Lisinopril dosage

In patients with severe CHF whose renal function may depend on the activity of the renin-angiotensin-aldosterone system, treatment with ACEIs may be associated with oliguria or progressive azotemia and, rarely, with acute renal failure or death. Impaired renal function decreases lisinopril elimination. The elimination half-life of quinaprilat increases as Ccr decreases. Dosage adjustment may be necessary for quinapril, benazepril, ramipril, and lisinopril. Impaired renal function decreases... 

The blood pressure of a 59-year-old man with hypertension and normal renal function rose when rofecoxib 25 mg/day was added to lisinopril 10 mg/day (from an average of 135/80-85 to 168/98 mmHg within 5 weeks). Four days after rofecoxib was withdrawn the blood pressure was 127/78 mmHg. Rechallenge with the same dose of rofecoxib produced the same effect and the blood pressure fell when the dosage of lisinopril was increased to 20 mg/day on continuous rofecoxib. The authors did not report on the course of renal function. 

A 68-year-old man who had taken lisinopril 10 mg/day for several years stopped taking it temporarily because of a cough. It was then restarted in a dosage of 5 mg/day and a few days later he developed several bean-sized non-pruritic erythematous plaques with scales over the whole body, particularly on the chest. The appearance was of seborrheic dermatitis, but histology showed the features of erythema multiforme. The eruptions cleared completely a few days after lisinopril withdrawal. Two months later, a rechallenge test was positive. 

Lisinopril (prinivil, zestril) Lisinopril is the Lys analog of enalaprilat unUke enalapril, lisinopiil itself is active. Lisinopril is slightly more potent than enalaprilat. Lisinopril is absorbed slowly, variably, and incompletely (about 30%) after oral administration (bioavailability is not reduced by food) peak concentrations in plasma are achieved in -7 hours. It is cleared intact by the kidney, and its tj, in plasma is about 12 hours. The oral dosage of lisinopril ranges from 5 to 40 mg daily (single or divided dosage), with 5 and 10 mg daily being appropriate for the initiation of therapy for heart failure and hypertension, respectively. A daily dose of 2.5 mg is recommended for patients with heart failure who are Na+-depleted or have renal impairment. 

Methods for the analysis of lisinopril in dosage forms are summarized in Table VIII. Methods (I), (II) and (III) have been developed to separate lisinopril from its principle degradation product, the SSS diketopiperazine (DKP) and a process impurity APBA (see Section 5.2.1). Method... 

However, in 1998 the manufacturers of lansoprazole had on record two reports of possible interactions. An elderly patient taking warfarin developed an INR of 7 when lansoprazole was added. Despite a warfarin dosage adjustment he had a gastrointestinal haemorrhage, a myocardial infarction and died after 3 weeks. Another man taking warfarin (as well as amiodarone, furosemide and lisinopril) became confused, had hallucinations and developed an increased INR (value not known) when given lansoprazole. The lansoprazole was stopped after 4 days, and he then recovered. However, it is uncertain whether this was an interaction or whether he had taken an incorrect warfarin dosage because of his confusion. ... 

Due to the absence of water, which catalyses many chemical reactions, chemical incompatibilities rarely occur in dry dosage forms. One exception is the incompatibility of the excipient lactose with primary amines, such as amphetamine and lisinopril. The rate of the reaction (Maillard reaction) is slow in absence of water, but may lead to yellow discolouration during storage [25]. 

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