LISINOPRIL 2.5 mg, 5 mg, 10 mg and 20 mg TABLETS

Read all of this leaflet carefully before you start taking this medicine.

  • Keep this leaflet. You may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
  • If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

IN THIS LEAFLET:

  1. What Lisinopril is and what it is used for
  2. Before you take Lisinopril
  3. How to take Lisinopril
  4. Possible side effects
  5. How to store Lisinopril
  6. Further information

1. WHAT LISINOPRIL IS AND WHAT IT IS USED FOR

Lisinopril belongs to a group of drugs called angiotensin-converting enzyme (ACE) inhibitors. These tablets are vasodilators (drugs which widen the blood vessels), making it easier for the heart to pump blood around the body. This helps lower blood pressure.

Lisinopril is used:

  • to treat a condition known as symptomatic heart failure where the heart no longer pumps blood as effectively as it should
  • to treat high blood pressure
  • to help prevent any more heart problems in patients who have recently had a heart attack
  • to treat kidney disease resulting from diabetes and high blood pressure.

Lisinopril is recommended in children (above 6 years old) only for the treatment of high blood pressure (hypertension).

Lisinopril should not be used in children with severe kidney impairment.

2. BEFORE YOU TAKE LISINOPRIL

DO NOT take Lisinopril if you:

  • are allergic (hypersensitive) to lisinopril (as dihydrate) or any of the other ingredients of this medicine
  • have suffered an allergic reaction to any other ACE inhibitors e.g. captopril, enalapril, which led to swelling of the face, lips, tongue and/or throat
  • or a member of your close family have a history of face or body swelling (angioneurotic oedema) which may be unrelated to the use of medicines
  • are more than 3 months pregnant. (It is also better to avoid Lisinopril in early pregnancy see pregnancy section).

Take special care with Lisinopril

Tell your doctor before you start to take this medicine if you:

  • have narrowing of the arteries leading to the kidneys, any other kidney problems or are undergoing dialysis
  • recently suffered from diarrhoea or vomiting
  • have been on a low-salt diet
  • have low blood pressure (you may notice this as dizziness or light-headedness especially when standing)
  • have liver disease
  • have insufficient blood supply to your heart (ischaemic heart disease)
  • have insufficient blood supply to your brain (cerebrovascular disease)
  • have aortic stenosis or outflow tract obstruction (a narrowing of the main artery leading from your heart), a narrowing of the heart valves (mitral valve stenosis) or an increase in the thickness of the heart muscle (hypertrophic cardiomyopathy)
  • have a collagen vascular disease e.g. systemic lupus erythematosus, an allergic condition which causes joint pain, skin rashes and fever
  • are to undergo desensitisation treatment (e.g. to reduce the effects of an allergy to wasp or bee stings)
  • are to undergo LDL apheresis (removal of cholesterol from the blood by machine)
  • recently had a heart attack and are suffering from low blood pressure or kidney problems
  • have been told you have severe congestive heart failure.

You must tell your doctor if you think you are (or might become) pregnant. Lisinopril is not recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your
baby if used at that stage (see pregnancy section).

If you are to have an operation requiring an anaesthetic (including treatment at the dentist), tell the doctor or dentist that you are taking Lisinopril tablets.

Taking other medicines

Talk to your doctor if you are taking any of the following:

  • other drugs to reduce blood pressure such as diuretics ( water tablets ) e.g. amiloride as your blood pressure may become too low
  • anti-psychotics e.g. chlorpromazine (to treat mental disorders) or tricyclic antidepressants e.g. amitriptyline, which may cause low blood pressure
  • lithium, as lithium levels may be increased insulin or tablets for diabetes as the risk of hypoglycaemia (low blood sugar) may be increased
  • potassium-containing salt substitutes or potassium supplements as Lisinopril may increase potassium levels
  • gold e.g. sodium aurothiomalate, given as an injection. The possible side effects of feeling flushed, sick, dizzy or having low blood pressure may occur more frequently if you are also taking an ACE inhibitor such as lisinopril.

Tell your doctor before taking Lisinopril in combination with any of the following as they may reduce the effectiveness of Lisinopril:

  • non-steroidal anti-inflammatory agents (a type of painkiller, e.g. indomethacin); kidney function may also be affected
  • sympathomimetic drugs e.g. ephedrine, adrenaline or isoprenaline. Ephedrine may be present in medicines for colds and nasal stuffiness.

Tell your doctor before taking Lisinopril in combination with any of the following as they may increase the risk of the blood disorder leucopenia (a reduction in the number of white blood cells) occurring:

  • procainamide (to treat abnormal heart rhythms)
  • allopurinol (to treat gout)
  • immunosuppressive drugs (used following organ transplant).

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

Pregnancy

You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Lisinopril before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Lisinopril. Lisinopril is not recommended in early pregnancy, and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. Lisinopril is not recommended for mothers who are breastfeeding, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your baby is newborn, or was born prematurely.

Driving and using machines

Lisinopril may cause dizziness or make you feel light headed especially if you are taking Lisinopril tablets for the first time. If affected do not drive or operate machinery.

Important information about some of the ingredients of Lisinopril

Lisinopril contains mannitol which may have a mild laxative effect.

3. HOW TO TAKE LISINOPRIL

Always take Lisinopril exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

The tablets should be swallowed preferably with a glass of water at approximately the same time each day. Lisinopril can be taken with or without food.

