Lisinopril (Prinivil)

• Type of Drug: Angiotensin-converting-enzyme (AGE) inhibitor.
• Prescribed for: High blood pressure and congestive heart failure.

Lisinopril (Prinivil) General Information

ACE inhibitors work by preventing the conversion of a hormone called angiotensin I to another hormone called angiotensin II, a potent blood-vessel constrictor. Preventing this conversion relaxes blood vessels and helps to reduce blood pressure and relieve the symptoms of heart failure by making it easier for a failing heart to pump blood around your body. The production of other hormones and enzymes that participate in the regulation of blood vessel dilation is also affected by the ACE inhibitors and probably plays a role in the effectiveness of these medicines. Lisinopril begins working about 1 hour after you take it and lasts for a full 24 hours.

Some people who start taking an ACE inhibitor after they are already on a diuretic experience a rapid drop in blood pressure after their first dose or when the dose is increased. To prevent this, you may be told to stop taking the diuretic 2 or 3 days before starting the ACE inhibitor or increase your salt intake during that time. The diuretic may then be restarted gradually. Heart failure patients generally have been taking both Digoxin and a diuretic before starting on an ACE Inhibitor.

Lisinopril (Prinivil) Cautions and Warnings

Do not take Lisinopril if you have had an allergic reaction to it in the past. Occasionally, severe allergic reactions have occurred in people undergoing desensitization treatments or certain kinds of kidney dialysis. Lisinopril causes very low blood pressure in rare instances and can affect your kidneys, especially if you have congestive heart failure. It is advisable for your doctor to check your urine for changes during the first few months of treatment.

People with kidney disease who are taking Lisinopril may require a lower dosage because they have more drug in their blood and are more likely to develop drug side effects.
ACE inhibitors can affect white-blood-cell count, possibly increasing your susceptibility to infection. Blood counts should be monitored periodically.

Possible Side Effects

• Most common: headache, dizziness, fatigue, nausea, diarrhea, and chronic cough. The cough is more common in women than men and usually goes away a few days after you stop taking the medicine.
• Less common: chest pain, low blood pressure, vomiting, upset stomach, breathing difficulty, rash, and muscle weakness.
• Rare: sweating, flushing, itching, rash, male impotence, reduced sex drive, muscle cramps, muscle and joint aches, arthritis, fainting, anemia, blurred vision, fever, blood vessel irritation, angina, heart attack, stroke, heart palpitations, dizziness when rising from a sitting or lying position, rapid heartbeat, abnormal heart rhythms, swelling in the arms or legs, sleep disturbances, sleepiness, confusion, depression, feelings of ill health, nervousness, tingling in the hands or feet, appetite loss, constipation, reduced urine flow, dry mouth, hepatitis, jaundice, urinary infection, pancreas inflammation, asthma, bronchitis, and sinus inflammation.

Lisinopril (Prinivil) Drug Interactions

• The blood-pressure-lowering effect of Lisinopril is additive with diuretic drugs and beta blockers. Any other drug that can reduce blood pressure should be used with caution if you are taking an ACE inhibitor.
• Lisinopril may increase your blood potassium levels, especially when taken with Dyazide or other potassium-sparing diuretics.
• Lisinopril may increase the effects of Lithium; this combination should be used with caution.
• Antacids may reduce the amount of Lisinopril absorbed into the blood. Separate doses of the two medicines by at least 2 hours.
• Capsaicin may cause or aggravate cough associated with Lisinopril.
• Indomethacin may reduce the blood-pressure-lowering effect of Lisinopril.
• Phenothiazine tranquilizers and antiemetics may increase the effects of Lisinopril.
• The combination of Allopurinol and Lisinopril increases the chance of a drug reaction.
• Lisinopril increases blood levels of Digoxin, possibly increasing the chance of Digoxin side effects.

Food Interactions

Lisinopril is unaffected by food in the stomach and may be taken without regard to food or meals.

Usual Dose

5 to 40 mg a day. People with severe kidney disease should begin with 2.5 mg per day and can be increased up to 5 to 20 mg per day.

Lisinopril (Prinivil) Overdosage

The principal effect of Lisinopril overdose is a rapid drop in blood pressure, as evidenced by dizziness or fainting. Take the overdose victim to a hospital emergency room immediately. ALWAYS bring the medicine bottle with you.

Special Information

Call your doctor if you develop swelling of the face or throat, if you have sudden difficulty breathing, or if you develop a sore throat, mouth sores, abnormal heartbeat, chest pain, a persistent rash, or loss of taste perception.

Unexplained swelling of the face, lips, hands, and feet can also affect, the larynx (throat) and tongue and interfere with breathing. If this happens, the victim should be taken to a hospital emergency room at once for treatment.

You may get dizzy if you rise to your feet quickly from a sitting or lying position.

Avoid strenuous exercise and/or very hot weather because heavy sweating or dehydration can cause a rapid drop in blood pressure.

Avoid nonprescription diet pills, decongestants, and stimulants that can raise blood pressure.

If you forget to take a dose of Lisinopril, take it as soon as you remember. If it is within 8 hours of your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.

Lisinopril (Prinivil) Special Populations

Pregnancy/Breast-feeding
ACE inhibitors have caused low blood pressure, kidney failure, slow formation of the skull, and death in developing fetuses when taken during the last 6 months of pregnancy. Women who are pregnant should not take Lisinopril. Women who may become pregnant while taking Lisinopril should use an effective contraceptive method and stop taking the medicine if they do become pregnant.
It is not known if Lisinopril passes into breast milk. However, nursing mothers who must take this drug should consider an alternative feeding method since infants, especially newborns, are more susceptible than adults to the effects of ACE inhibitors.

Seniors
Older adults may be more sensitive to the effects of Lisinopril than younger adults because of the possibility of normal age-related reductions in kidney function. Your Lisinopril dosage must be individualized to your needs.