Lisinopril

Zestril | Prinivil | Qbrelis

FDA ApprovedCardiovascular AgentsACE Inhibitors
FDA: 1987Half-life: 12 hoursPregnancy: Category D

Overview

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension, heart failure, and improve survival after myocardial infarction.

Indications

  • Hypertension
  • Heart Failure
  • Acute Myocardial Infarction
  • Diabetic Nephropathy

Contraindications

  • Angioedema history with ACE inhibitors
  • Pregnancy
  • Bilateral renal artery stenosis

Mechanism of Action

Inhibits angiotensin-converting enzyme (ACE), preventing conversion of angiotensin I to angiotensin II, resulting in vasodilation and reduced aldosterone secretion.

Pharmacodynamics

Reduces blood pressure by decreasing peripheral vascular resistance. Cardioprotective effects include reduction in cardiac preload and afterload.

Pharmacokinetics

Absorption
Approximately 25% bioavailability. Not affected by food.
Distribution
Does not appear to bind to plasma proteins other than ACE.
Metabolism
Not metabolized.
Excretion
Excreted unchanged in urine.
Half-life
12 hours
Bioavailability
25%
Protein Binding
Minimal

Dosage

Typical dosage: 10-40 mg once daily

Available Forms

  • Tablet
  • Oral solution

Side Effects

Common

  • Dry cough
  • Dizziness
  • Headache
  • Fatigue

Serious

  • Angioedema
  • Hyperkalemia
  • Acute kidney injury

Rare

  • Agranulocytosis
  • Hepatotoxicity

Drug Interactions

Potassium supplementsmoderate

Increased risk of hyperkalemia.

NSAIDsmoderate

May reduce antihypertensive effect and increase renal impairment risk.

Warnings

⚠️BLACK BOX WARNING

Drugs that act on the renin-angiotensin system can cause fetal harm. Discontinue as soon as pregnancy is detected.

Pregnancy

Category D

Toxicity

Hypotension in overdose. Treat with IV fluids and supportive care.

Overdose

Symptoms include severe hypotension. Treatment includes IV fluids, vasopressors if needed.

References

Looking for patient-friendly information? Visit RemedyDoor for easy-to-read guides about this medication.