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Lisinopril (lye-SIN-o-pril) is a drug of the angiotensin converting enzyme (ACE) inhibitor
ACE inhibitor

ACE inhibitors, or inhibitors of angiotensin-converting enzyme, are a group of pharmaceuticals that are used primarily in treatment of hypertension and congestive heart failure, in some cases as the drugs of first choice....
 class that is primarily used in treatment of hypertension
Hypertension

Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the blood pressure is chronically elevated....
, congestive heart failure
Congestive heart failure

Heart failure is a condition in which a problem with the structure or function of the heart impairs its ability to supply sufficient blood flow to meet the body's needs....
, heart attacks
Myocardial infarction

Myocardial infarction , commonly known as a heart attack, occurs when the Blood flow to part of the heart is interrupted. This is most commonly due to occlusion of a coronary artery following the rupture of a Vulnerable plaque, which is an unstable collection of lipids and white blood cells in the wall of an artery....
 and also in preventing renal
Kidney

The kidneys are Organ that have numerous biological roles. Their primary role is to maintain the homeostasis balance of bodily fluids by filtering and secreting Metabolomics#Metabolitess and minerals from the blood and excreting them, along with water , as urine....
 and retina
Retina

The vertebrate retina is a light sensitive tissue lining the inner surface of the eye. The optics of the eye create an image of the visual world on the retina, which serves much the same function as the film in a camera....
l complications of diabetes
Diabetes mellitus

Diabetes mellitus , often referred to simply as diabetes , is a syndrome of disordered metabolism, usually due to a combination of genetic disorder and environmental causes, resulting in abnormally high blood sugar levels ....
. It has been compared with omapatrilat
Omapatrilat

Omapatrilat is a novel antihypertensive agent that inhibits both neutral endopeptidase and angiotensin converting enzyme . NEP inhibition results in elevated natriuretic peptide levels, promoting natriuresis, diuresis, vasodilation, and reductions in preload and ventricular remodeling....
 which is of similar function.

Historically, lisinopril was the third ACE inhibitor, after captopril
Captopril

Captopril is an angiotensin-converting enzyme inhibitor used for the treatment of hypertension and some types of congestive heart failure. Captopril was the first ACE inhibitor developed and was considered a breakthrough both because of its novel mechanism of action and also because of the revolutionary development process....
 and enalapril, and was introduced into therapy in the early 1990s. Lisinopril has a number of properties that distinguish it from other ACE inhibitors: it is hydrophilic
Hydrophile

Hydrophile, from the Greek language ' "water" and f???a ' "friendship," refers to a physical property of a molecule that can transiently bond with water through hydrogen bonding....
, has long half-life
Half-life

The half-life of a quantity whose value decreases with time is the interval required for the quantity to decay to half of its initial value. The concept originated in describing how long it takes atoms to undergo radioactive decay but also applies in a wide variety of other situations....
 and tissue penetration and is not metabolized
Metabolism

Metabolism is the set of chemical reactions that occur in living organisms in order to maintain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments....
 by the liver.

nopril is the lysine
Lysine

Lysine is an a-amino acid with the chemical formula HO2CCH4NH2. This amino acid is an essential amino acid, which means that humans cannot synthesize it....
-analog of enalapril.






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Encyclopedia


Lisinopril (lye-SIN-o-pril) is a drug of the angiotensin converting enzyme (ACE) inhibitor
ACE inhibitor

ACE inhibitors, or inhibitors of angiotensin-converting enzyme, are a group of pharmaceuticals that are used primarily in treatment of hypertension and congestive heart failure, in some cases as the drugs of first choice....
 class that is primarily used in treatment of hypertension
Hypertension

Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the blood pressure is chronically elevated....
, congestive heart failure
Congestive heart failure

Heart failure is a condition in which a problem with the structure or function of the heart impairs its ability to supply sufficient blood flow to meet the body's needs....
, heart attacks
Myocardial infarction

