Medication

Lisinopril

Structure

The main component of the drug is lisinopril dihydrate. But, depending on the manufacturer of the drug, the composition of additional substances may be different.

The Ukrainian company Avant produces Lisinopril with such auxiliary components as corn starch, calcium hydrogen phosphate, iron oxide, mannitol, magnesium stearate.

And the Russian manufacturer ALSI Pharma produces a product with the following additional components: pregelatinized starch, silicon dioxide colloidal, talc, lactose monohydrate, microcrystalline cellulose, magnesium stearate.

In addition, such forms of release of the drug are known as Lisinopril-Ratiopharm, Lisinopril-Astrapharm, Lisinopril Teva, Lisinopril Stada. They have the following additional components:

  • Lisinopril-Astrapharm - corn starch, silicon dioxide colloidal, mannitol, calcium hydrogen phosphate, magnesium stearate;
  • Lisinopril-Ratiopharm - mannitol, calcium hydrogen phosphate, magnesium stearate, pregelatinized starch, croscarmellose sodium (20 mg tablets also contain the dye PB-24824, and the medicine in tablets of 10 mg contains the dye PB-24823).

Lisinopril Stada has as an active ingredient lisinopril hydrate. And in addition, the following additional substances: pregelatinized starch, silicon oxide colloidal anhydrous, mannitol, magnesium stearate, corn starch, calcium phosphate disubstituted dihydrate.

Release form

Pills.

Pharmachologic effect

The medicine is having hypotensive, cardioprotective, vasodilatingand natriureticeffect on the human body.

Pharmacodynamics and pharmacokinetics

Lisinopril tablets block ACEincrease content endogenous vasodilating GHG and hinder the transition angiotensin I at angiotensin II. They also reduce conversion. arginine-vasopressinand endothelin-1, reduce myocardial afterload, total peripheral vascular resistance, pulmonary capillary pressure and systemic blood pressure. In patients with heart failure increase myocardial tolerance to exercise and cardiac output. Contribute to increased activity renin plasma.

The medicine blocks tissue renin-angiotensin heart system, prevents the appearance of myocardial hypertrophy and dilatations left ventricle or helps in their disappearance.

The effect of the drug appears after about 60 minutes, increases for 6-7 hours and lasts for a day. Maximum antihypertensivethe effect manifests itself in a course of several weeks.

The active substance is absorbed by about 25%. Meal time does not affect absorption. Communication with plasma proteins is low. The active substance is not biotransformed and excreted by the kidneys unchanged. The elimination half-life is 12 hours.

Indications for the use of lisinopril

This medicine should not be taken without the appointment of a specialist. Indications for the use of lisinopropyl may be different. How to take and from what the tablets will help in each case, only a doctor knows.

As a rule, lisinopril tablets are indicated for use as follows:

  • arterial hypertension;
  • chronic heart failure;
  • diabetic nephropathy when insulin dependent and type II diabetes;
  • acute myocardial infarction without arterial hypotension.

Contraindications

The drug should not be taken with hypersensitivity to its components, lactation and pregnancy.

It is undesirable to prescribe this remedy for:

  • hyperkalemia;
  • anaphylactoid reactions;
  • collagenoses;
  • cerebrovascular insufficiency;
  • impaired kidney and liver function;
  • bilateral renal artery stenosis;
  • transplanted kidney;
  • gout;
  • advanced age;
  • Quincke's edema at history;
  • bone marrow depression;
  • hypotension;
  • obstructive changes that prevent outflow blood from the heart;
  • hyponatremia, as well as when eating with a limited intake of sodium;
  • stenosis of a single kidney artery;
  • hyperuricemia;
  • children's age.

Side effects

Side effects can be different, they arise from different systems and organs:

  • nervous system - irritability, headache, ataxiafatigue, transient cerebrovascular accident, tremor, drowsinessvisual impairment confusion, nervousness, fainting, peripheral neuropathymemory impairment dizziness, insomnia, paresthesiacramps, tinnitus;
  • gastrointestinal tract - dry mouth heartburnvomiting flatulencepain in the abdomen gastritis, indigestionnausea diarrhea, constipationcramping hepatotoxicity, pancreatitis;
  • musculoskeletal system - arthralgia, myalgia, arthritispain in the neck and back;
  • respiratory system - malignant tumors lungs embolism and pulmonary infarction, dry cough, asthmapain during breathing, hemoptysis, laryngitis, pharyngitisnasal bleeding, paroxysmal postural dyspnea, infiltration, pleural effusion, rhinitis, bronchitis, bronchospasm, sinusitisrunny nose;
  • genitourinary system - acute renal failureproblems with kidney function, pyelonephritis, oliguria, uremia, impotence, dysuria, anuria, swellingdecreased libido;
  • skin - hives, alopecia, pemphigus, Lyell's syndromephotosensitization, rash, damage and infection of the skin, Stevens-Johnson syndrome.

