) is a drug of the angiotensin converting enzyme (ACE) inhibitor
class that is primarily used in treatment of hypertension
, congestive heart failure
, heart attacks
and also in preventing renal
complications of diabetes
. It has been compared with omapatrilat
which is of similar function.
Historically, lisinopril was the third ACE inhibitor, after captopril and enalapril, and was introduced into therapy in the early 1990s. Lisinopril has a number of properties that distinguish it from other ACE inhibitors: it is hydrophilic, has long half-life and tissue penetration and is not metabolized by the liver.
Lisinopril is the lysine
-analog of enalapril. Unlike other ACE inhibitors, lisinopril is not a prodrug
and is excreted unchanged in the urine. In cases of overdosage
, it can be removed from circulation by dialysis
Its indications, contraindications and side effects are as those for all ACE inhibitors
. Its long half-life allows for once a day dosing which aids patient compliance
. The usual daily dose in all indications ranges from 2.5 mg in sensitive patients to 40 mg. Some patients have been treated with 80 mg daily and have tolerated this high dose well. Lower dosages must be used in patients with higher grade renal impairment (glomerular filtration rate
(GFR) lower than 30 ml/min).
Rare, serious side effects
that would require immediate medical attention include:
Less severe side effects of moderate concern include:
- abdominal pain, bloating, vomiting
- chest pain or tightness, dizziness, lightheadedness, fainting (syncope)
- joint pain
The following side effects are common and likely to improve with time:
- diarrhea, loss of taste, nausea
- drowsiness, headache, tiredness
Lisinopril causes the kidneys to retain potassium, which may lead to hyperkalemia.
Lisinopril was developed by Merck & Co.
and is marketed worldwide as Prinivil
and by AstraZeneca
. In India it is marketed by Micro Labs
. In the United States, a generic version is available.
Like other ACE inhibitors, it is derived from the venom of the jararaca, a Brazilian pit viper (Bothrops jararaca
- Bussien JP, Waeber B, Nussberger J, Gomez HJ, Brunner HR. Once-daily lisinopril in hypertensive patients: Effect on blood pressure and the renin-angiotensin system. Curr Therap Res 1985;37:342-51.
- Lisinopril info - rx-list.com
- Goodman & Gilman's : The pharmacological basis of therapeutics, 10th. ed., 2001
- Lisinopril.com - Lisinopril information