Myocardial infarction , commonly known as a heart attack, occurs when the Blood flow to part of the heart is interrupted. This is most commonly due to occlusion of a coronary artery following the rupture of a Vulnerable plaque, which is an unstable collection of lipids and white blood cells in the wall of an artery....
 and also in preventing renal
Kidney

The kidneys are Organ that have numerous biological roles. Their primary role is to maintain the homeostasis balance of bodily fluids by filtering and secreting Metabolomics#Metabolitess and minerals from the blood and excreting them, along with water , as urine....
 and retina
Retina

The vertebrate retina is a light sensitive tissue lining the inner surface of the eye. The optics of the eye create an image of the visual world on the retina, which serves much the same function as the film in a camera....
l complications of diabetes
Diabetes mellitus

Diabetes mellitus , often referred to simply as diabetes , is a syndrome of disordered metabolism, usually due to a combination of genetic disorder and environmental causes, resulting in abnormally high blood sugar levels ....
. It has been compared with omapatrilat
Omapatrilat

Omapatrilat is a novel antihypertensive agent that inhibits both neutral endopeptidase and angiotensin converting enzyme . NEP inhibition results in elevated natriuretic peptide levels, promoting natriuresis, diuresis, vasodilation, and reductions in preload and ventricular remodeling....
 which is of similar function.

Historically, lisinopril was the third ACE inhibitor, after captopril
Captopril

Captopril is an angiotensin-converting enzyme inhibitor used for the treatment of hypertension and some types of congestive heart failure. Captopril was the first ACE inhibitor developed and was considered a breakthrough both because of its novel mechanism of action and also because of the revolutionary development process....
 and enalapril, and was introduced into therapy in the early 1990s. Lisinopril has a number of properties that distinguish it from other ACE inhibitors: it is hydrophilic
Hydrophile

Hydrophile, from the Greek language ' "water" and f???a ' "friendship," refers to a physical property of a molecule that can transiently bond with water through hydrogen bonding....
, has long half-life
Half-life

The half-life of a quantity whose value decreases with time is the interval required for the quantity to decay to half of its initial value. The concept originated in describing how long it takes atoms to undergo radioactive decay but also applies in a wide variety of other situations....
 and tissue penetration and is not metabolized
Metabolism

Metabolism is the set of chemical reactions that occur in living organisms in order to maintain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments....
 by the liver.

Pharmacology

Lisinopril is the lysine
Lysine

Lysine is an a-amino acid with the chemical formula HO2CCH4NH2. This amino acid is an essential amino acid, which means that humans cannot synthesize it....
-analog of enalapril. Unlike other ACE inhibitors, lisinopril is not a prodrug
Prodrug

A prodrug is a Pharmacology substance that is administered in an inactive form. Once administered, the prodrug is drug metabolism in vivo into an active metabolite....
 and is excreted unchanged in the urine. In cases of overdosage
Effective dose

An effective dose in pharmacology is the amount of medication that produces a therapeutic response in 50% of the people taking it, sometimes also called ED-50....
, it can be removed from circulation by dialysis
Dialysis

In medicine, dialysis is primarily used to provide an artificial replacement for lost kidney function due to renal failure. Dialysis may be used for very sick patients who have suddenly but temporarily, lost their kidney function or for quite stable patients who have permanently lost their kidney function ....
.

Clinical use

Its indications, contraindications and side effects are as those for all ACE inhibitor
ACE inhibitor

ACE inhibitors, or inhibitors of angiotensin-converting enzyme, are a group of pharmaceuticals that are used primarily in treatment of hypertension and congestive heart failure, in some cases as the drugs of first choice....
s. Its long half-life allows for once a day dosing which aids patient compliance
Compliance (medicine)

Compliance is a medical term that is used to indicate a patient's correct following of medical advice. Most commonly it is a patient taking medication , but may also apply to use of surgical appliances such as compression stockings, chronic wound care, self-directed physiotherapy exercises, or attending counselling or other courses of therap...
. The usual daily dose in all indications ranges from 2.5 mg in sensitive patients to 40 mg. Some patients have been treated with 80 mg daily and have tolerated this high dose well. Lower dosages must be used in patients with higher grade renal impairment (glomerular filtration rate (GFR) lower than 30 ml/min).

