ACE inhibitor, reduces the formation of angiotensin II from angiotensin I. Reduction of angiotensin II leads to a direct reduction of aldosterone release. Reduces the degradation of bradykinin and increases the synthesis of Pg. Reduces PR, blood pressure, preload, the pressure in the pulmonary capillaries, causing an increase in IOC and increase tolerance to myocardial stress in patients with CHF. Expands the artery to a greater extent than the vein. Some effects are explained by effects on tissue renin-angiotensin system. With prolonged use decreases myocardial hypertrophy and arterial wall resistive type. Improves blood flow to ischemic myocardium. ACE inhibitors prolong life in patients with CHF, slow the progression of left ventricular dysfunction in patients with myocardial infarction without clinical signs of heart failure. Onset of action - after 1 hour. The maximum effect is determined by 6-7 hours duration - 24 hours. When hypertension effect noted in the first few days after starting treatment, stable operation develops in 1-2 months.
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Various forms of arterial hypertension (elevation of blood pressure), including renovascular (due to kidney disease). Heart failure (in the complex therapy).
In arterial hypertension (persistent high blood pressure) drug is prescribed in an initial dose of 10 mg 1 time per day. In case of insufficient expression of the hypotensive (lowers blood pressure) effect of the drug dose was increased to 20-40 mg (rarely up to 80 mg). In chronic heart failure prescribed an initial dose 2.5 mg maintenance dose - 5-20 mg. For patients with impaired water-electrolyte metabolism, renal failure, renovascular hypertension, as well as receiving diuretics initial dose of lisinopril is 2,5-5 mg. The drug is taken once a day regardless of meals.
From the CAS: lowering blood pressure, arrhythmia, chest pain, rarely - orthostatic hypotension and tachycardia. The nervous system: dizziness, headache, fatigue, drowsiness, muscle twitching limbs and lips, rarely - fatigue, mood lability, confusion. From the digestive system: nausea, dyspepsia, decreased appetite, change in taste, abdominal pain, diarrhea, dry mouth. On the part of hematopoiesis: leukopenia, thrombocytopenia, neutropenia, agranulocytosis, anemia (decreased Hb, erythropenia). Allergic reaction: angioedema, skin rash, itching. Laboratory indicators: hyperkalemia, hyperuricemia, rarely - increased activity of liver transaminases, hyperbilirubinemia. Other: dry cough, decreased potency, rarely - acute renal failure, arthralgia, myalgia, fever, edema (tongue, lips, limbs), impaired development of fetal kidney.
Hypersensitivity to lisinopril or any other ACE inhibitors, pregnancy, laktatsii.C caution. Angioedema in the history of the therapy with ACE inhibitors, hereditary or idiopathic angioedema, aortic stenosis, cerebrovascular disease (including cerebrovascular insufficiency), ischemic heart disease, coronary insufficiency, severe autoimmune systemic connective tissue diseases (including SLE, scleroderma ), inhibition of bone marrow hematopoiesis, diabetes mellitus, hyperkalaemia, bilateral renal artery stenosis, stenosis of the artery a single kidney, a condition after kidney transplantation, renal failure, a diet with restriction of Na +, the state, accompanied by a decrease in the bcc (including diarrhea, vomiting) old age, the age of 18 years (safety and efficacy have not been studied).
Hypotensive effect of diuretics, enhance, relax - indomethacin. When combined with nitrates, propranolol, and digoxin is not a clinically significant adverse pharmacokinetic interactions. Increases lithium toxicity. Potassium-sparing diuretics, potassium supplements and potassium-based means of increasing the risk of hyperkalemia.
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