Lisinopril
Active material: Lisinopril
When ATH: C09AA03
CCF: ACE inhibitor
When CSF: 01.04.01.02
Manufacturer: ALSI Pharma Company Inc. (Russia)
Pharmaceutical form, composition and packaging
Pills white or nearly white colors, Valium, a facet and Valium.
| 1 tab. | |
| Lisinopril (in the form of dihydrate) | 10 mg |
Excipients: lactose, microcrystalline cellulose, starch 1500 (pregelatinized), colloidal silicon dioxide (aэrosyl), talc, magnesium stearate.
10 PC. – packings Valium planimetric (1) – packs cardboard.
10 PC. – packings Valium planimetric (2) – packs cardboard.
10 PC. – packings Valium planimetric (3) – packs cardboard.
10 PC. – packings Valium planimetric (4) – packs cardboard.
10 PC. – packings Valium planimetric (5) – packs cardboard.
Pills white or nearly white, Valium, a facet and Valium.
| 1 tab. | |
| Lisinopril (in the form of dihydrate) | 20 mg |
Excipients: lactose, microcrystalline cellulose, starch 1500 (pregelatinized), colloidal silicon dioxide (aэrosyl), talc, magnesium stearate.
10 PC. – packings Valium planimetric (1) – packs cardboard.
10 PC. – packings Valium planimetric (2) – packs cardboard.
10 PC. – packings Valium planimetric (3) – packs cardboard.
10 PC. – packings Valium planimetric (4) – packs cardboard.
10 PC. – packings Valium planimetric (5) – packs cardboard.
Pills white or nearly white, Valium, chamfered.
| 1 tab. | |
| Lisinopril (in the form of dihydrate) | 5 mg |
Excipients: lactose, microcrystalline cellulose, starch 1500 (pregelatinized), colloidal silicon dioxide (aэrosyl), talc, magnesium stearate.
10 PC. – packings Valium planimetric (1) – packs cardboard.
10 PC. – packings Valium planimetric (2) – packs cardboard.
10 PC. – packings Valium planimetric (3) – packs cardboard.
10 PC. – packings Valium planimetric (4) – packs cardboard.
10 PC. – packings Valium planimetric (5) – packs cardboard.
DESCRIPTION OF ACTIVE SUBSTANCES
Pharmacological action
ACE inhibitor. Antigipertenzivnogo mechanism of action is related to the inhibition of ENZYME activity, which leads to a decrease in the rate conversion of angiotensin I to angiotensin II (which has a strong vasoconstrictive effect and stimulates the secretion of aldosterone in the adrenal cortex). As a result, reduce the formation angiotenzina II occurs secondary increase of plasma Renin activity by eliminating negative feedback when released Renin and aldosterone secretion reduced direct. Reduced aldosterone secretion may contribute to an increase in the concentration of potassium.
Decreases round (afterload), wedge pressure in the pulmonary capillaries (preload) and pulmonary vascular resistance, improves cardiac output and exercise tolerance.
Pharmacokinetics
After intake of lisinopril slowly and incompletely absorbed from the digestive tract. Absorption averages 25%, It is characterized by high variability – 6-60%. Cmax plasma is approximately 7 no. Plasma protein binding is negligible. Excreted unchanged in the urine. In patients with normal renal function T1/2 is 12 no.
Lisinopril is excreted from the body by hemodialysis.
Testimony
Arterial hypertension (incl. renovascular); congestive heart failure (in a combination therapy).
Dosage regimen
Individual, depending on the evidence, regimens, renal function. The initial dose 2.5 mg 1 time / day. Maintenance doses 5-20 mg.
Side effect
Cardio-vascular system: possible arterial gipotenzia, chest pain.
CNS: dizziness, headache, muscular weakness.
From the digestive system: diarrhea, nausea, vomiting.
The respiratory system: dry cough.
From the hematopoietic system: agranulocytosis, decrease in hemoglobin and hematocrit (especially in the long admission); in a few cases – increased erythrocyte sedimentation rate.
From the water-electrolyte metabolism: hyperkalemia.
Metabolism: increased creatinine, BUN (especially in patients with renal diseases, diabetes, renovascular hypertension).
Allergic reactions: skin rash, angioedema.
Other: in a few cases – arthralgia.
Contraindications
Pregnancy, hypersensitivity to lizinoprilu or other AGENTS.
Pregnancy and lactation
Lisinopril is contraindicated for use in pregnancy.
Unknown, is allocated whether lisinopril with breast milk. Be wary of lactation (breast-feeding).
Cautions
Lisinopril should not be used in patients with aortic stenosis, pulmonary heart. Do not use in patients with acute myocardial infarction: with the threat of serious violations hemodynamics, involving the use of vazodilatatora; renal impairment.
Before and during therapy should monitor kidney function.
Before starting treatment with lisinopril should compensate for the loss of fluids and salts.
With the utmost care use in patients with the human kidney, Renal artery stenosis, severe congestive heart failure.
The likelihood of arterial hypotension increases in fluid loss due to diuretic therapy, diet with salt restriction, nausea, vomiting.
In patients with congestive heart failure with normal or slightly reduced HELL lisinopril may cause expressed arterial hypotension.
Not recommended simultaneous application of lisinopril with kalisberegatmi dioretikami, Food supplements and substitutes for salt, containing potassium.
Together with the use of lisinopril with drugs lithium should monitor the concentration of lithium in the blood plasma.
Drug Interactions
If you are applying with antigipertenzivei means possible additive antihypertensive effect.
While the use of potassium-sparing diuretics (spironolactone, Triamteren, amiloridom), potassium supplements, Salt substitutes, containing potassium, increased risk of hyperkalemia, especially in patients with impaired renal function.
Together with the use of ACE inhibitors and NSAIDS increases the risk of kidney function, rarely observed hyperkalemia.
While applying the petlevami dioretikami, tiazidnami dioretikami amplified antihypertensive. The emergence of arterial expressed hypotension, especially after the first dose of the diuretic, It is, apparently, by hypovolemia, which leads to a transitory strengthening gipotenzivnogo effect lisinopril. Increased risk of kidney function.
Together with the use of indomethacin reduces the antihypertensive effect of lisinopril, apparently, influenced by inhibiting prostaglandin synthesis NSAIDS (that, believed, play a role in the development of hypotensive effect of ACE inhibitors).
Together with the use of insulin, sulfonylurea hypoglycemic agents may develop hypoglycemia due to increase glucose tolerance.
If you are applying with klozapinom clozapine concentrations in plasma.
Together with the use of lithium carbonate lithium concentration increases in serum, accompanied by symptoms of lithium intoxication.
Describes the case of severe hyperkalemia in the patient with diabetes together with lovastatinom.
Describes a case of severe arterial hypotension, together with the application pergolidom.
Together with the use of ethanol is enhanced by the action of ethanol.