Adverse effects

Serious side effect
Side effect

Side effect can mean:* Adverse reaction, an unintended consequence specifically arising from drug therapy* Therapeutic effect, an unintended but desirable consequence of any kind of medical treatment...
s that would require immediate medical attention include:

  • chills, infection
    Infection

    An infection is the detrimental colonization of a host organism by a foreign species. In an infection, the infecting organism seeks to utilize the host resources to multiply ....
  • dark urine, decreased urination (oliguria
    Oliguria

    Oliguria and anuria are the decreased or absent production of urine, respectively. The decreased production of urine may be a sign of dehydration, renal failure or urinary obstruction/urinary retention....
    )
  • difficulty swallowing or breathing (signs of angioedema), allergic reaction (anaphylaxis
    Anaphylaxis

    Anaphylaxis is an acute Circulatory system and very severe Type I hypersensitivity allergy reaction in humans and other mammals. The term comes from the Greek words a?a ana and f??a??? phylaxis ....
    )
  • hoarseness
  • itching
  • rapid weight gain, stomach pain
  • yellowing of skin or eyes (jaundice
    Jaundice

    Jaundice, also known as icterus , is a yellowish discoloration of the skin, the conjunctival membranes over the sclera , and other mucous membranes caused by hyperbilirubinemia ....
    )


  • abdominal pain, bloating, vomiting
  • chest pain or tightness, dizziness, lightheadedness, fainting (syncope
    Syncope

    In phonology, syncope is the loss of one or more sounds from the interior of a word; especially, the loss of an unstressed vowel....
    )
  • dry cough
  • fever
  • joint pain
  • rash


  • diarrhea, loss of taste, nausea
  • drowsiness, headache, tiredness
  • Change in mood/ irrational behaviour
  • blurred vision
  • muscle cramps
  • Fainting / Blackouts


Lisinopril causes the kidneys to retain potassium, which may lead to hyperkalemia
Hyperkalemia

Hyperkalemia Hyperkalaemia is an elevated blood level of the electrolyte potassium. The prefix hyper- means high . The middle kal refers to kalium, which is neo-Latin for potassium....
.

A severe allergic reaction can occur that rarely can affect the bowel wall and secondarily cause abdominal pain. This "anaphylactic" reaction is very rare, and must be given immediate medical attention.

History/brand names

Lisinopril was developed by Merck & Co.
Merck & Co.

Merck & Co., Inc. , also known as Merck Sharp & Dohme or MSD outside the USA and Canada, is one of the largest pharmaceutical companies in the world....
 and is marketed worldwide as Prinivil or Tensopril and by AstraZeneca
AstraZeneca

AstraZeneca plc , is a large Anglo-Swedish pharmaceutical company formed on 6 April 1999 by the remerger of Swedish Astra AB and British Zeneca Group plc....
 as Zestril. In India it is marketed by Micro Labs as Hipril. In the United States, a generic version is available. Like other ACE inhibitors, it is derived from the venom of the jararaca, a Brazilian pit viper (Bothrops jararaca
Bothrops jararaca

Bothrops jararaca is a venomous snake Crotalinae species found in southern Brazil, Paraguay and northern Argentina. The species name is derived from the Tupian languages words yarar? and ca, which means "large snake." Within its range it is often abundant and is an important cause of snakebite....
).

Footnotes


External links


See also

  • Omapatrilat
    Omapatrilat

    Omapatrilat is a novel antihypertensive agent that inhibits both neutral endopeptidase and angiotensin converting enzyme . NEP inhibition results in elevated natriuretic peptide levels, promoting natriuresis, diuresis, vasodilation, and reductions in preload and ventricular remodeling....