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Operational Medicine 2001
Lisinopril (Prinivil, Zestril)

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Category:

  • Anytihypertensive

Description:

  • Angiotensin-converting enzyme (ACE) inhibitor

Indications:

  • Hypertension

  • CHF

  • Acute MI

  • Diabetic nephropathy (non FDA approved)

Precautions:

  • Pregnancy category C (1st trimester), D (2nd and 3rd trimester); ACE inhibitors can cause fetal and neonatal morbidity and death when administered to pregnant women

  • Impaired renal function, dialysis patients, hypovolemia

  • Diuretic therapy, collagen-vascular diseases, elderly, bilateral renal artery stenosis

Adverse Reactions (Side Effects):

  • CNS: anxiety, dizziness, fatigue, headache, insomnia, paresthesia

  • CV: angina, hypotension, palpitations, postural hypotension, syncope (especially with 1st dose)

  • GI: abdominal pain, constipation, melena, nausea, vomiting

  • GU: acute renal failure, decreased libido, impotence, increased BUN, creatinine

  • HEME: agranulocytosis, neutropenia

  • METAB: hyperkalemia, hyponatremia

  • MS: arthralgia, arthritis, myalgia

  • RESP: asthma, bronchitis, cough, dyspnea, sinusitis

  • SKIN: angioedema, flushing, rash, sweating

 

Dosage:

Administered orally

  • Adult:            

    • Hypertension: PO 10mg daily; usual dose 20-40mg daily

    • CHF: PO 5mg daily; usual range 5-20mg daily

    • Acute MI: PO in hemodynamically stable patients within 24 hours of acute MI, 5mg followed by 5mg after 24 hours, 10mg after 48 hours, then 10mg daily; continue 6 weeks (or longer if concurrent hypertension or CHF)

    • Renal impairment: PO initial dose 5mg daily (serum creatinine > or = to 3 mg/dl); initial dose 2.5mg daily (dialysis patients)

Drug interactions:

  • Allopurinol: predisposition to hypersensitivity reactions to ACE inhibitors

  • Aspirin, NSAIDs: inhibition of the antihypertensive response to ACE inhibitors

  • Prazosin, terazosin, doxazosin: exaggerated first-dose hypotensive response to a-blockers

Approved for public release; Distribution is unlimited.

The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. 

Operational Medicine 2001

Health Care in Military Settings

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001

 United States Special Operations Command
7701 Tampa Point Blvd.
MacDill AFB, Florida
33621-5323

*This web version is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

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