Monograph Details
|
|
Cardiovascular System
> Hypertension
|
|
ZESTRIL |
| Manufacturer |
|
AstraZeneca Pharmaceuticals |
| Legal Classification |
|
Rx
|
| Pharmacological Class |
|
ACE inhibitor. |
| Generic Name |
|
Lisinopril 2.5mg, 5mg, 10mg, 20mg, 30mg, 40mg; tabs. |
| Indications |
|
Hypertension. |
| Children |
|
<6yrs or CrCl <30mL/min/1.73m2: not recommended. ≥6yrs: initially 0.07mg/kg (max 5mg) once daily; usual max 0.61mg/kg (40mg) once daily. |
| Adults |
|
Initially and if not on diuretics: 10mg once daily. Usual range: 20–40mg once daily. If on diuretic: suspend diuretic for 2–3 days before starting; resume diuretic if BP not controlled by lisinopril alone. If diuretic cannot be discontinued: initially 5mg daily (supervise 1st dose). CrCl 10–30mL/min: initially 5mg daily; CrCl <10mL/min: initially 2.5mg daily; max 40mg daily. |
| Contraindications |
|
History of ACEI-associated or other angioedema. Pregnancy (Cat.D in 2nd and 3rd trimesters). |
| Precautions |
|
Renal impairment. Dialysis (esp. high-flux membrane). Salt/volume depletion. Hypertrophic cardiomyopathy. CHF. Ischemic heart disease. Cerebrovascular disease. Renal artery stenosis. Surgery. Monitor electrolytes, renal and liver function. Monitor serum potassium in diabetics. Monitor WBC count in renal and collagen vascular disease. Discontinue if angioedema or laryngeal edema (have SC epinephrine available), jaundice or elevated liver enzymes occur. Elderly. Pregnancy (Cat.C in 1st trimester). Nursing mothers: not recommended. |
| Interactions |
|
May cause hypotension or increased BUN with diuretics, hyperkalemia with K+ sparing diuretics or K+ supplements. May increase lithium levels; monitor frequently. Antagonized by, and increased risk of renal failure with, NSAIDs. |
| Adverse Reactions |
|
Dizziness, headache, fatigue, diarrhea, upper respiratory symptoms, cough, nausea, orthostatic hypotension, hyperkalemia, renal impairment, angioedema; liver dysfunction, blood dyscrasias (rare). |
| How Supplied |
|
Tabs—100 |
| Additional Resources |
|
• Related Prescribing Note |
|
|
|
|
