How does it work?

This medicine contains the active ingredient lisinopril, which is a type of medicine called an ACE inhibitor. ACE inhibitors work by blocking the action of a compound in the body called angiotensin converting enzyme (ACE). Normally ACE produces another compound called angiotensin II, as part of the body's natural control of blood pressure. Angiotensin II has two actions. Firstly, it causes blood vessels to constrict and narrow, and secondly, it reduces the production of urine by the kidneys. Both these actions increase the pressure within the blood vessels. As lisinopril blocks the action of ACE, it reduces the production of angiotensin II. This means that the blood vessels are allowed to relax to widen and more urine is produced by the kidneys. The overall effect of this is a drop in blood pressure. The reduced pressure within the blood vessels means that the heart doesn't have to work as hard to pump the blood around the body. This is why ACE inhibitors can be used to improve the symptoms of heart failure, where the heart is not pumping as efficiently, and to improve survival following a heart attack.

What is it used for?

Diabetic kidney disease

Heart failure

High blood pressure caused by compression or blockage of the arteries that carry blood to the kidneys (renovascular hypertension)

High blood pressure with no known cause

Improving survival following a heart attack

Warning!

Some people may experience dizziness caused by low blood pressure in the first few days of taking this medicine. This can be relieved by lying down until the symptoms pass.

Alcohol may enhance the blood pressure lowering effect of this medicine, which may result in dizziness or fainting.

The use of this medicine in children has not been studied.

Your blood pressure and kidney function should be regularly monitored while taking this medicine.

Stop taking this medicine and consult your doctor immediately if you experience difficulty breathing or swallowing, or swelling of your face, lips, tongue, throat, hands, feet or ankles while taking this medicine.

Use with caution in

Decreased kidney function

Diabetes

Disease of the blood vessels in and around the brain (cerebrovascular disease)

Diseases affecting connective tissue, eg scleroderma, systemic lupus erythematosus, rheumatoid arthritis (collagen vascular diseases)

Heart disease caused by inadequate blood flow to the heart

Low blood pressure (hypotension)

Narrowing of blood vessels in the extremities

Narrowing of the artery which supplies blood to the kidneys (renal artery stenosis)

People aged over 70 years

People receiving therapy to remove certain types of fat from the blood using a machine (LDL apheresis)

People taking blood pressure lowering medicines

People undergoing therapy to decrease allergy to bee or wasp stings (desensitisation).

People with low fluid volume or salt levels in the body, eg due to diuretic therapy, low-sodium diet, diarrhoea or vomiting

Severe heart failure

Not to be used in

Any condition in which there is obstruction to the pumping of blood out of the heart (outflow tract obstruction)

Enlargement of a chamber of the heart (right ventricle) due to high blood pressure in the pulmonary artery (cor pulmonale)

Heart disease characterised by thickening of the internal heart muscle and a blockage inside the heart (hypertrophic obstructive cardiomyopathy)

Hereditary angioedema

History of swelling of the lips, face or tongue (angioedema) caused by an ACE inhibitor

History of swelling of the lips, face or tongue with no known cause (idiopathic angioedema)

Kidney failure requiring a certain type of haemodialysis

Narrowing of the main artery of the body (aortic stenosis)

Pregnancy

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used in pregnancy, particularly in the second and third trimesters, as it may affect the growth and development of the foetus or have adverse effects on foetal tissues. Seek medical advice from your doctor.

It is not known if this medicine passes into breast milk. It should be used with caution in nursing mothers, and only if the benefits to the mother outweigh any risks to the nursing infant. Discuss this with your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Headache

Rash

Faster than normal heart beat (tachycardia)

Dry mouth

Changes in mood

Inability of a man to have an erection (impotence)

Confusion

Fatigue

Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain

Dry cough

Severe swelling of lips, face or tongue (angioedema)

Dizziness

Alteration in taste

Chest pain (angina)

Difficulty in breathing (dyspnoea)

Disorders of the blood, kidney or liver

Decreased kidney function

Drop in blood pressure which may be accompanied by dizziness or fainting

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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