Lisinopril

Lisinopril is a medication of the angiotensin-converting enzyme (ACE) inhibitor class used to treat high blood pressure, heart failure, and after heart attacks. For high blood pressure it is usually a first line treatment, although in black people calcium-channel blockers or thiazide diuretics work better. It is also used to prevent kidney problems in people with diabetes. Lisinopril is taken by mouth. Full effect may take up to four weeks to occur. Common side effects include headache, dizziness, feeling tired, cough, nausea, and rash. Serious side effects may include low blood pressure, liver problems, high blood potassium, and angioedema. Use during pregnancy is not recommended as it may harm the baby. Lisinopril works by inhibiting the renin-angiotensin-aldosterone system. Lisinopril was patented in 1978 and approved for medical use in the United States in 1987. It is available as a generic medication. In the United States the wholesale cost per month was less than 0.70 USD as of 2018. In the United Kingdom it cost the NHS about 10 pounds per month as of 2018. In 2016, it was the 2nd most prescribed medication in the United States, with more than 110 million prescriptions. Lisinopril is typically used for the treatment of high blood pressure, congestive heart failure, acute myocardial infarction (heart attack), and diabetic nephropathy. A review concluded that lisinopril was effective for treatment of proteinuric kidney disease, including diabetic proteinuria. The dose must be adjusted in those with poor kidney function. Dose adjustments may be required when creatinine clearance is less than or equal to 30mL/min. Since lisinopril is removed by dialysis, dosing changes must also be considered for people on dialysis. Lisinopril has been assigned to pregnancy category D by the FDA. Animal and human data have revealed evidence of lethal harm to the embryo and teratogenicity associated with ACE inhibitors. No controlled data in human pregnancy are available. Birth defects have been associated with use of lisinopril in any trimester. However, there have been reports of death and increased toxicities to the fetus and newly born child with the use of lisinopril in the second and third trimesters. The label states, 'When pregnancy is detected, discontinue Zestril as soon as possible.' The manufacturer recommends mothers should not breastfeed while taking this medication because of the lack of safety data that currently exists. Treatment with lisinopril should be avoided for people who have a history of angioedema (hereditary or idiopathic) or who have diabetes and are taking aliskiren.