Zestril Tablets
Lisinopril
20mg
AstraZeneca UK Limited
| Pack size | 28's Blister (Calendar Pack) |
|---|---|
| Dispensing mode | POM |
| Source | UK |
| Agent | Modern Pharmaceutical Co. |
| Retail Price | 90.50 AED |
Available as:
Indications
Zestril Tablets is used for:
Heart failure, Myocardial infarction, Diabetic nephropathy, Hypertension
Adult Dose
Oral
Hypertension
Adult: Initially, 10 mg/day, 1st dose given preferably at bedtime to avoid precipitous fall in BP. Patient w/ renovascular HTN, volume depletion, severe HTN: Initially, 2.5-5 mg once daily.
Patient on diuretic: Initially, 5 mg once daily. Maintenance: 20 mg once daily, up to 80 mg/day may be given if needed.
Heart failure
Adult: As adjunct: Initially, 2.5 or 5 mg/day, increased by increments of >10 mg at intervals of at least 2 wk to max maintenance dose of 40 mg/day.
Post myocardial infarction
Adult: Initially, 5 mg once daily for 2 days started w/in 24 hr of the onset of symptoms. Increase to 10 mg once daily.
Patients w/ low systolic BP: Initially, 2.5 mg once daily.
Diabetic nephropathy
Adult: Hypertensive type 2 diabetics w/ microalbuminuria: 10 mg once daily, may increase to 20 mg once daily to achieve a sitting diastolic BP <90 mmHg.
Child Dose
Oral
Hypertension
Child: >6 yr Initially, 0.07 mg/kg, up to 5 mg once daily.
Renal Dose
Hypertension
Renal impairment: Adult: CrCl <10 mL/min or on dialysis: Initially, 2.5 mg once daily. CrCl 10-30 mL/min: Initially, 2.5-5 mg once daily. CrCl 31-80 mL/min: Initially, 5-10 mg once daily. Dose can be adjusted up to max 40 mg once daily based on patient's response. Child: Do not give if GFR <30 mL/min/1.73 m2.
CrCl (ml/min)
<10 Initially, 2.5 mg once daily.
10-30 Initially 2.5-5 mg once daily.
31-80 Initially, 5-10 mg once daily.
Administration
May be taken with or without food.
Contra Indications
History of angioedema related to previous treatment with ACE inhibitors, hereditary or idiopathic angioedema. Bilateral renal artery stenosis. Pregnancy (2nd or 3rd trimester), lactation.
Precautions
Hypovolaemia, hyperkalaemia, collagen vascular disease, valvular stenosis; before, during or immediately after anaesthesia, preexisting renal insufficiency, unilateral renal artery stenosis. Children <6 yr. Assess renal function. May impair ability to drive or operate machinery.
Lactation: Not known if excreted into breast milk; not recommended
Pregnancy-Lactation
Pregnancy category: D
Discontinue as soon as pregnancy detected; during the second and third trimesters of pregnancy, drugs that act directly on the renin-angiotensin system have been associated with fetal injury, including hypotension, neonatal skull hypoplasia, anuria, reversible and irreversible renal failure, and death
Lactation: Not known if excreted into breast milk; not recommended
Interactions
May enhance hypotensive effect w/ diuretics. May increase risk of renal function deterioration and decrease antihypertensive effect w/ NSAIDs. May increase serum levels and toxicity of lithium. Increased risk of hyperkalaemia w/ K-sparing diuretics and K supplements. May increase nitritoid reactions of gold Na thiomalate.
Potentially Fatal: Increased risk of hypotension, hyperkalaemia and changes in renal function w/ aliskiren in patients w/ diabetes or renal impairment.
Adverse Effects
Side effects of Lisinopril :
>10%
Dizziness (5-12%)
1-10%
Cough (4-9%), Headache (4-6%), Hyperkalemia (2-5%), Diarrhea (3-4%), Hypotension (1-4%), Chest pain (3%), Fatigue (3%), Nausea/vomiting (2%), Kidney disease, of AMI patients (2%), Rash (1-2%)
<1%
Immune hypersensitivity reaction, Psoriasis, Angioedema of the face, lips, throat; intestinal angioedema, Anuria, Atrial tachycardia, Acute renal failure, Arthralgia, Alopecia, Atrial fibrillation, Bone marrow suppression, Cutaneous pseudolymphoma, Hypersomnia, Leukopenia, Mood changes, Pancreatitis, Skin infections
Potentially Fatal: Severe hypotension, angioedema.
Mechanism of Action
Lisinopril competitively inhibits ACE from converting angiotensin I to angiotensin II (a potent vasoconstrictor) resulting in increased plasma renin activity and reduced aldosterone (a hormone that causes water and Na retention) secretion. This promotes vasodilation and BP reduction.
Note
Zestril 20mg Tablets manufactured by AstraZeneca UK Limited. Its generic name is Lisinopril. Zestril is availble in United Arab Emirates.
Farmaco UAE drug index information on Zestril Tablets is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.