Lisinopril (Antihypertensive)

Question 1

What is the brand name(s) of Lisinopril?

Answer 1

Prinivil & Zestril

Question 2

What strength Prinivil tablets are available?

Answer 2

2.5mg, 5mg, 10mg, 20mg, 30mg, 40mg

Question 3

What strength oral solution Qbrelis is available?

Answer 3

1mg/mL

Question 4

What is the FDA approved indication for Lisinopril?

Answer 4

Treatment of hypertension

Dose: Initially give 10mg PO QD. Adjust dosage according to BP response, usually 20-40my/day administered in a single daily dose. If BP is not controlled with Prinivil alone, consider adding a mild diuretic such a thiazide. Reduce the dose of Prinivil if a diuretic is added.

Question 5

What id the FDA approved dose for Zestril when used in a patient with renal impairment?

Answer 5

If creatinine clearance <30mL/min, start with 5mg daily. For patients with creatinine clearance <10, start with 2.5mg daily

Question 6

What dose of Zestril is used in patients managing CHF?

Answer 6

Initially give 5mg QD with diuretics & digitalis. Usual effective dosage range is 5-20mg/day as a single dose

If the patient is hyponatremic, start dose at 2.5mg/day

Question 7

What dose of Prinivil is used for treating hemodynamically stable patients within 24 hours of acute myocardial infarction?

Answer 7

5mg PO followed by 5mg after 24 h, 10 mg after 48 h, and then 10mg QD for 6 weeks. In patients with a systolic BP <120mmHg, start with a 2.5mg dose

Question 8

What should the providers monitor when their patient is taking Lisinopril?

Answer 8

Blood Pressure, Potassium

Question 9

What is the mechanism of action for Zestril?

Answer 9

Zestril is an ACE inhibitor

Question 10

What are the drug interactions for Prinivil?

Answer 10

• The pharmacological effect is reduced when used with indomethacin
• Capsaicin may increase the indigence of coughing.
• A higher risk of hypersensitivity reaction occurs when use with allopurinol.
• Lisinopril decreases lithium elimination
• Use with potassium supplements may cause hyperkalemia.
• May potentate the action of oral anti diabetics and/or insulin

Question 11

What are the contraindications of Zestril?

Answer 11

• Contraindicated in patients with a history of angioedema related to a previous treatment with an angiotensin-converting enzyme inhibitor (ACE Inhibitor).
• Use with caution in impaired renal function
• Risk for potentially serious hyperkalemia is increased with use of potassium-sparing drugs, potassium supplements, diabetes mellitus, and impaired renal function.
• Hypoglycemia may occur when therapy is added to patients taking oral anti diabetics and/or insulin.
• Angioedema and/or severe hypotension may warrant DC of medication
• Rarely, ACE inhibitors have been associated with a syndrome that starts with cholestatic jaundice or hepatitis and progresses to fulminant hepatic necrosis and sometimes death
• Pregnancy Category D

Question 12

What are the adverse effects of Prinivil/Lisinopril/Zestril?

Answer 12

Dizziness, headache, fatigue, cough, diarrhea

Question 13

What should the RPh say when counseling on Lisinopril?

Answer 13

• May be taken w/o regard to meals
• Do not DC med unless otherwise directed to by MD
• Avoid OTC cough, cold, & allergy medications unless otherwise directed
• Avoid salt substitutes containing potassium
• If a dose is missed, take ASAP. If it is closer in time to the next dose than the missed dose, skip the missed dose. Do not double dose
• Contact a physician if the side effects become severe
• Contact a physician if signs of swelling occur