Lizoprel. 20 mg. 28 tablets
- Hypertension (alone or in combination with other antihypertensive agents)
- Congestive heart failure (as adjunctive therapy) .
Lizoprel. 20 mg. 28 tablets
Lisinopril is a long-acting competitive inhibitor of angiotensin converting enzyme.
Lisinopril is used for treatment of :
- Hypertension (alone or in combination with other antihypertensive agents )
- Congestive heart failure ( as adjunctive therapy )
- Prophylactically after an acute myocardial infarction (within 24 hours in patients with stable hemodynamics )
Lisinopril is contraindicated in :
- Angioneurotic edema ( swelling of the face , lips, tongue , nasopharynx , extremities ) caused in previously treated with ACE inhibitors
- Hypersensitivity to ACE inhibitors
- Pregnancy (especially in the second - and third trimesters )
If in doubt Always ask your doctor or pharmacist for advice.
Lisinopril should not be taken during pregnancy because it may harm the fetus. During the adoption of lisinopril possible hypersensitivity reactions (swelling of face, lips, excess limbs, tongue, glottis and / or larynx ) . When fluid loss for any reason there is a risk of developing severe hypotension (low blood pressure). Efficacy and safety of lisinopril for children not yet izyasnena.Tova medicine has been prescribed for you. Never give it to anyone else! May harm them .
Antacids should be taken at least 2 hours before lisinopril . NSAIDs may reduce the antihypertensive effect of lisinopril and cause significant delays cardiac . Reduced body fluid due to diuretic therapy may lead to a sharp drop in blood pressure and / or renal insufficiency. Bupivacaine can also cause a decrease in blood pressure. Concomitant administration of lisinopril and insulin can lead to a dramatic reduction in blood sugar. Lisinopril can cause an increased level of potassium in the blood and this must be taken into account , if the patient takes potassium syhranyavashti diuretics, potassium preparations or potassium salt substituent .
Tell your doctor if you are taking any of these medicines together with lisinopril : allopurinol , azathioprine, mercaptopurine , cyclosporine , erythropoietin , lithium ( danger of lithium toxicity ) .
Upon the adoption of lisinopril is possible to affect certain laboratory tests : possible false positive liver enzymes, serum bilirubin, uric acid and blood sugar. Low may increase the levels of blood urea and serum creatinine, but are reversible after cessation of therapy with lisinopril . This increase was more frequently observed in patients receiving concomitant lisinopril and diuretics and in patients with a stenosis of the renal artery . Frequently in patients treated with lisinopril slight decrease in hemoglobin and hematocrit , but this is usually not clinically relevant. During treatment with lisinopril were also seen false positive results for acetone urinata.Vinagi tell your doctor if you are prescribed another medicine can only be obtained with or without a prescription.
Pregnancy and lactation
When pregnancy is diagnosed , treatment with lisinopril should be discontinued as soon as possible . Use of lisinopril in the second and third trimester of pregnancy may lead to birth defects or death to him . Exact data on the secretion of lisinopril in human milk. It is believed that its adoption during breastfeeding is safe .
During pregnancy and lactation ALWAYS consult your doctor or pharmacist before taking this medicine
EFFECTS ON THE ABILITY TO DRIVE AND USE MACHINES
Lisinopril can cause a decrease in blood pressure , resulting in dizziness , lethargy , drowsiness, and reduced attention .
DOSAGE AND ADMINISTRATION
Dosing is individually depending on the state of renal function, age of the patient, the administration of other drugs , and the blood pressure values . Lisinopril is usually taken once a day , at bedtime with a glass of water .
Treatment is started with 2.5 mg once daily and the dose is gradually increased to 2-4 weeks, depending on the values of blood pressure (measured just before the next dose ) to obtain the optimum effect . Typically, the effective dose is 10-20 mg . The dose of 2.5 mg rarely produce a therapeutic effect. The maximum daily dose is 40 mg . Lowering blood pressure can be avoided if the dose be taken at bedtime. The antihypertensive effect may diminish toward the end of the dosing interval regardless of the administered dose . This can be determined by measuring blood pressure just before the next dose.
Abrupt discontinuation of lisinopril has not been associated with a sharp rise in blood pressure.
Patients on diuretic therapy:
For patients on diuretic therapy when initiating treatment with lisinopril it is possible to symptomatic hypotension after the initial dose . If possible , the diuretic should be discontinued 2-3 days before treatment . If it is not possible to stop the diuretic , the first dose of lisinopril should be 2.5 mg but not more than 5 mg . The dose should be adjusted according to blood pressure .
If blood pressure is adjusted with lisinopril it to therapy can be added and low dose diuretic. It has been shown that 12.5 mg of Hydrochlorothiazide an additive effect . After the addition of a diuretic may be necessary to reduce the dose of the drug.
Co as use of lisinopril by the potassium salt , potassium preparations or potassium-sparing diuretics may lead to an increase in serum potassium.
Congestive heart failure :
In congestive heart failure, lisinopril is administered as an adjunctive therapy to diuretics and digitalis. The dose range of 2.5 - 5-20 to 40 mg once a day, once , depending on the blood pressure values . Usually it starts with the 5 mg . The first dose should be under strict medical supervision , especially in patients with low blood pressure (systolic blood pressure below 100 mm Hg). After dosing, blood pressure drops in the next 6-8 hours and the patient should be monitored until blood pressure has stabilized. If the patient takes a diuretic , the dosage should be reduced ( if possible ) , so as not to contribute to the reduced amount of fluid in the body in the development of hypotension.
