Medicine Information

Lipril

Name: Lipril
Brand: Lipril
Rating: 4.5 (117 reviews)

Tablet10 mgAntihypertensive, ACE InhibitorATC: C09AA03

Generic Name

Lisinopril

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
lipril 10 mg tablet	৳ 5.53	৳ 55.30

Description

Overview of the medicine

Lisinopril is an Angiotensin-Converting Enzyme (ACE) inhibitor used to treat high blood pressure (hypertension), heart failure, and to improve survival after a heart attack. It helps relax blood vessels, allowing blood to flow more easily.

Uses & Indications

Hypertension (high blood pressure)

Heart failure

Acute myocardial infarction (heart attack)

Diabetic nephropathy (kidney disease in diabetes)

Dosage

Adults

Hypertension: Initial dose 10 mg once daily. Maintenance dose typically 20-40 mg once daily. Heart failure: Initial dose 2.5-5 mg once daily, gradually increased as tolerated, maximum 35 mg once daily. Acute MI: Initial dose 5 mg within 24 hours, followed by 5 mg after 24 hours, then 10 mg after 48 hours, continued for 6 weeks.

Elderly

Lower initial doses (e.g., 2.5-5 mg) may be considered, especially if renal function is compromised. Dose should be titrated carefully.

Renal_impairment

Initial dose should be adjusted based on creatinine clearance. For creatinine clearance <30 mL/min, initial dose is 2.5 mg once daily. Monitor renal function closely.

How to Take

Lipril 10 mg tablet should be taken orally, once daily. It can be taken with or without food. It is recommended to take it at the same time each day.

Mechanism of Action

Lisinopril inhibits the angiotensin-converting enzyme (ACE), which prevents the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor and stimulates aldosterone secretion. By reducing angiotensin II, lisinopril causes vasodilation, decreases systemic vascular resistance, and reduces sodium and water retention, thereby lowering blood pressure and reducing cardiac workload.

Pharmacokinetics

Onset

Within 1 hour

Excretion

Primarily excreted unchanged by the kidneys in urine.

Half life

Effective half-life for accumulation is approximately 12 hours. Terminal half-life is longer due to slow elimination from ACE binding sites.

Absorption

Oral absorption is variable and incomplete, approximately 25% bioavailability. Peak plasma concentrations reached within 6-8 hours.

Metabolism

Not metabolized in the liver; excreted unchanged.

Side Effects

Contraindications

Hypersensitivity to lisinopril or any other ACE inhibitor.
History of angioedema related to previous ACE inhibitor treatment.
Hereditary or idiopathic angioedema.
Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment.
Pregnancy (especially 2nd and 3rd trimesters).

Drug Interactions

Lithium

Increased serum lithium concentrations and symptoms of lithium toxicity.

Aliskiren

Contraindicated in diabetic patients or those with renal impairment (GFR <60 mL/min/1.73m²) due to increased risk of hypotension, hyperkalemia, and renal dysfunction.

Diuretics

Increased hypotensive effect. Dose reduction of diuretic or lisinopril may be necessary.

Non-steroidal anti-inflammatory drugs (NSAIDs)

May reduce the hypotensive effect of lisinopril and increase the risk of renal impairment, especially in elderly or dehydrated patients.

Potassium-sparing diuretics, potassium supplements, or potassium-containing salt substitutes

Increased risk of hyperkalemia. Monitor serum potassium levels.

Storage

Store below 30°C, in a dry place, protected from light and moisture. Keep out of reach of children.

Overdose

Symptoms of overdose include severe hypotension (low blood pressure) with possible bradycardia or tachycardia, electrolyte disturbances, and renal failure. Management involves supportive measures, including intravenous fluid administration for hypotension. Vasopressors may be used if needed. Lisinopril can be removed from systemic circulation by hemodialysis.

Pregnancy & Lactation

Pregnancy Category D (2nd and 3rd trimesters), Category C (1st trimester). Not recommended during pregnancy, especially in the 2nd and 3rd trimesters, due to significant risk of fetal injury and death. Discontinue if pregnancy is detected. Not recommended during breastfeeding due to potential risks to the infant, though limited data suggest low levels in breast milk.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets per blister, 3 blisters per box (30 tablets)

Shelf Life

Typically 2 to 3 years from the date of manufacture. Refer to the packaging for specific expiry date.

Availability

Pharmacies, hospitals

Approval Status

Approved by major regulatory bodies (e.g., FDA, DGDA)

Patent Status

Generic available

WHO Essential Medicine

Yes

Clinical Trials

Lisinopril has undergone extensive clinical trials demonstrating its efficacy and safety in the treatment of hypertension, heart failure, and post-myocardial infarction.

Lab Monitoring

Blood pressure regularly.
Renal function (serum creatinine, blood urea nitrogen - BUN) periodically, especially at initiation and dose escalation.
Serum potassium levels periodically, especially in patients at risk of hyperkalemia (e.g., renal impairment, concomitant potassium-sparing diuretics).

Doctor Notes

Monitor blood pressure, renal function (creatinine, BUN), and serum potassium levels regularly, especially when initiating therapy or adjusting dosage.
Counsel patients on the importance of adherence to therapy and the potential for angioedema. Instruct them to seek immediate medical attention if angioedema symptoms occur.
Consider alternative antihypertensive agents if a persistent troublesome cough develops.

Patient Guidelines

Take Lipril 10 mg exactly as prescribed by your doctor.
Do not stop taking this medicine suddenly without consulting your doctor, even if you feel well.
Report any signs of swelling of the face, lips, tongue, or throat immediately to your doctor as this could be a serious side effect (angioedema).
Inform your doctor if you experience a persistent dry cough.
Avoid potassium-rich foods or salt substitutes containing potassium unless advised by your doctor.

Missed Dose Advice

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Driving Precautions

Lipril 10 mg may cause dizziness or lightheadedness, especially when starting treatment, increasing the dose, or standing up suddenly. Exercise caution when driving or operating machinery until you know how the medicine affects you.