Left ventricular dysfunction post-myocardial infarction
Diabetic nephropathy
Dosage
Hypertension (adults): 10 mg orally once daily initially; may titrate to 20–40 mg/day
Heart failure: 2.5–5 mg orally once daily initially; titrate as tolerated to 20–40 mg/day
Post-MI: 5 mg orally once daily initially; titrate to 10 mg once daily
Children: Specialist-guided dosing based on weight
Note: Adjust dose in renal impairment; monitor blood pressure, renal function, and electrolytes.
Route of Administration
Oral (tablet)
Mechanism of Action
Lisinopril inhibits ACE, reducing conversion of angiotensin I to angiotensin II. This decreases vasoconstriction and aldosterone secretion, lowering blood pressure and reducing cardiac workload.
Common Adverse Effects
Dry cough
Dizziness
Fatigue
Rash
Hypotension
Serious Adverse Effects
Angioedema (potentially life-threatening)
Severe hypotension
Hyperkalemia
Acute renal failure
Contraindications
History of angioedema related to ACE inhibitors
Pregnancy (especially 2nd and 3rd trimester)
Severe bilateral renal artery stenosis
Hypersensitivity to lisinopril
Precautions
Monitor blood pressure, renal function, and electrolytes regularly
Use caution in elderly patients and in renal impairment
Avoid potassium supplements unless indicated
Taper cautiously if switching from other antihypertensives
Drug Interactions
Potassium-sparing diuretics or potassium supplements – risk of hyperkalemia
NSAIDs – may reduce antihypertensive effect and impair renal function
Other antihypertensives – additive hypotensive effect
Diuretics – may potentiate hypotension initially
Pregnancy & Lactation
Contraindicated in pregnancy (2nd/3rd trimester). Use with caution during breastfeeding; consult healthcare provider.
Patient Counseling
Take at the same time each day
Monitor blood pressure regularly
Report cough, swelling, dizziness, or signs of hyperkalemia