Lisinopril
(Prinivil, Zestril)
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Category:
Description:
Indications:
Precautions:
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Pregnancy
category C (1st trimester), D (2nd and 3rd
trimester); ACE inhibitors can cause fetal and neonatal morbidity and
death when administered to pregnant women
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Impaired
renal function, dialysis patients, hypovolemia
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Diuretic
therapy, collagen-vascular diseases, elderly, bilateral renal artery
stenosis
Adverse
Reactions (Side Effects):
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CNS:
anxiety, dizziness, fatigue, headache, insomnia, paresthesia
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CV:
angina, hypotension, palpitations, postural hypotension, syncope
(especially with 1st dose)
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GI:
abdominal pain, constipation, melena, nausea, vomiting
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GU:
acute renal failure, decreased libido, impotence, increased BUN,
creatinine
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HEME:
agranulocytosis, neutropenia
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METAB:
hyperkalemia, hyponatremia
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MS:
arthralgia, arthritis, myalgia
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RESP:
asthma, bronchitis, cough, dyspnea, sinusitis
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SKIN:
angioedema, flushing, rash, sweating
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Dosage:
Administered
orally
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Adult:
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Hypertension:
PO 10mg daily; usual dose 20-40mg daily
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CHF:
PO 5mg daily; usual range 5-20mg daily
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Acute
MI: PO in hemodynamically stable patients within 24 hours of
acute MI, 5mg followed by 5mg after 24 hours, 10mg after 48 hours,
then 10mg daily; continue 6 weeks (or longer if concurrent
hypertension or CHF)
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Renal
impairment: PO initial dose 5mg daily (serum creatinine >
or = to 3 mg/dl); initial dose 2.5mg daily (dialysis patients)
Drug
interactions:
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Allopurinol:
predisposition to hypersensitivity reactions to ACE inhibitors
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Aspirin,
NSAIDs: inhibition of the antihypertensive response to ACE inhibitors
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Prazosin,
terazosin, doxazosin: exaggerated first-dose hypotensive response to a-blockers
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Source:
Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
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