what is lisinopril?

About Lisinopril pills in different forms
Drug class
Antihypertensive
ACE inhibitors
Finished products (selection)
Zestril ®
Lisibeta ®
LisiHEXAL ®
Effect
Lisinopril inhibits angiotensin-converting enzyme, angiotensin I into
angiotensin II leads. The formation of angiotensin II, one of the
strongest blood pressure-enhancing drugs is suppressed, and as a
consequence of reduced peripheral resistance. Lisinopril is in
hypertension, heart failure, hypertension, used with incipient
diabetic nephropathy, and acute myocardial infarction.
Mechanism of action
General information about the mechanism of action of ACE inhibitors
can be found here.
Lisinopril is a lysine derivative of enalaprilat, the active
metabolite of the ACE inhibitor enalapril. In contrast to most of the
ACE inhibitors captopril and similar to lisinopril is not a prodrug,
but an independently active substance.
Lisinopril is used in combination with thrombolytics, aspirin and / or
beta-blockers for the treatment of acute myocardial infarction in
stable blood pressure, but can be used independently of ventricular
function. In studies, a significant increase in survival was observed.
Here, the negative consequence of myocardial infarction in the role of
angiotensin II is reduced, which is mainly in an increased oxygen
demand of the heart muscle, and thus expresses an increased necrosis
of myocytes. Especially when lisinopril is given together with
nitrates, the formation of a left ventricular dysfunction or heart
failure can be prevented or reduced.
At the recommended daily dose remains the antihypertensive effect is
maintained even during long-term therapy. I.d.R. it came into clinical
trials may not be clinically relevant changes in renal plasma flow and
glomerular filtration rate.
In hypertensive patients with type II diabetes mellitus and incipient
nephropathy (microalbuminuria) is in lisinopril not only reduced blood
pressure but also the excretion of albumin in reduced urine by about
40% (reference to an additional direct effect on the kidney tissue).
Lisinopril treatment does not affect the control of blood glucose levels.
Contraindications (contraindications)
The following are absolute Gegenanzeiegn (situations in which the drug
should be administered in any case) and relative contraindications
(situations in which the drug should be administered with caution)
listed. For more information or answers to your questions please use
the forum or ask your doctor or pharmacist.
Absolute contraindications
- Hypersensitivity to lisinopril or another ACE inhibitor
- A history of angioedema related to previous therapy with ACE inhibitors
- Hereditary or idiopathic angioedema
- State shortly after kidney transplantation
- 2 or 3 Trimester of pregnancy
- Age <18 years
Indication of acute myocardial infarction, in addition:
- Cardiogenic shock
- Systolic blood pressure <= 100 mm Hg at baseline
- Symptoms of renal impairment (serum creatinine> 177 micromol / l and
proteinuria or greater than 500 mg/24 h)
Relative contraindications
- Impaired immune response or Gefäßkollagenosen
- Volume and / or electrolyte deficiency (balancing possible prior to treatment)
- Impaired renal function (creatinine clearance <80 ml / min)
- Severe or renovascular hypertension
- Severe heart failure
- Bilateral renal artery stenosis or renal artery stenosis in a solitary kidney
- Hemodynamically significant aortic or mitral valve stenosis or
hypertrophic cardiomyopathy
- Pre-existing higher risk of symptomatic hypotension
- Ischemic heart disease (myocardial infarction at increased risk of
excessive blood pressure drop)
- Cerebrovascular disease (increased risk of cerebrovascular events
caused by excessive blood pressure drop)
- Breast-feeding
- 1 Trimester of pregnancy (if possible rapid discontinuation of lisinopril)
Side effects (adverse reactions)
This is a complete list of the known side effects, for more
information or answers to your questions please use the forum or ask
your doctor or pharmacist.
Adverse effects, without specifying the frequency
- Skin changes with fever, myalgia, arthralgia, arthritis, vasculitis,
eosinophilia, leukocytosis, elevated ESR and / or increased ANA
titers, photosensitivity
- Depression
- Syncope, arrhythmias
- Constipation


- Fatigue, asthenia
Common adverse reactions (> 1 / 100)
- Orthostatic effects (including hypotension, especially with
pre-existing high risk, such as salt and / or dehydration, heart
failure, or severe renal hypertension, advanced age, especially after
the first dose)
- Dizziness, headache
- Non-productive cough (reversible upon discontinuation)
- Diarrhea, vomiting
- Renal impairment (especially with pre-existing renovascular hypertension)
Uncommon adverse reactions (> 1 / 1000)
- Mood swings, paresthesia, vertigo, taste disturbances, insomnia
- Myocardial infarction or cerebrovascular accident (possibly
secondary to excessive hypotension in high risk pre-existing),
palpitations, tachycardia, Raynaud's syndrome
- Rhinitis
- Nausea, abdominal pain, digestive disorders
- Skin rash, itching
- Impotence
- Fatigue, weakness
(Mellitus especially with pre-existing diabetes, renal failure) rise
in blood urea, serum creatinine (especially on one side with renal
artery stenosis, both sides or a solitary kidney, especially in
pre-existing renal dysfunction, reversible upon discontinuation of
treatment in most cases), increased liver enzymes, hyperkalaemia -
Rare adverse reactions (> 1 / 10000)
- Decrease in hemoglobin, decrease in hematocrit
- Dry mouth
- Allergic / angioneurotic edema (face, extremities, lips, tongue,
glottis and / or larynx), urticaria, alopecia, psoriasis
- Uremia, acute renal failure (especially with pre-existing heart
failure with hypotension, usually reversible)
- Gynecomastia
- Increase of serum bilirubin, hyponatraemia
Very rare adverse reactions (<1 / 10000)
- Bone marrow depression, anemia, thrombocytopenia, leukopenia,
neutropenia, agranulocytosis (usually reversible, occurs primarily in
pre Gefäßkollagenosen or limitations of the immune system in
conjunction with renal dysfunction), hemolytic anemia,
lymphadenopathy, autoimmune disease
- Hypoglycemia
- Mental confusion
- Bronchospasm, sinusitis, allergic alveolitis / eosinophilic pneumonia
- Pancreatitis, intestinal angioedema, hepatitis (hepatocellular or
cholestatic), jaundice, liver failure, hepatic disease (starting with
cholestatic jaundice, progressing up to [possibly fulminant] hepatic
necrosis, possibly with fatal outcome)
- Diaphoresis, pemphigus, toxic epidermal necrolysis, Stevens-Johnson
syndrome, erythema multiforme
- Angioneurotic edema with fatal outcome (especially in operations in
the history of the airways)
- Oliguria, anuria