[lie-SIN-oh-prill] Pregnancy Category: C

Prinivil, Zestril [Rx]

Classification: Antihypertensive, ACE inhibitor

See also Angiotensin-Converting Enzyme Inhibitors.

Action/Kinetics: Both supine and standing BPs are reduced, although the drug is less effective in blacks than in Caucasians. Although food does not alter the bioavailability of li-sinopril, only 25% of a PO dose is absorbed. Onset: 1 hr. Peak serum levels: 7 hr. Duration: 24 hr. tV2: 12 hr. 100% of the drug is excreted unchanged in the urine. Uses: Alone or in combination with a diuretic (usually a thiazide) to treat hypertension (step I therapy). In combination with digitalis and a diuretic for treating CHF not responding to other therapy. Use within 24 hr of acute MI to improve survival in hemo-dynamically stable clients (clients should receive the standard treatment, including thrombolytics, aspirin, and beta blockers). Contraindications: See also An-giotensin-Converting Enzyme Inhibitors.

Special Concerns: Use with caution during lactation. Safety and efficacy have not been established in children. Geriatric clients may manifest higher blood levels. Dosage should be reduced in clients with impaired renal function. Side Effects: CNS: Dizziness, headache, fatigue, vertigo, insomnia, depression, sleepiness, paresthesias, malaise, nervousness, confusion. Oral: Dysgeusia, dry mouth. GI: Diarrhea, N&V, dyspepsia, anorexia, constipation, abdominal pain, flatulence. Respiratory: Cough, dyspnea, bronchitis, upper respiratory symptoms, nasal congestion, sinusitis, pharyngeal pain, bronchospasm, asthma. CV: Hypotension, orthostatic hypotension, angina, tachycardia, palpitations, rhythm disturbances, stroke, chest pain, orthostatic effects, peripheral edema, MI, CVA. Musculos-keletal: Asthenia, muscle cramps, joint pain, shoulder and back pain, myalgia, arthralgia, arthritis. Hepatic: Hepatitis, cholestatic jaundice, pancreatitis. Dermatologic: Rash, pruritus, flushing, increased sweating, urticaria. GU: Impotence, oliguria, progressive azotemia, acute renal failure, UTI. Miscellaneous: Angioedema (may be fatal if laryngeal edema oc-

curs), hyperkalemia, neutropenia, anemia, bone marrow depression, decreased libido, chest pain, fever, blurred vision, syncope, vasculitis of the legs, gout.

Drug Interactions: See also An-giotensin-Converting Enzyme Inhibitors.

How Supplied: Tablet: 2.5 mg, 5 mg, 10 mg, 20 mg, 40 mg


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