Irumed (Lisinopril)

Lisinopril belongs to the ACE inhibitor class and is used to manage conditions linked to the renin‑angiotensin‑aldosterone system.

• Hypertension: reduces elevated blood pressure and lowers cardiovascular risk.
• Heart failure: improves symptoms and decreases hospitalization rates.
• Post‑myocardial infarction ventricular dysfunction: helps prevent remodeling and further cardiac events.

• Lisinopril inhibits the angiotensin‑converting enzyme (ACE), preventing the conversion of angiotensin I to the vasoconstrictor angiotensin II and reducing aldosterone secretion. This results in vasodilation, decreased peripheral resistance, and lowered blood pressure, while also diminishing cardiac workload.

Lisinopril may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Cough: persistent dry cough.
• Dizziness or light‑headedness, especially after standing.
• Headache.
• Fatigue.
• Mild hypotension.
• Elevated blood potassium levels.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue, or throat.
• Severe hypotension leading to fainting.
• Acute kidney injury or worsening renal function.
• Hyperkalemia with potentially dangerous cardiac effects.
• Hepatic dysfunction.
• Neutropenia or other blood dyscrasias.

Before initiating therapy, several safety considerations are recommended.

• Blood pressure monitoring: check regularly to avoid excessive hypotension.
• Renal function assessment: evaluate serum creatinine and eGFR before and during treatment.
• Serum potassium: monitor especially if combined with potassium‑sparing agents.
• History of angioedema: avoid use in patients with prior episodes.
• Elderly patients: start at lower doses and titrate cautiously.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Lisinopril can interact with several drug classes, requiring attention to avoid adverse outcomes.

Major Interactions (Avoid)

• Concomitant use with aliskiren in diabetic patients.
• Combination with other ACE inhibitors, ARBs, or direct renin inhibitors.
• Potassium‑sparing diuretics or potassium supplements leading to hyperkalemia.

Moderate Interactions (Monitor Closely):\n- Non‑steroidal anti‑inflammatory drugs (NSAIDs) may blunt antihypertensive effect.

• Loop or thiazide diuretics: may increase risk of hypotension.
• Lithium: increased lithium levels and toxicity risk.
• Gold therapy: may enhance nephrotoxic potential.
• Certain antibiotics (e.g., trimethoprim‑sulfamethoxazole) affecting renal function.