Instruction for use
Diroton (lisinopril) is an angiotensin converting factor (ACE). Interrupts the chain formation of angiotensin II from angiotensin I. lisinopril reduces vasoconstrictor effect of angiotensin II, reduces concentration in plasma aldosterone.
Reduces the amount predserdno resistance. Does not affect the heart rate, this increases the minute volume of blood. Renal blood flow under the influence of lisinopril increases. The maximum effect is observed after 6 h and lasts about a day after application. Duration of lisinopril corresponds to the dosage of the drug. Long-term use efficiency is not reduced.
Lisinopril absorbed from the gastrointestinal tract, enters the blood plasma where protein does not bind. Bioavailability of 25-30%. The intake of food during ingestion does not alter the rate of absorption of lisinopril. The duration of excretion of the drug is 12 hours. The body's metabolism does not happen – is excreted unchanged in the urine. Withdrawal syndrome upon sudden discontinuation of lisinopril does not develop.
Indications for use
Used as monotherapy or as part of complex treatment of arterial hypertension. In chronic heart failure is used as additional therapy in case of treatment with digitalis and/or diuretics.
Method of application
Lisinopril in essential hypertension taking 10 mg/day. (as seed treatment). Maintenance dosage is 20 mg/day. The maximum daily dose is 40 mg. the Maximum effect of the drug is achieved after 2-4 weeks of continuous use, which should be considered in case of insufficient severity of the antihypertensive effect and the desire to increase the dosage.
In the absence of the effect of treatment with dirotonom maximum daily dose it is necessary to use another drug to reduce the pressure. You must cancel the diuretic drugs (if they were received by the patient) 2-3 days before taking lisinopril. If this cannot be done – the starting dose of lisinopril should be reduced to 5 mg/day.
Renovascular hypertension or hyperfunction of the renin-angiotensin-aldosterone system: a starting dose of 2.5-5 mg/day., maintenance dose depends on the blood pressure level.
In the case of heart failure using a combination of lisinopril with diuretics and/or digitalis preparations. However, it is recommended the diuretic dose reduced.
In renal failure or in the case of chronic haemodialysis the starting dose depends on creatinine clearance. The clearance of 30-70 ml/min 5-10 mg/day, in 10-30 ml/min 2.5-5 mg/day, with the clearance less than 10 ml/min – 2.5 mg/day. lisinopril. Maintenance dose depends on the blood pressure level. The necessary monitoring of the functional state of the kidneys, the content of potassium and sodium in the serum.
Lisinopril take 1 times a day, squeezed small amounts of water. We recommend taking the same time regardless of meals, preferably in the morning.
Cardiovascular system: orthostatic collapse, chest pain.
Central nervous system: pain headaches, dizziness.
Gastrointestinal tract: dyspepsia, vomiting, nausea.
Allergic reactions: rash, itching, angioedema.
Blood formation: a decrease in hemoglobin, decrease in the number of gematokritnogo, agranulocytosis, accelerated erythrocyte sedimentation rate (often occurs only with prolonged use).
Pattern of serum biochemical indicators: increased creatinine, increased potassium, urea nitrogen (occurs more frequently in diabetes, renal disease, renovascular hypertension).
Other effects: General weakness, pain in the joints.
• Are allergic to lisinopril or other inhibitors of angiotensin-converting factor;
• primary aldosteronism;
• condition after surgery for kidney transplantation;
• stenosis of renal arteries on one or both sides with the presence of azotemia;
• stenosis of the artery only kidneys;
• decompensated renal failure;
• changes in biochemical parameters (increased levels of potassium, asteniceski syndrome);
• children under 16 years of age;
• stenosis of estuary of aorta;
• hypersensitivity to the drug or to other angiotensin-converting factor.
Lisinopril teratogenic effect. Use during pregnancy is strictly forbidden (or used exclusively for health reasons). If necessary, the appointment during lactation breastfeeding you want to cancel.
Receiving lisinopril together with spironolactone, amiloride, triamterene and other potassium-sparing diuretics, potassium-containing drugs increases the risk of giperkaliemii. It should also be considered when ingestion of salt substitutes that contain potassium. Most often, hyperkalemia develops in patients with impaired renal function. In the case of a combination of these drugs, the necessary laboratory monitoring of potassium levels in the blood and monitoring of renal function.
Concomitant use of antihypertensive drugs, diuretics lisinopril antihypertensive effects lisinopril potentiated. NSAIDs (especially indometacin) – reduce the antihypertensive effect of lisinopril.
The effects of ethanol potenziruetsa lisinopril. When you receive a lithium-containing medicines decrease the excretion of lithium (recommended monitoring of lithium levels while receiving dirotona).
In case of overdose of lisinopril observed hypotension. Treatment is symptomatic, correction of water-electrolyte balance. In severe cases require hemodialysis.
Tablets of 5, 10, 20 mg.
Dry dark place, protected from children, at temperatures from 25 to 30°C. is Sold only by prescription. Shelf life not more than 3 years.
Active ingredient: lisinopril.
Auxiliary ingredients: starch, magnesium stearate, mannitol, dihydrate calcium hydrogen phosphate.
Active substance: Lisinopril
Lisinopril is used with caution in case of excessive fluid loss through sweat, vomiting, diarrhea, when using diuretics. In such cases, there is an increased risk of arterial hypotension. The drug should stabilize the electrolyte composition of the blood and restore the lack of fluid. Patients elderly prescribed with caution. Kidney function can deteriorate significantly in the case of renal artery stenosis, grave violations of water-electrolyte balance. Renal failure, which may develop reversible (the drug should be discontinued).
The possibility of taking lisinopril while driving a car or managing a complex machine is decided individually after evaluating the patient response to the drug.