Universal reference book for medicines
Product name: LITEN (LITEN)

Active substance: lisinopril

Type: ACE inhibitor

Manufacturer: BOSNALIJEK (Bosnia and Herzegovina)
Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
ACE inhibitor.
The mechanism of antihypertensive action is associated with inhibition of ACE activity, which leads to a decrease in the rate of conversion of angiotensin I into angiotensin II (which has a pronounced vasoconstrictive effect and stimulates the secretion of aldosterone in the adrenal cortex). As a result of the decrease in the formation of angiotensin II, a secondary increase in plasma renin activity occurs due to the elimination of negative feedback during the release of renin and a direct decrease in the secretion of aldosterone. Reducing the secretion of aldosterone can increase the concentration of potassium.
Reduces OPSS (afterload), wedging pressure in the pulmonary capillaries (preload) and resistance in the pulmonary vessels, increases the minute volume of the heart and tolerance to the load.

Lizinopril reduces albuminuria.
In patients with hyperglycemia contributes to the normalization of the function of the damaged glomerular endothelium. Does not affect the concentration of glucose in the blood in patients with diabetes mellitus and does not lead to an increase in cases of hypoglycemia.
PHARMACOKINETICS
After ingestion, lisinopril is slowly and incompletely absorbed from the digestive tract.
Absorption on the average is 25%, differs high variability - 6-60%. C max in plasma is achieved after about 7 hours. Binding to plasma proteins is negligible. It is excreted unchanged in the urine. In patients with normal renal function, T 1/2 is 12 hours.
Lizinopril is excreted from the body during hemodialysis.

INDICATIONS
Essential and Renovascular Hypertension (in the form of monotherapy or in combination with other antihypertensive drugs).

Chronic heart failure (as part of combination therapy).

Acute myocardial infarction (within the first 24 hours with stable hemodynamic parameters to maintain these parameters and prevention of left ventricular dysfunction and heart failure).

Diabetic nephropathy (to reduce albuminuria in patients with insulin-dependent diabetes mellitus at normal BP and in patients with non-insulin-dependent diabetes mellitus with hypertension).

DOSING MODE
Individual, depending on the indications, treatment regimens, kidney function.
The initial dose of 2.5 mg 1 time / day. Supportive doses of 5-20 mg.
SIDE EFFECT
From the cardiovascular system: possible arterial hypotension, pain behind the breastbone.

From the side of the central nervous system: dizziness, headache, muscle weakness.

From the digestive system: diarrhea, nausea, vomiting.

From the respiratory system: dry cough.

On the part of the hematopoiesis system: agranulocytosis, reduction of hemoglobin and hematocrit (especially with prolonged admission);
in isolated cases - an increase in ESR.
From the side of water-electrolyte metabolism: hyperkalemia.

On the part of metabolism: increased levels of creatinine, urea nitrogen (especially in patients with kidney disease, diabetes, and renovascular hypertension).

Allergic reactions: skin rash, angioedema.

Other: in isolated cases - arthralgia.

CONTRAINDICATIONS
Pregnancy, hypersensitivity to lisinopril and other ACE.

PREGNANCY AND LACTATION
Lizinopril is contraindicated in pregnancy.

It is not known whether lisinopril is excreted in breast milk.
Use with caution during lactation (breastfeeding).
APPLICATION FOR FUNCTIONS OF THE LIVER
Use with extreme caution in patients with impaired renal function. Before and during therapy, kidney function should be monitored.

SPECIAL INSTRUCTIONS
Lizinopril should not be used in patients with aortic stenosis, pulmonary heart disease.
Do not use in patients with acute myocardial infarction: with the threat of development of serious hemodynamic disorders associated with the use of a vasodilator; with violations of kidney function.
Before and during therapy, kidney function should be monitored.

Before starting treatment with lisinopril, it is necessary to compensate for the loss of fluid and salts.

With special care apply in patients with impaired renal function, with stenosis of the renal artery, severe congestive heart failure.

The likelihood of developing arterial hypotension increases with loss of fluid due to diuretic therapy, diets with salt restriction, nausea, vomiting.

In patients with congestive heart failure with normal or slightly reduced blood pressure, lisinopril can cause severe arterial hypotension.

It is not recommended simultaneous use of lisinopril with potassium-sparing diuretics, dietary supplements to food and salt substitutes containing potassium.

With the simultaneous use of lisinopril with lithium preparations should monitor the concentration of lithium in blood plasma.

DRUG INTERACTION
With simultaneous use with antihypertensive agents, additive antihypertensive action is possible.

With simultaneous use with potassium-sparing diuretics (spironolactone, triamterene, amiloride), potassium preparations, substitutes for edible salt containing potassium, the risk of hyperkalemia increases, especially in patients with impaired renal function.

With the simultaneous use of ACE inhibitors and NSAIDs, the risk of developing renal dysfunction increases, and hyperkalemia is rarely observed.

With simultaneous use with "loop" diuretics, thiazide diuretics intensify antihypertensive effect.
The appearance of severe arterial hypotension, especially after the first dose of a diuretic, is apparently due to hypovolemia, which leads to a transient increase in the hypotensive effect of lisinopril. Increased risk of impaired renal function.
With simultaneous use with indomethacin, the antihypertensive effect of lisinopril decreases, apparently due to the inhibition of the synthesis of prostaglandins under the influence of NSAIDs (which are believed to play a role in the development of the hypotensive effect of ACE inhibitors).

When used simultaneously with insulin, hypoglycemic agents, derivatives of sulfonylureas may develop hypoglycemia due to increased tolerance to glucose.

With simultaneous application with clozapine, the concentration of clozapine in the blood plasma increases.

With simultaneous application of lithium carbonate, the concentration of lithium in the serum increases, accompanied by symptoms of lithium intoxication.

A case of the development of severe hyperkalemia in a patient with diabetes mellitus is described with simultaneous application with lovastatin.

A case of severe arterial hypotension with simultaneous application with pergolide is described.

With simultaneous use with ethanol, the action of ethanol is enhanced.

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