In addition, the following manifestations are possible: the development of infections, weight loss, sweating, diabetesraising antinuclear antibody titer and content urea, goutlevel increase creatinine, hyperkalemia, hyperuricemia, fever, allergy, dehydration, hyponatremia.

If any side effects are detected, you should immediately consult a specialist.

Instructions for use of lisinopril (method and dosage)

The medicine is taken daily 1 time in the morning, regardless of the meal. This should be done at the same time, while washing down with a certain amount of liquid.

The exact dosage and treatment regimen is selected by a specialist individually. It depends on what lisinopropyl is used, what drugs are taken with it and what is the condition of the kidneys.

At arterial hypertensionin case of treatment without others antihypertensive the dosage is 2.5 mg once a day. For maximum effectiveness, a 2-4 week therapy is performed. Only then can the daily dosage be increased to a maximum of 20 mg. The daily dose should not be more than 40 mg.

If necessary antihypertensive the effect is not achieved, you need to take another antihypertensive other remedy pharmacotherapeutic group.

When acute myocardial infarctionif the medicine Lisinopril was prescribed, the instructions for use report that it should be taken within 24 hours after the first symptoms of the disease have manifested. The initial dosage is 5 mg once a day. May be increased to 10 mg. People with arterial systolic pressureup to 120 mmHg Art. 2.5 mg per day is indicated. And when arterial hypotensionone dose does not exceed 5 mg (if necessary, it can be reduced). If within 60 minutes after taking blood pressure up to 90 mm RT. Art., the tablets are canceled. At a dosage of 10 mg, therapy for 6 weeks is recommended.

When heart failure The daily starting dosage is 2.5 mg. It can be gradually increased depending on the individual indications of the patient. Therapeutic daily dosage is 20 mg.

When insulin-dependent diabetes mellitus and nephropathy therapy begins with low doses and is carried out under close supervision by a specialist. The initial daily dosage for type II diabetesis 10 mg. It is forbidden to exceed a daily dose of 20 mg.

At renal failure dosage adjustment required depending on QC:

  • 30-70 ml / min - you need to take 5-10 mg / day;
  • 10-30 ml / min - you need to take 2.5-5 mg / day;
  • up to 10 ml / min - you need to take 2.5 mg / day.

A daily dose of 20 mg cannot be exceeded, but for people with QC up to 30 ml / min the highest daily dosage is 10 mg.

In some cases, it is also possible to extend the interval between doses of the drug from one to two days.

There may be some changes in the regimen of the drug, depending on the manufacturer. So the instructions for use of Lisinopril-Astrapharm reports the following daily dosages, depending on the diagnosis:

  • arterial hypertension- To start, the dosage should be 10 mg per day. However, after the first application, a significant decrease may occur. HELL. In this case, the initial dosage is 2.5-5 mg. Therapy should be supervised by a specialist. The maintenance daily dosage is 20 mg. If the proper effect has not been achieved in 14-28 days, it can be increased. But you can not exceed the daily dosage of 80 mg;
  • chronic heart failure- the medicine can be used as part of therapy diuretics, beta blockersand digitalis drugs. At the beginning of treatment, a daily dosage of 2.5 mg is prescribed. The medicine should be consumed under the supervision of a specialist. It is possible to increase the dose, but not more than 10 mg and not earlier than 14 days. The maximum daily dosage should not exceed 35 mg. The exact dose depends on the individual indicators of the patient;
  • acute myocardial infarction - the drug is taken as part of therapy thrombolyticmedicines beta blockersand acetylsalicylic acid. The dosage of Lisinopril-Astrafarm in the first two days is 5 mg. The course should be started when the first symptoms occur and if systolic blood pressuredoes not exceed 100 mm RT. Art. Two days later, a daily dosage of 10 mg is prescribed. If arterial pressure up to 120 mmHg Art., in the first 3 days you need to take 2.5 mg. When prolonged arterial hypotension therapy is stopped immediately. The course is designed for 6 weeks, after which the patient's condition must again be assessed for further treatment;
  • diabetic nephropathy- The initial dosage is 10 mg per day. If necessary, the dose is increased to 20 mg.

With any diagnosis in the case of renal failure dosages are adjusted depending QC. So the initial dose may be:

  • QCup to 10 ml / min - you need to take 2.5 mg / day;
  • QC 10-30 ml / min - you need to take 2.5-5 mg / day;
  • QC31-80 ml / min - you need to take 5-10 mg / day.

