individual solution attending physician with regular monitoring of serum potassium and kidney function. It can be carefully used with diuretics: with the additional administration of a diuretic to a patient taking Lisinopril, as a rule, an additive antihypertensive effect occurs - the risk of a pronounced decrease in blood pressure.

Overdose

Symptoms (occur when taking a single dose of 50 mg and above): a pronounced decrease in blood pressure; dry mouth, drowsiness, urinary retention, constipation, anxiety, irritability.
Treatment: symptomatic therapy, intravenous fluids, control of blood pressure, water and electrolyte balance and the normalization of the latter. Lisinopril can be removed from the body through hemodialysis.

Storage conditions

In the dark place at a temperature of no higher than 25 ° C.

Shelf life

3 years.