The usual dose is:

Adults and the elderly

  • High blood pressure
    Treatment is generally started with one 10 mg tablet daily. Some patients, such as those with kidney problems may require a lower starting dose. The dose will then be gradually increased every 2 4 weeks until your blood pressure is controlled. The usual long-term dosage is 20 mg once daily.
  • Heart failure
    Treatment is generally started in hospital with one 2.5 mg tablet daily. The dose will then be gradually increased until your symptoms are controlled. The usual long-term dosage is 5-35 mg once daily. The dose of any diuretics ( water tablets ) that you are taking may be reduced before starting treatment with Lisinopril.
  • After a heart attack
    The usual dosage is 5 mg on the first and second days, then 10 mg taken once daily which would normally continue for six weeks. Patients that have a low blood pressure (hypotension) are usually given a lower dose of 2.5 mg with a maintenance dose of 5 mg with temporary reductions to 2.5 mg if needed. If prolonged low blood pressure occurs your doctor may withdraw your Lisinopril treatment.
  • Kidney disease resulting from diabetes and high blood pressure
    Treatment is generally started with one 10 mg tablet daily. The dose will then be gradually adjusted according to your needs. The usual long-term dosage is 10 20 mg once daily.

Some Afro-Caribbean patients may require higher doses of Lisinopril to obtain adequate control of symptoms.

Children under 6 years

The use of Lisinopril is not recommended.

Children and adolescents aged 6 to 16 years

The dose depends on your weight. The usual starting dose is between 2.5 mg and 5 mg once daily, which can be increased to a maximum of 20 mg to 40 mg once daily. Patients with kidney problems should take a lower dose. Your doctor will decide the correct dose for you.

If you take more Lisinopril than you should

If you (or someone else) swallow a lot of the tablets all together, or if you think a child has swallowed any of the tablets contact your nearest hospital casualty department or your doctor immediately. An overdose is likely to cause severe lowering of blood pressure, changes in heart rate, dizziness, anxiety, cough, disturbances in the salt balance of the blood and failure of the kidneys to function, symptoms of which are drowsiness, nausea, vomiting, breathlessness and fainting. Please take this leaflet, any remaining tablets and the container with you to the hospital or doctor so that they know which tablets were consumed.

If you forget to take Lisinopril

If you forget to take a tablet, take one as soon as you remember, unless it is nearly time to take the next one. Do not take a double dose to make up for a forgotten dose.

If you stop taking Lisinopril

Do not stop taking your medicine without talking to your doctor first even if you feel better.

4. POSSIBLE SIDE EFFECTS

Like all medicines, Lisinopril can cause side effects, although not everybody gets them.

If the following happens, stop taking the tablets and tell your doctor immediately or go to the
casualty department at your nearest hospital:

  • an allergic reaction (swelling of the lips, face or neck leading to severe difficulty in breathing; skin rash or hives)
  • severe blistering, bleeding of the lips, eyes, mouth, nose and genital areas.

These are very serious but rare side effects. You may need urgent medical attention or hospitalisation.

If you are taking Lisinopril tablets for the first time you may feel dizzy or light-headed for a short time afterwards. This is unlikely to happen if you are taking the tablets regularly. Tell your doctor if you are worried.

The following side effects have been reported at the approximate frequencies shown:

Common (affecting fewer than one person in 10 but more than one person in 100):

  • headache
  • dizziness or light headedness, especially on standing up
  • vomiting, diarrhoea
  • dry cough
  • problems with kidney function.

Uncommon (affecting fewer than one person in 100 but more than one person in 1,000):

  • palpitations (awareness of overactivity of the heart), fast heart rate, poor circulation which makes the fingers and toes pale, cold and num
  • heart attacks or stroke in susceptible patients (possibly due to an excessive drop in blood pressure)
  • pins-and-needles, vertigo (a sensation that your surroundings are spinning, either up and down or from side to side)
  • mood swings, changes in your sense of taste
  • feeling sleepy or other sleeping problems such as inability to sleep
  • runny nose
  • abdominal pain, indigestion, feeling sick
  • skin rash including hives, itching
  • loss of muscle strength (asthenia)
  • high potassium levels in the blood
  • increased levels of liver enzymes in the blood
  • impotence (an inability to get or keep an erection).

Rare (affecting fewer than one person in 1,000 but more than one person in 10,000):

  • anaemia which is a reduction in red blood cells
  • acute kidney failure resulting in nausea, vomiting, lethargy, drowsiness
  • confusion
  • dry mouth
  • hair loss
  • psoriasis (condition causing red, flaky, crusty patches on the skin)

5. HOW TO STORE LISINOPRIL

Keep out of the reach and sight of children.

Do not store above 25 °C. Store in the original container. Do not transfer to another container. Do not use Lisinopril after the expiry date that is stated on the outer packaging. The expiry date refers to the last day of that month. Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

6. FURTHER INFORMATION

What Lisinopril Tablets contain:

  • The active ingredient is lisinopril (as dihydrate), 2.5 mg, 5 mg, 10 mg, or 20 mg.
  • The other ingredients are pregelatinised starch, maize starch, calcium hydrogen phosphate, mannitol and magnesium stearate.

What Lisinopril Tablets look like and contents of the pack:

  • Lisinopril 20 mg Tablets are white oval tablets marked “LSN 20”on one side and a breakline on the other.
  • Lisinopril 10 mg Tablets are white oval tablets, marked “LSN 10” on one side and a breakline on the other.
  • Lisinopril 5 mg Tablets are white oval tablets, marked “LSN 5” on one side and a breakline on the other.
  • Lisinopril 2.5 mg Tablets are white oval tablets, marked “LSN 2.5” on one side and plain on the other.
  • The product is available in blister packs of 28, 30, 50 and 100 tablets and hospital packs of 50 (EAV) and 100.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

TEVA UK Limited, Eastbourne, BN22 9AG.

PL 00289/0348-0351

This leaflet was last revised: September 2011

Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

Hide
(web5)