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Prinivil

Pronunciation

Generic Name: lisinopril (Oral route)

lye-SIN-oh-pril

Oral route(Tablet)

When pregnancy is detected, discontinue lisinopril as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus .

Commonly used brand name(s)

In the U.S.

  • Prinivil
  • Zestril

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antihypertensive

Pharmacologic Class: ACE Inhibitor

Uses For Prinivil

Lisinopril is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure can reduce the risk of strokes and heart attacks.

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Lisinopril works by blocking a substance in the body that causes the blood vessels to tighten. As a result, lisinopril relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

Lisinopril is also used to help treat heart failure. It is also used in some patients after a heart attack. After a heart attack, some of the heart muscle is damaged and weakened. The heart muscle may continue to weaken as time goes by. This makes it more difficult for the heart to pump blood. Lisinopril may be started within 24 hours after a heart attack to increase survival rate.

This medicine is available only with your doctor's prescription.

Before Using Prinivil

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of lisinopril to treat hypertension in children 6 to 16 years of age. However, safety and efficacy have not been established in children younger than 6 years of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of lisinopril in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving lisinopril.

Pregnancy

Pregnancy Category Explanation
All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Aliskiren

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alteplase, Recombinant
  • Amiloride
  • Azathioprine
  • Azilsartan
  • Candesartan Cilexetil
  • Canrenoate
  • Eplerenone
  • Eprosartan
  • Irbesartan
  • Losartan
  • Olmesartan Medoxomil
  • Potassium
  • Spironolactone
  • Telmisartan
  • Triamterene
  • Valsartan

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aceclofenac
  • Acemetacin
  • Amtolmetin Guacil
  • Aspirin
  • Azosemide
  • Bemetizide
  • Bendroflumethiazide
  • Benzthiazide
  • Bromfenac
  • Bufexamac
  • Bumetanide
  • Bupivacaine
  • Bupivacaine Liposome
  • Buthiazide
  • Capsaicin
  • Celecoxib
  • Chlorothiazide
  • Chlorthalidone
  • Choline Salicylate
  • Clonixin
  • Clopamide
  • Cyclopenthiazide
  • Cyclothiazide
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyrone
  • Ethacrynic Acid
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Furosemide
  • Gold Sodium Thiomalate
  • Hydrochlorothiazide
  • Hydroflumethiazide
  • Ibuprofen
  • Ibuprofen Lysine
  • Indapamide
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Lithium
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Methyclothiazide
  • Metolazone
  • Morniflumate
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Nesiritide
  • Niflumic Acid
  • Nimesulide
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Phenylbutazone
  • Piketoprofen
  • Piretanide
  • Piroxicam
  • Polythiazide
  • Pranoprofen
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Quinethazone
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sodium Salicylate
  • Sulindac
  • Tenoxicam
  • Tiaprofenic Acid
  • Tizanidine
  • Tolfenamic Acid
  • Tolmetin
  • Torsemide
  • Trichlormethiazide
  • Valdecoxib
  • Xipamide

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Angioedema (swelling of the face, lips, tongue, throat, arms, or legs) with other ACE inhibitors, history of—May increase risk of this condition occurring again.
  • Collagen vascular disease (an autoimmune disease) together with kidney disease—Increased risk of blood problems.
  • Diabetes or
  • Kidney problems—Increased risk of potassium levels in the body becoming too high.
  • Diabetes patients who are also taking aliskiren (Tekturna®) or
  • Hereditary or idiopathic angioedema or
  • Patients who have kidney problems and are also taking aliskiren (Tekturna®)—Should not be used in patients with these conditions.
  • Electrolyte imbalance (eg, low sodium in the blood) or
  • Fluid imbalances (caused by dehydration, vomiting, or diarrhea) or
  • Heart or blood vessel problems (eg, aortic stenosis, hypertrophic cardiomyopathy) or
  • Liver disease—Use with caution. May make these conditions worse.

Proper Use of lisinopril

This section provides information on the proper use of a number of products that contain lisinopril. It may not be specific to Prinivil. Please read with care.

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

If your child cannot swallow the tablets, an oral liquid may be given. Shake the oral liquid well just before each use. Ask your doctor or pharmacist about this.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For high blood pressure:
      • Adults—At first, 10 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 40 mg per day.
      • Children 6 years of age and older—Dose is based on body weight and must be determined by your doctor. The starting dose is usually 0.07 mg per kilogram (kg) of body weight per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 0.61 mg per kg of body weight or 40 mg per day.
      • Children younger than 6 years of age—Use is not recommended.
    • For heart failure:
      • Adults—At first, 5 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 40 mg per day.
      • Children—Use and dose must be determined by your doctor.
    • For immediate treatment after a heart attack:
      • Adults—At first, 5 milligrams (mg), followed by 5 mg after 24 hours, followed by 10 mg after 48 hours, and then 10 mg once a day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Store the mixed oral liquid at or below room temperature for up to 4 weeks.

Precautions While Using Prinivil

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.

This medicine may cause serious types of allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.

Call your doctor right away if you have severe stomach pain (with or without nausea or vomiting). This could be a symptom of intestinal angioedema.

Dizziness, lightheadedness, or fainting may also occur, especially when you get up from a lying or sitting position or if you have been taking a diuretic (water pill). Make sure you know how you react to the medicine before you drive, use machines, or do other things that could be dangerous if you are dizzy or not alert. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water or salt and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

Check with your doctor if you have a fever, chills, or sore throat. These could be symptoms of an infection resulting from low white blood cells.

Hyperkalemia (high potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have the following symptoms: abdominal or stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, shortness of breath, or weakness or heaviness of the legs. Do not use supplements or salt substitutes containing potassium without first checking with your doctor.

Check with your doctor right away if you have upper stomach pain, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests, or if you have any questions, check with your doctor.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery.

This medicine may be less effective in black patients. Black patients also have an increased risk of angioedema (swelling of the hands, arms, face, mouth, or throat).

Do not take other medicines unless they have been discussed with your doctor. This includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

Prinivil Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Blurred vision
  • cloudy urine
  • confusion
  • decrease in urine output or decrease in urine-concentrating ability
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • sweating
  • unusual tiredness or weakness
Less common
  • Abdominal or stomach pain
  • body aches or pain
  • chest pain
  • chills
  • common cold
  • cough
  • diarrhea
  • difficulty breathing
  • ear congestion
  • fever
  • headache
  • loss of voice
  • nasal congestion
  • nausea
  • runny nose
  • sneezing
  • sore throat
  • vomiting
Rare
  • Arm, back, or jaw pain
  • chest discomfort, tightness, or heaviness
  • fast or irregular heartbeat
  • general feeling of discomfort or illness
  • joint pain
  • loss of appetite
  • muscle aches and pains
  • shivering
  • trouble sleeping

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
  • Decreased interest in sexual intercourse
  • inability to have or keep an erection
  • lack or loss of strength
  • loss in sexual ability, desire, drive, or performance
  • rash
Rare
  • Acid or sour stomach
  • belching
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • feeling of constant movement of self or surroundings
  • heartburn
  • indigestion
  • muscle cramps
  • sensation of spinning
  • stomach discomfort or upset
  • swelling

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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