Instructions for use Lisinopril-Ratiopharm, Lisinopril Teva, Lisinopril Stada have no significant differences in the dosage regimen.

Overdose

In case of an overdose, as a rule, appears acute arterial hypotension. As a treatment, physiological saline is administered. Symptomatic therapy is performed.

In addition, shock is possible, hyperventilation, acute renal failure, bradycardia, cough, imbalance electrolytes in blood, tachycardiaheartbeat dizzinessfeeling anxious.

The drug must be canceled. If the patient is conscious, they rinse the stomach, lay the patient on his back with a low head restraint, raised legs and head set aside. In addition, they give enterosorbents.

When taking medication in particularly high doses, the patient should be hospitalized immediately. In a hospital, treatment is carried out aimed at maintaining normal perfusion pressure, blood circulation, respiration, restoration of the volume of circulating blood and normal kidney function. Effective hemodialysis. Be sure to monitor the indicators of vital functions, as well as the level creatinine and electrolytesin blood serum.

Interaction

Taking the drug with antihypertensivemedication can provoke additive antihypertensive effect.

Potassium-sparing diuretics, substitutes for edible salt with potassium, as well as drugs with potassium increase the possibility of development hyperkalemia.

Combination with blockers ACE and NSAIDsincreases the likelihood of impaired renal function. In rare cases, it is also possible hyperkalemia.

And applications in conjunction with loopback and thiazide diuretics fraught with amplification antihypertensive actions. This also significantly increases the risk of impaired renal function.

Indomethacin or funds with estrogen in combination with lisinopril lead to a decrease antihypertensive actions of the latter. A simultaneous reception Insulin and hypoglycemic drugs can cause hypoglycemia.

The combination with clozapine leads to an increase in its content in plasma. While taking lithium carbonate its level in blood serum increases. This may be accompanied by symptoms of lithium intoxication.

The drug also increases the effect of ethanol. The symptoms of intoxication are aggravated. At the same time, an increase is possible antihypertensive the effect of lisinopril, so it is necessary to avoid alcohol during therapy with this drug or not to take it within 24 hours after drinking alcohol.

The use of this medication in conjunction with funds for anesthesianarcotic analgesics, antidepressants, muscle relaxants from hypotensive action, as well as sleeping pills leads to an increase antihypertensive effect.

Thrombolytics increase the likelihood arterial hypotension. This combination should be prescribed with caution and carefully monitor the patient's condition.

Sympathomimetics greatly weaken antihypertensive effect of the drug. A combination with drugs that provide myelosuppressiveaction increase risk agranulocytosis and / or neutropenia.

Concomitant use with Allopurinol, immunosuppressants, Procainamide, cytostatics, corticosteroids may cause leukopenia.

At dialysistherapies are possible anaphylactoid reactions in case of application high flow polyacrylonitrile metal sulfonate membranes.

Terms of sale

On prescription.

Storage conditions

Keep the medicine in a dry place, inaccessible to small children, at a temperature of up to 250C.

Shelf life

Shelf life Lisinopril, Lisinopril Stada and Lisinopril-Astrapharm - 3 years. Lisinopril-Ratiopharm can be stored for maximum 4 years. And the shelf life of Lisinopril Teva is 2 years.

Analogs of Lisinopril

Matches for ATX Level 4 code:DilaprelPrenesaEnapDirotonLiprilReniprilParnawelFozinapTritaceEnamZokardisFosinoprilCaptoprilMonoprilRenetekHartilFosicardAmprilanRamiprilPerindopril

The main analogues of Lisinopril in pharmacies can be found as follows:

  • Lizinokol;
  • Aurolyza;
  • Lysoryl;
  • Vitopril;
  • Lipril;
  • Dapril;
  • Rileys-Sanovel;
  • Diroton;
  • Scopril;
  • Zonixem;
  • Lizinovelov;
  • Lizi sandoz.

The cost of these drug is not much different. All analogues of Lisinopril have their own characteristics of use, so they should not be used without a doctor's prescription.

Reviews about Lisinopril

Reviews of patients characterize this drug as an effective tool that helps with chronic heart failureas well as in the case dandabetic nephropathy, arterial hypertension and after myocardial infarction.

Experts report that the full therapeutic effect can be seen as early as 14-28 days after the start of administration. Reviews of doctors are also mostly positive.

There are not many negative opinions. Negative reviews about Lisinopril mainly tell about the appearance of side effects. Most commonly reported fatigue, dizziness, nausea, headache, dry cough, diarrhea.

