Lisinopril

Lisinopril Brand Names

Prinivil | QBRELIS | Zestril

What is Lisinopril

Lisinopril is an oral angiotensin-converting enzyme (ACE) inhibitor used in the treatment of hypertension, congestive heart failure (CHF), postmyocardial infarction, and diabetic nephropathy or retinopathy.

Chemically, it is the lysine ester of enalaprilat, the active moiety of enalapril. In most patients, lisinopril and enalapril given orally are equipotent. Unlike enalapril, however, lisinopril is not a prodrug; it is active unchanged.

The pharmacodynamics of lisinopril are similar to those of benazepril, fosinopril, quinapril, and ramipril; however, these agents are all prodrugs. Lisinopril has a slower onset and a longer duration of action than either captopril or enalapril and can be dosed once daily.

Finally, lisinopril does not contain a sulfhydryl group.

Lisinopril was originally approved by the FDA in December 1987 for use in the treatment of hypertension.

In July 1993, it was also approved for use in the treatment of CHF.

Finally, in November 1995, lisinopril was approved to improve survival in hemodynamically stable patients within 24 hours post-myocardial infarction. The patents for Prinivil and Zestril tablets expired in 2002.

In August 2016, Qbrelis oral solution was approved for use in patients 6 years and older.

Indications

  1. acute myocardial infarction
  2. diabetic nephropathy
  3. diabetic retinopathy
  4. heart failure
  5. hypertension
  6. migraine prophylaxis
  7. persistent albuminuria
  8. postmyocardial infarction
  9. proteinuria

Side Effects

  1. alopecia
  2. anaphylactoid reactions
  3. anemia
  4. angioedema
  5. arthralgia
  6. asthenia
  7. azotemia
  8. blurred vision
  9. chest pain (unspecified)
  10. cholestasis
  11. confusion
  12. constipation
  13. cough
  14. depression
  15. diabetes mellitus
  16. diaphoresis
  17. diarrhea
  18. diplopia
  19. dizziness
  20. dysgeusia
  21. dysosmia
  22. elevated hepatic enzymes
  23. eosinophilia
  24. erythema
  25. fatigue
  26. fever
  27. flatulence
  28. flushing
  29. gout
  30. hallucinations
  31. headache
  32. hemolytic anemia
  33. hepatic failure
  34. hepatic necrosis
  35. hepatitis
  36. hyperkalemia
  37. hypoglycemia
  38. hyponatremia
  39. hypotension
  40. impotence (erectile dysfunction)
  41. jaundice
  42. laryngeal edema
  43. leukocytosis
  44. leukopenia
  45. myalgia
  46. neutropenia
  47. oliguria
  48. orthostatic hypotension
  49. pancreatitis
  50. paresthesias
  51. photophobia
  52. photosensitivity
  53. pruritus
  54. psoriasis
  55. rash
  56. renal failure (unspecified)
  57. SIADH
  58. Stevens-Johnson syndrome
  59. syncope
  60. teratogenesis
  61. thrombocytopenia
  62. tinnitus
  63. toxic epidermal necrolysis
  64. urticaria
  65. vasculitis
  66. vertigo
  67. visual impairment
  68. xerostomia

Monitoring Parameters

  • blood pressure
  • serum creatinine/BUN
  • serum potassium
  • serum sodium

Contraindications

  • ACE-inhibitor induced angioedema
  • acute myocardial infarction
  • Angiotensin-converting enzyme inhibitors (ACE inhibitors) hypersensitivity
  • aortic stenosis
  • autoimmune disease
  • Black patients
  • bone marrow suppression
  • breast-feeding
  • cardiomyopathy
  • cerebrovascular disease
  • children
  • collagen-vascular disease
  • coronary artery disease
  • diabetes mellitus
  • dialysis
  • geriatric
  • heart failure
  • hereditary angioedema
  • history of angioedema
  • hymenoptera venom (insect sting) allergy desensitization
  • hyperkalemia
  • hyponatremia
  • hypotension
  • hypovolemia
  • immunosuppression
  • infants
  • jaundice
  • low-density lipoprotein apheresis
  • neonates
  • pregnancy
  • renal artery stenosis
  • renal disease
  • renal failure
  • renal impairment
  • scleroderma
  • surgery
  • systemic lupus erythematosus (SLE)

