Zestril: Effective Angiotensin-Converting Enzyme Inhibition for Hypertension Control
Zestril
| Product dosage: 10mg | |||
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| Product dosage: 2.5mg | |||
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| Product dosage: 5mg | |||
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Synonyms | |||
Zestril (lisinopril) is a prescription angiotensin-converting enzyme (ACE) inhibitor medication designed for the management of hypertension and heart failure, as well as for improving survival after a heart attack. It functions by relaxing blood vessels, allowing blood to flow more smoothly and the heart to pump more efficiently. This medication is a cornerstone in cardiovascular therapeutic regimens, supported by extensive clinical evidence and trusted by healthcare professionals globally for its efficacy and well-established safety profile when used as directed.
Features
- Active ingredient: Lisinopril
- Available in tablet formulations: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, 40 mg
- Administration: Oral, once-daily dosing
- Mechanism: Selective inhibition of angiotensin-converting enzyme (ACE)
- Onset of action: Within 1 hour; peak effect at 6 hours
- Duration: 24-hour antihypertensive effect
- Bioavailability: Approximately 25%, not significantly affected by food
- Elimination half-life: 12 hours
- Excretion: Primarily renal
Benefits
- Significantly lowers both systolic and diastolic blood pressure, reducing long-term cardiovascular risk.
- Decreases afterload on the heart, improving symptoms and functional capacity in patients with heart failure.
- Shown to increase survival rates post-myocardial infarction when initiated within 24 hours.
- Offers renal protective effects in hypertensive patients with diabetes, slowing the progression of diabetic nephropathy.
- Convenient once-daily dosing supports medication adherence and consistent therapeutic coverage.
- Well-tolerated profile with a lower incidence of certain metabolic side effects compared to other antihypertensive classes.
Common use
Zestril is primarily indicated for the treatment of hypertension in adults and pediatric patients 6 years and older, either as monotherapy or in combination with other antihypertensive agents. It is also approved for the management of heart failure, adjunctive therapy in hemodynamically stable patients within 24 hours of acute myocardial infarction to improve survival, and for the treatment of diabetic nephropathy in hypertensive patients with type 1 diabetes.
Dosage and direction
The dosage of Zestril must be individualized based on the patient’s clinical condition and renal function. For hypertension in adults not on a diuretic, the initial dose is 10 mg once daily; maintenance dose is 20–40 mg once daily. In heart failure, start with 5 mg once daily under close medical supervision. Post-myocardial infarction, start with 5 mg within 24 hours, then 5 mg after 24 hours, 10 mg thereafter daily. For pediatric hypertensive patients (≥6 years), the dose is based on body weight. Tablets should be taken orally, with or without food, at approximately the same time each day. Dosage adjustment is necessary in patients with renal impairment.
Precautions
Patients should be monitored for hypotension, especially after the initial dose or dosage increase. Assess renal function and serum potassium before and during treatment. Use with caution in patients with renal artery stenosis, collagen vascular disease, or on dialysis with high-flux membranes. Angioedema has been reported; discontinue immediately if involvement of the tongue, glottis, or larynx occurs. Avoid use during pregnancy due to risk of fetal injury. Caution advised in surgery or anesthesia. Patients should report persistent dry cough, signs of infection, or symptoms of hyperkalemia.
Contraindications
Zestril is contraindicated in patients with a history of angioedema related to previous ACE inhibitor treatment, hereditary or idiopathic angioedema, or hypersensitivity to lisinopril or any component of the formulation. Do not co-administer with aliskiren in patients with diabetes. Contraindicated in patients with bilateral renal artery stenosis or solitary kidney with renal artery stenosis.
Possible side effect
Common adverse reactions include dizziness (6–12%), headache (5–6%), cough (3–9%), fatigue (3–5%), and nausea (2–4%). Less frequently, orthostatic hypotension, rash, impotence, diarrhea, and taste disturbance may occur. Serious side effects can include angioedema, hyperkalemia, renal impairment, neutropenia/agranulocytosis, and hepatic failure. Monitor for signs and symptoms and report any severe or persistent reactions to a healthcare provider.
Drug interaction
Concomitant use with diuretics may increase risk of hypotension. Potassium supplements, potassium-sparing diuretics, or salt substitutes containing potassium may lead to hyperkalemia. NSAIDs may diminish the antihypertensive effect and increase risk of renal dysfunction. Dual blockade of the renin-angiotensin system with ARBs, aliskiren, or other ACE inhibitors increases risks of hypotension, hyperkalemia, and renal impairment. Lithium levels may increase. Antidiabetic agents may require dosage adjustment. Gold injections may cause nitritoid reactions.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. If it is near the time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. Consistent daily administration is important for maintaining stable blood pressure control.
Overdose
Symptoms of overdose may include severe hypotension, bradycardia, circulatory shock, hyperkalemia, renal failure, and electrolyte disturbances. Management involves supportive measures, including volume expansion with normal saline for hypotension. Lisinopril is poorly removed by hemodialysis. Administer appropriate monitoring and symptomatic treatment under medical supervision.
Storage
Store Zestril tablets at controlled room temperature, 20–25°C (68–77°F), with excursions permitted between 15–30°C (59–86°F). Keep in the original container, tightly closed, and protect from moisture and light. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read here. Individual patient responses and necessary dosages may vary.
Reviews
Clinical trials and post-marketing surveillance have consistently demonstrated Zestril’s efficacy in blood pressure control and cardiovascular risk reduction. In the ATLAS trial, high-dose lisinopril significantly reduced mortality and hospitalization in heart failure patients. Many healthcare professionals regard it as a reliable first-line agent due to its proven benefits and manageable side effect profile. Patient reviews often highlight effective hypertension management, though some note the persistent dry cough as a reason for discontinuation. Adherence is generally high due to once-daily dosing. Always consult a healthcare professional for personalized assessment.