Reviews about Lisinopril Teva, as well as synonyms of the drug from other manufacturers, are also mostly positive. However, patients report some side effects. But definitely attribute them about this ACE inhibitor in most cases it is impossible, since it is often used in combination with other agents, which also have their own adverse reactions.

Price of lisinopril, where to buy

The price of Lisinopril may vary slightly depending on the form of release and the manufacturer. The cost of 10 mg tablets (in a package of 20 or 30 pieces) from the manufacturer ALSI Pharma is 17 rubles. The price of Lisinopril in tablets of 5 mg (in a package of 30 pieces) from the same manufacturer is about 25 rubles. Lisinopril-Astrapharm in tablets of 10 mg (in a package of 20 pieces) costs about 90 rubles. And Lisinopril-Ratiopharm 10 mg (in a package of 30 pieces) is about 330 rubles.

  • Online Pharmacies in Russia
  • Online pharmacies in UkraineUkraine
  • Online pharmacies in Kazakhstan

ZdravCity

  • Lisinopril tablets 10mg No. 30 VertexVertex AO110 rub.order
  • Lisinopril-Akrikhin tab. 5mg No. 30Adipharm EAD89 rub.order
  • Lisinopril tablets 5mg No. 30 OzonOzon OOO33 rub.order
  • Lisinopril Tab. 20mg n50North Star CJSC165 rub.order
  • Lisinopril-Teva Tab. 20mg No. 30OOO "Teva" 202 rub.order

Pharmacy Dialog

  • Lisinopril-STADA (tab. 10mg No. 20) 110 rub.
  • Lisinopril-Akrikhin tablets 5mg No. 3090 rub.order
  • Lisinopril-Akrikhin tablets 20mg No. 30162 rub.order
  • Lisinopril (tab. 5mg No. 30) 87 rub.order
  • Lisinopril (tab. 5mg No. 30) 16 rub.order

Eurofarm * 4% discount on the promotional code medside11

  • Lisinopril-Teva 5 mg No. 30 tabletsTeva, OOO161 rub.order
  • Lisinopril-Teva 20 mg No. 20 tabletTeva OOO171 rub.order
  • Lisinopril-Teva 20 mg No. 30 tabletsTeva, OOO226 rub.order
  • Lisinopril-Teva 10 mg No. 20 tabletsTeva OOO120 rub.order
  • Lisinopril-Teva 10 mg No. 30 tabletTeva OOO165 rub.order
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Pharmacy24

  • Lisinopril-Lupine 20 mg No. 30 tablets Lyupin Limited, India 41 UAH to order
  • Lisinopril 20 НL KRKA 20 mg / 12.5 mg No. 30 tablets KRKA Pharma doo, Zagreb, Croatia140 UAH order
  • Lisinopril 5 mg N20 tablets TOV "Astrapharm", Ukraine 10 UAH order
  • Lisinopril 10 НL KRKA 10 mg / 12.5 mg No. 30 KRKA Pharma doo, Zagreb, Croatia101 UAH order
  • Lisinopril-Teva 5 mg N30 tablets Merkle GmbH, Nimechchina29 UAH

Pani Pharmacy

  • LYSINOPRIL tablets Lizinopril tablets 20mg No. 30 Germany, Merckle 106 UAH order
  • LYSINOPRIL tablets Lizinopril tablets 5mg No. 30 Germany, Merckle 43 UAH to order
  • Lisinopril NL tablets Lisinopril 10NL tablets 10mg / 12.5mg No. 30 Croatia, KRKA Farma 122 UAH order
  • Lisinopril NL tablets Lisinopril 20NL tablets 20mg / 12.5mg No. 30 Croatia, KRKA Farma 136 UAH order
  • LYSINOPRIL tablets Lisinopril tablet. 20mg No. 30 Croatia, KRKA Farma 140 UAH order
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BIOSPHERE

  • Lisinopril-ratiopharm 5 mg No. 30 tab. blister Merckle GmbH for ratiopharm GmbH (Germany) 1 tenge
  • Lisinopril-Teva 20 mg No. 30 tablets Merckle GmbH (Germany) 2 tg.
  • Lisinopril-Teva 10 mg No. 50 tablets Merckle GmbH (Germany) 2 tg.
  • Lisinopril-ratiopharm 20 mg No. 50 tab. blister Merckle GmbH for ratiopharm GmbH (Germany) 3 tg.
  • Lisinopril-ratiopharm 20 mg No. 30 tab. blister Merckle GmbH for ratiopharm GmbH (Germany) 2 tg.
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