Lisinopril is a peptidyl dipeptidase inhibitor. Lisinopril inhibits the angiotensin converting enzyme (ACE) that catalyzes the convertion of the angiotensin I to the vasoconstrictor peptide, Angiotensin II. Angiotensin II also stimulates aldosterone secretion by the adrenal cortex. Inhibiton of ACE results in decreased concentrations of angiotensin II which results in decreased vasopressor activity and reduced aldosterone secretion. The latter decrease may result in an increase in serum potassium concentration.
Lisinopril Indications:
- Congestive heart failure as an adjunctive treatment with diuretics and when appropriate, digitalis
- Essential hypertension and renovascular hypertension. Lisinopril may be used alone or concomtantly with other classes of antihypertensive agents
- Acute myocardial infarction with hawmodynamically stable patients within 2-4 hours, to prevent the subsequent development left ventricular dysfunction or heart failure and the standard recommended treatment eg. aspirin, beta blocker and thrombolytics.
Dosage and Administrations:
- Lisinopril should be administered in a single daily dose.
- Essential Hypertension, Starting dose 10 mg, maintenance dose 20 mg. Dosage should be adjusted according to blood pressure respond.
- Renovascular Hypertension, A lower starting dose of 2.5 of 5 mg is recommended. Thereafter, the dosage may be adjusted according to the blood pressure response.
- Acute Myocardial Infarction, Lisinopril can be given within 24 hours of the onset of symptoms. The first dose is 5 mg given orally, followed by 5 mg after 24 hours, 10 mg after 48 hours and then 10 mg once daily thereafter.
