Cosmos Pharmaceutical Limited | LISACE®
Cosmos Limited is one of the leading manufacturers of pharmaceutical products in Kenya and East Africa. Through our specialized Human Health and Animal Health.
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LISACE®

CLINICAL PHARMACOLOGY:

Lisinopril is an ACE inhibitor. ACE inhibitors are antihypertensive drugs that act as vasodilators and reduce peripheral resistance. They inhibit angiotensin-converting enzyme (ACE), which is involved in the conversion of angiotensin I to angiotensin II. Angiotensin II stimulates the synthesis and secretion of aldosterone and raises blood pressure via a potent direct vasoconstrictor effect. ACE is identical to bradykininase (kininase II) and ACE inhibitors also reduce the degradation of bradykinin, which is a direct vasodilator and is also involved in the generation of prostaglandins. The pharmacological actions of ACE inhibitors are thought to be primarily due to the inhibition of the renin-angiotensin-aldosterone system, but since they also effectively reduce blood pressure in patients with low renin concentrations other mechanisms are probably also involved.

Pharmacokinetics:

Lisinopril is slowly and incompletely absorbed following oral administration. About 25% of a given dose is absorbed on average, but the absorption varies considerably between individuals, ranging from about 6 to 60%. It is already an active diacid and does not need to be metabolised in vivo. Peak concentrations in plasma are reported to occur after about 7 hours. Lisinopril is reported not to be significantly bound to plasma proteins. It is excreted unchanged in the urine. The effective half-life for accumulation following multiple doses is 12 hours in patients with normal renal function. Lisinopril is removed by haemodialysis.

USES:

Lisace®  is used in the treatment of hypertension and heart failure, prophylactically after myocardial infarction and in diabetic nephropathy.

DOSAGE  AND  ADMINISTRATION:

In the treatment of hypertension – initial dose is 10mg daily.
In the management of heart failure – initial dose of 2.5mg daily.
Following myocardial infarction – initial dose of 2.5mg once daily.

In diabetic nephropathy – initial dose of 2.5mg once daily.
Administration in renal impairment – 2.5mg once daily but the dose should be adjusted according to response, to a maximum of 40mg once daily.

CONTRA-INDICATIONS AND  WARNINGS:

ACE inhibitors are contra-indicated in patients with hypersensitivity to ACE inhibitors (including angioedema) and in known or suspected renovascular disease, aerotic stenosis or outflow tract obstruction. ACE inhibitors should not be used in pregnancy.

Precautions:

ACE inhibitors need to be initiated with care in patients receiving diuretics; first doses may cause hypotension especially in patients taking high doses of diuretics, on a low-sodium diet, on dialysis, dehydrated or with heart failure. They should also be used with caution in peripheral vascular disease or generalised etherosclerosis owing to risk of clinically silent renovascular disease. Renal function should be monitored before and during treatment, and the dose reduced in renal impairment.

Adverse Effects:

The most common adverse effects are due to the vascular effects of ACE inhibitors and include hypotension, dizziness, fatigue, headache, and nausea and other gastro-intestinal disturbances. Other adverse effects include persistent dry cough and other upper respiratory tract symptoms, and angioedema; these may be related to effects on bradykinin or prostaglandin metabolism. Skin rashes (including erythema multiforme and toxic epidermal necrolysis) may occur; photosensitivity, alopecia, and other hypersensitivity reactions have also been reported.

Interactions:

Excessive hypotension may occur when ACE inhibitors are used concurrently with diuretics, other antihypertensives, or other agents, including alcohol, that lower blood pressure.


PHARMACEUTICAL PRECAUTIONS:

Store in a dry place below 25ºC. Protect from light. Keep out of reach of children.

LEGAL CATEGORY:
Prescription Only Medicine (POM)
®Regd. TM            Ref. No.: INS246/07.05

IMAGES
  • LISACE® 5 Tablets

    PresentationLight pink, round standard biconvex tablet embossed 'COSMOS' on one side and a breakline on the other side. Each tablet contains: Lisinopril USP 5mg. Pack size - 28's (2x14's)

  • LISACE® 10 Tablets

    PresentationLight pink, round standard biconvex tablet embossed 'C' on one side and a breakline on the other side. Each tablet contains: Lisinopril USP 10mg. Pack size - 28's (2x14's)