Interactions

  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Pseudoephedrine
  • Acrivastine; Pseudoephedrine
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Alogliptin; Metformin
  • Alpha-glucosidase Inhibitors
  • Alprostadil
  • Amifostine
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amobarbital
  • Amphetamine; Dextroamphetamine Salts
  • Amyl Nitrite
  • Angiotensin II
  • Angiotensin II receptor antagonists
  • Apomorphine
  • Apraclonidine
  • Aprotinin
  • Aripiprazole
  • Asenapine
  • Azathioprine
  • Azilsartan
  • Azilsartan; Chlorthalidone
  • Baclofen
  • Benzphetamine
  • Bosentan
  • Brexpiprazole
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Cabergoline
  • Calcium Phosphate, Supersaturated
  • Canagliflozin; Metformin
  • Candesartan
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Carvedilol
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chloroprocaine
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Clozapine
  • Co-Enzyme Q10, Ubiquinone
  • Cocaine
  • Codeine; Phenylephrine; Promethazine
  • Conivaptan
  • Cyclophosphamide
  • Cyclosporine
  • Dapagliflozin; Metformin
  • Desloratadine; Pseudoephedrine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmethylphenidate
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Quinidine
  • Diazoxide
  • Diethylpropion
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Phenylephrine
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Duloxetine
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enflurane
  • Entecavir
  • Ephedrine
  • Eplerenone
  • Eprosartan
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Ertugliflozin; Metformin
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Etomidate
  • Everolimus
  • Fexofenadine; Pseudoephedrine
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Fluorescein
  • Fluoxetine; Olanzapine
  • Fospropofol
  • General anesthetics
  • Glipizide; Metformin
  • Glyburide; Metformin
  • Gold
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Haloperidol
  • Halothane
  • Heparin
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Ibritumomab Tiuxetan
  • Ibuprofen; Pseudoephedrine
  • Icatibant
  • Iloperidone
  • Iloprost
  • Incretin Mimetics
  • Indapamide
  • Insulins
  • Intravenous Lipid Emulsions
  • Iohexol
  • Iopamidol
  • Iopromide
  • Ioversol
  • Irbesartan
  • Iron Dextran
  • Isocarboxazid
  • Isoflurane
  • Isoproterenol
  • Isosorbide Dinitrate, ISDN
  • Isosorbide Mononitrate
  • Isosulfan Blue
  • Kanamycin
  • Ketamine
  • Lanthanum Carbonate
  • Levodopa
  • Linagliptin; Metformin
  • Lisdexamfetamine
  • Lithium
  • Loop diuretics
  • Loratadine; Pseudoephedrine
  • Losartan
  • Lovastatin; Niacin
  • Lurasidone
  • Magnesium Salts
  • Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
  • Meglitinides
  • Mestranol; Norethindrone
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methamphetamine
  • Methohexital
  • Methylphenidate
  • Milrinone
  • Naproxen; Pseudoephedrine
  • Nateglinide
  • Nebivolol; Valsartan
  • Nefazodone
  • Nesiritide, BNP
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Nitrates
  • Nitroglycerin
  • Nitroprusside
  • Non-Ionic Contrast Media
  • Nonsteroidal antiinflammatory drugs
  • Olanzapine
  • Olmesartan
  • Oxymetazoline
  • Paliperidone
  • Pentoxifylline
  • Phenelzine
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Polyethylene Glycol; Electrolytes
  • Polyethylene Glycol; Electrolytes; Ascorbic Acid
  • Potassium
  • Potassium Phosphate
  • Potassium Phosphate; Sodium Phosphate
  • Pramlintide
  • Prazosin
  • Pregabalin
  • Procainamide
  • Procaine
  • Propofol
  • Pseudoephedrine
  • Quinidine
  • Rasagiline
  • Repaglinide
  • Risperidone
  • Sacubitril; Valsartan
  • Salicylates
  • Selegiline
  • Sevoflurane
  • SGLT2 Inhibitors
  • Silodosin
  • Sirolimus
  • Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Spironolactone
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfonylureas
  • Tacrolimus
  • Telavancin
  • Telbivudine
  • Telmisartan
  • Temsirolimus
  • Tetrabenazine
  • Tetracaine
  • Thiazide diuretics
  • Thiazolidinediones
  • Thiopental
  • Thiothixene
  • Tizanidine
  • Tolvaptan
  • Tranylcypromine
  • Trazodone
  • Triamterene
  • Trimethoprim
  • Valsartan
  • Yohimbine
  • Ziprasidone