Table of Contents
What is Zestril?
Zestril (lisinopril) is prescribed either alone or in conjunction with other medications for the management of high blood pressure in adults and children aged 6 years and older. In adults, Zestril is also employed to address congestive heart failure and enhance survival following a heart attack.
Mechanism of Action
Zestril belongs to the class of angiotensin-converting enzyme (ACE) inhibitors. Its mode of action involves reducing specific chemicals that constrict blood vessels, facilitating smoother blood flow and more efficient pumping of blood by the heart.
Warnings
- Pregnancy: Refrain from using Zestril if pregnant, as it may harm the unborn baby. Cease medication and promptly inform your doctor of pregnancy.
- Angioedema History: Avoid Zestril if a history of angioedema exists. Allow a 36-hour interval before or after taking medications containing sacubitril (e.g., Entresto).
- Diabetes: Do not combine Zestril with any medication containing aliskiren (e.g., Amturnide, Tekturna, Tekamlo) if diabetic. Caution is advised, especially in the presence of kidney disease.
Before Taking this Medicine
- Allergies: Do not use Zestril if allergic to lisinopril or any other ACE inhibitor.
- Sacubitril Medication: Allow a 36-hour gap before or after Zestril if using sacubitril-containing medications.
- Aliskiren Medication: Diabetic patients should avoid Zestril with aliskiren-containing medications, particularly in the presence of kidney disease.
- Medical History: Ensure your doctor is aware of your medical history, including heart disease, recent heart attack, low blood pressure, low white blood cell count, stomach pain, adherence to a low-salt diet, diabetes, liver disease, or kidney disease (including dialysis).
- Pregnancy and Breastfeeding: Zestril can pose risks to the unborn baby; avoid during the second or third trimester of pregnancy. Breastfeeding is not recommended.
Related/Similar Drugs
amlodipine, lisinopril, aspirin, metoprolol, losartan, furosemide, carvedilol
How should I take Zestril?
- Adhere strictly to your doctor’s prescription and read all provided instructions.
- Zestril can be taken with or without food.
- Regular blood pressure checks and frequent blood tests may be necessary.
- Notify your doctor if surgery is planned.
- In case of persistent vomiting, diarrhea, or increased sweating, contact your doctor to mitigate the risk of dehydration.
- Continue Zestril use even if feeling well, especially for managing high blood pressure.
- Store tightly closed at room temperature, avoiding freezing.
Dosing Information
- Hypertension (Adults):
- Initial dose: 10 mg orally once a day; 5 mg orally once a day
- Maintenance dose: 20 to 40 mg orally once a day
- Maximum dose: 80 mg orally once a day
- Note: Adjustments may involve adding a diuretic if blood pressure is not controlled with Zestril alone.
- Congestive Heart Failure (Adults):
- Initial dose: 2.5 to 5 mg orally once a day
- Maintenance dose: Increase dosage as tolerated
- Maximum dose: 40 mg orally once a day
- Myocardial Infarction (Adults):
- Initial dose: 5 mg orally (within 24 hours of the onset of acute myocardial infarction)
- Subsequent doses: 5 mg orally after 24 hours, then 10 mg orally after 48 hours
- Maintenance dose: 10 mg orally once a day for at least 6 weeks
- Diabetic Nephropathy (Adults):
- Initial dose: 10 to 20 mg orally once a day
- Maintenance dose: 20 to 40 mg orally once a day
- Hypertension (Geriatric):
- Initial dose: 2.5 to 5 mg orally once a day
- Maintenance dose: Increase dosages at 2.5 mg to 5 mg per day at 1 to 2-week intervals.
- Maximum dose: 40 mg orally once a day
- Hypertension (Pediatric):
- Initial dose: 0.07 mg/kg orally once a day (Maximum initial dose is 5 mg once a day)
- Maintenance dose: Adjust dosage according to blood pressure response at 1 to 2-week intervals.
- Maximum dose: Doses above 0.61 mg/kg or greater than 40 mg have not been studied in pediatric patients
Missed Dose and Overdose
- Take a missed dose promptly, but skip it if nearly time for the next dose. Avoid doubling doses.
- For an overdose, seek emergency medical attention or contact Poison Help at 1-800-222-1222.
What should I avoid while taking Zestril?
- Rise slowly from sitting or lying positions to prevent dizziness.
- Avoid potassium supplements or salt substitutes unless advised by your doctor.
- Prevent overheating or dehydration, especially during exercise or in hot weather. Follow your doctor’s fluid intake instructions.
Zestril Side Effects
- Seek emergency medical help for signs of allergic reaction: severe stomach pain, hives, difficult breathing, swelling of face, lips, tongue, or throat.
- Serious side effects warranting immediate medical attention include a light-headed feeling, high blood potassium, low white blood cell counts, kidney problems, or liver problems.
- Common side effects may include headache, dizziness, low blood pressure, cough, or chest pain.
What other drugs will affect Zestril?
- Lisinopril can impact kidneys, particularly when used with certain medicines for infections, cancer, or osteoporosis.
- Disclose all other medicines to your doctor, especially diuretics, NSAIDs, insulin or diabetes medications, drugs preventing organ transplant rejection, or heart/blood pressure medications.
Note: This list is not exhaustive; consult your doctor for comprehensive information on potential drug interactions.
Ingredients
- Active ingredient: lisinopril.
- Inactive ingredients:
- 2.5 mg tablets: calcium phosphate, magnesium stearate, mannitol, starch.
- 5, 10, 20, and 30 mg tablets: calcium phosphate, magnesium stearate, mannitol, red ferric oxide, starch.
- 40 mg tablets: calcium phosphate, magnesium stearate, mannitol, starch, yellow ferric oxide.
