Zestril

Generic Name: lisinopril (lyse IN oh pril)
Brand Names: Prinivil, Zestril

What is Zestril?

Zestril (lisinopril) is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme.

Zestril is used to treat high blood pressure (hypertension), congestive heart failure, and to improve survival after a heart attack.

Zestril may also be used for purposes not listed in this medication guide.

Important information about Zestril

Do not use Zestril if you are pregnant. It could harm the unborn baby. Stop using Zestril and tell your doctor right away if you become pregnant. Drinking alcohol can further lower your blood pressure and may increase certain side effects of Zestril. Do not use salt substitutes or potassium supplements while taking Zestril, unless your doctor has told you to.

Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking Zestril. Drink plenty of water each day while you are taking this medication.

Before taking Zestril

Do not use Zestril if you are allergic to lisinopril or to any other ACE inhibitor, such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

To make sure you can safely take Zestril, tell your doctor if you have any of these other conditions:

• kidney disease (or if you are on dialysis);

• liver disease;

• heart disease or congestive heart failure;

• diabetes; or

• a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis.

FDA pregnancy category D. Do not use Zestril if you are pregnant. Stop using this medication and tell your doctor right away if you become pregnant. Zestril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control while taking Zestril. It is not known whether lisinopril passes into breast milk or if it could harm a nursing baby. Do not use Zestril without telling your doctor if you are breast-feeding a baby.

See also: Zestril pregnancy and breastfeeding warnings (in more detail)

How should I take Zestril?

Take Zestril exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Take each dose with a full glass of water.

Zestril can be taken with or without food.

Your blood pressure will need to be checked often. Your kidney or liver function may also need to be tested. Visit your doctor regularly.

If you need surgery, tell the surgeon ahead of time that you are using Zestril. You may need to stop using the medicine for a short time. If you are being treated for high blood pressure, keep using Zestril even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store Zestril at room temperature away from moisture and heat.

See also: Zestril dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include feeling extremely dizzy or light-headed, or fainting.

What should I avoid while taking Zestril?

Drinking alcohol can further lower your blood pressure and may increase certain side effects of Zestril. Do not use salt substitutes or potassium supplements while taking Zestril, unless your doctor has told you to. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Zestril side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Zestril: hives; severe stomach pain, difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

• feeling like you might pass out;

• urinating less than usual or not at all;

• swelling, rapid weight gain;

• fever, chills, body aches, flu symptoms;

• tired feeling, muscle weakness, and pounding or uneven heartbeats;

• chest pain; or

• high potassium (slow heart rate, weak pulse, muscle weakness, tingly feeling).

Less serious Zestril side effects may include:

• cough;

• dizziness, drowsiness, headache;

• depressed mood;

• nausea, vomiting, diarrhea, upset stomach; or

• mild skin itching or rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Zestril side effects (in more detail)

Zestril Dosing Information

Usual Adult Zestril Dose for Hypertension:

Initial dose: 10 mg orally once a day, in patients not receiving a diuretic.
Maintenance dose: 20 to 40 mg orally once a day.
Some patients appear to have a further response to 80 mg, but experience with this dose is limited.

Usual Adult Zestril Dose for Congestive Heart Failure:

Initial dose: 5 mg orally once a day (If on diuretic, the diuretic dose should be reduced).
Maintenance dose: 5 to 20 mg orally once a day.

Usual Adult Zestril Dose for Myocardial Infarction:

Initial dose: 5 mg orally (within 24 hours of the onset of acute myocardial infarction).
Subsequent doses: 5 mg orally after 24 hours.
10 mg orally after 48 hours.
Maintenance dose: 10 mg orally once a day. Dosing should continue for six weeks.
Patients with a low systolic blood pressure (<=120 mm Hg) when treatment is started or during the first 3 days after the infarct should be given a lower 2.5 mg oral dose of Zestril. If hypotension occurs (systolic blood pressure <=100 mm Hg) a daily maintenance dose of 5 mg may be given with temporary reductions to 2.5 mg if needed. If prolonged hypotension occurs (systolic blood pressure <90 mm Hg for more than 1 hour), Zestril should be withdrawn.

Usual Geriatric Dose for Hypertension:

Initial dose: 2.5 to 5 mg orally once a day.
Maintenance dose: Dosages should be increased at 2.5 to 5 mg/day increments at 1 to 2 week intervals.
Maximum dose: 40 mg/day.

What other drugs will affect Zestril?

Tell your doctor about all other medicines you use, especially:

• any other blood pressure medications;

• gold injections to treat arthritis;

• lithium (Lithobid, Eskalith);

• a potassium supplement such as K-Dur, Klor-Con;

• salt substitutes that contain potassium;

• insulin or diabetes medication you take by mouth;

• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others; or

• a diuretic (water pill).

This list is not complete and other drugs may interact with Zestril. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Zestril.