Zestril Tablets

Lisinopril
20mg
AstraZeneca UK Limited
Pack size 28's Blister (Calendar Pack)
Dispensing mode POM
Source UK
AgentModern Pharmaceutical Co.
Retail Price 90.50 AED

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.

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