Lisinopril

Lisinopril – Full Introduction

Lisinopril is an oral antihypertensive medication belonging to the angiotensin-converting enzyme (ACE) inhibitor class. It is primarily used to lower blood pressure, manage heart failure, and protect kidney function in patients with diabetes or chronic kidney disease.

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Drug Class

• ACE inhibitor

• Antihypertensive

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Mechanism of Action

Lisinopril works by:

1. Inhibiting the angiotensin-converting enzyme (ACE) → reduces conversion of angiotensin I to angiotensin II

2. Decreasing angiotensin II levels → vasodilation and reduced blood pressure

3. Reducing aldosterone secretion → decreased sodium and water retention

4. Reducing afterload and preload → beneficial in heart failure

5. Renal protection → reduces intraglomerular pressure

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Therapeutic Uses

• Hypertension (high blood pressure)

• Heart failure (especially with reduced ejection fraction)

• Post-myocardial infarction (to improve survival)

• Diabetic nephropathy (renal protection)

• Proteinuria management

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Benefits

• Effective blood pressure control

• Improves heart failure outcomes

• Protects kidneys in diabetes and chronic kidney disease

• Once-daily dosing improves compliance

• Well tolerated in most patients

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Common Side Effects

• Cough (dry, persistent)

• Dizziness or lightheadedness

• Fatigue

• Headache

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Serious but Rare Side Effects

• Hyperkalemia (elevated potassium)

• Angioedema (swelling of face, lips, tongue – potentially life-threatening)

• Hypotension (especially after first dose)

• Renal impairment

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Contraindications & Precautions

• History of angioedema related to ACE inhibitors

• Pregnancy (contraindicated, especially in 2nd and 3rd trimester)

• Bilateral renal artery stenosis

• Severe renal impairment

• Caution in patients with hyperkalemia or dehydration

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Dosage & Administration

• Hypertension: 10–40 mg once daily

• Heart failure: Start with 2.5–5 mg once daily, titrate as needed

• Renal protection: Dose adjusted according to kidney function

• Can be taken with or without food

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Conclusion

Lisinopril is a first-line ACE inhibitor for hypertension, heart failure, and renal protection in diabetic patients. Its benefits in cardiovascular and renal outcomes make it a cornerstone therapy, but monitoring for cough, hyperkalemia, and renal function is essential.