Maintenance dose :
The dose should be gradually increased , depending on the condition of the patient to the maintenance dose of about 5-20 mg per day . Increasing the dose gradually for 2-4 weeks, or quicker if required by the clinical point of view .
Patients with heart failure and renal failure or hyponatremia : In renal insufficiency (creatinine clearance <30 mL / min or serum creatinine> 3 mg / dl) or hyponatremia (serum sodium < 130 mEq / L) dose should be 2.5 mg once daily strict medical kontrol.Vazrastni patients over b5g . : starting with 2.5 - 5 mg as adjunctive therapy to diuretics and digitalis , the dose may be increased by no more than 10 mg for 2 weeks, to a maximum dose of 40 mg / day. The maintenance dose is 5-40 mg / day in a single dose .
Acute myocardial infarction
( within 24 hours in patients with stable haemodynamics )
Immediately 5 mg lisinopril adopted ; 24TM of time to be 5 mg , 48 hour, take 10 mg , and then taken at 10 mg daily for a period of 6 weeks. Treatment with lisinopril is complementary to therapy with thrombolytics , aspirin and beta- blockers.
Therapy with lisinopril should last for 6 WEEKS.
At lower doses (2.5 mg) to be administered at an initial low pressure ( less than 120 mmHg). Maintenance dose of 2.5-5 mg used for hypotension (systolic pressure below 100 mmHg), continuing the first 3 days of treatment . In cases of persistent hypotension ( systolic blood pressure less than 90 mmHg for more than 1 hour), lisinopril should be spre.Lekarstveniyat product may be administered together with glyceryl trinitrate .
SETTING dosage regimen of lisinopril in patients with hypertension , congestive heart failure or heart attack should always include assessment of the state of renal function .
Dosing in renal insufficiency
In GFR over 50 ml / min is not necessary dose adjustments . When glomerular filtration rate of 10 to 50 ml / min the dose should be reduced to 2.5 - 5 - 7.5 mg / day ( 50-75 % of normal dose ), while values less than 10 ml / min the dose is to is 1.25 - 2.5 mg / day ( 25-50 % of normal dose ) .
In patients with glomerular filtration rate below 30 ml / min , if necessary to be added to diuretic therapy with lisinopril , it is preferably a loop diuretic rather than hydrochlorothiazide.
In hypertensive patients with severe renal insufficiency (creatinine clearance 5-30 ml / min ) was observed accumulation of lisinopril and dosage adjustment . But despite its high serum levels not seen an increased antihypertensive effect .
Dosing in dialysis :
Lisinopril dialysable. In the days when patients not on dialysis dose should be determined by the blood pressure . Predialysis patients may receive the usual dose of medicine.
Four hours after the adoption of the hemodialysis 2.5mg lisinopril resulted in 47% reduction of serum concentration .
Dialysis patients starting lisinopril 2.5 mg and then the dose was adjusted according to blood nalyagane.Sled hemodialysis is recommended to adopt additional 20% of the daily doza.Sled continuous arteriovenous hemoperfusion recommended the adoption of additional 50-75 % the usual dose.
By the cardiovascular system is most commonly seen chest pain, low blood pressure and disturbance of the heart rhythm. Lisinopril can cause dizziness, headache , lethargy , insomnia , nervousness, confusion, a . Depression , lethargy , pruritus, flushing, urticaria, urinary tract infections, diarrhea or constipation, nausea, vomiting , abdominal pain, dry mouth, altered taste and flatulence .
Slight decrease in hemoglobin and hematocrit are common in patients taking lisinopril without clinical significance .
In patients receiving high doses often observed increase in serum potassium. Risk factors include renal insufficiency , diabetes, concomitant administration of potassium- sparing diuretics, potassium -containing preparations or potassium- containing salt. Rarely monitor the development of gynecomastia. The process is reversible after stopping terapiyata.Lekarstveniyat product may cause nonproductive , persistent cough, which resolves after discontinuation of therapy.
Rarely hypersensitivity to light and hyperpigmentation , impotence , bone marrow depression , hemolytic anemia , muscle cramps , back pain , shoulder and joints , gout , impaired vision or hearing-impaired .
In hypersensitivity reactions seek immediate medical pomosht.Otok the face, lips , excess limbs , tongue and / or throat may develop at any time during therapy with lisinopril , but most likely after the first dose. In these cases, the drug should be stopped immediately , seek medical advice immediately and appropriate therapy initiated ( antihistamines ) until symptoms subside . Whenever there is swelling, which may cause shortness of breath due to airway obstruction should be initiated at an appropriate therapy such as epinephrine subcutaneously (0.5 ml of 1:1,000 ) . Laryngeal edema may be fatal .
DO NOT hesitate to ask your doctor or pharmacist for advice. Informed about any undesirable or unpleasant effect you've noticed there has been in this leaflet,
At temperatures below 25 ° C, dry and protected from light .
Shelf life : 2 years .
DO NOT use the medicine after the date on the external packaging