Lisinopril
Hypertension, Heart failure (HFrEF), Diabetic nephropathy, Post-MI
Indications
- Hypertension
- Heart failure (HFrEF)
- Diabetic nephropathy
- Post-MI
Adult dosing
- htn: dose: 10; unit: mg; route: PO daily; interval: Titrate to 20-40mg daily; fixed: true; hf: dose: 2.5; unit: mg; route: PO daily; interval: Titrate to target 20-40mg daily as tolerated; fixed: true
Contraindications
- Bilateral renal artery stenosis
- History of angioedema from ACEi
- Pregnancy (teratogenic)
- Concurrent use with aliskiren in diabetes
Clinical pearls
- Cough (dry, persistent) occurs in ~10% — switch to ARB if intolerable
- Angioedema risk — higher in Black patients; can occur years after starting
- Monitor K and Cr within 1-2 weeks of starting or dose change
- Expected Cr rise of up to 30% is acceptable — stop only if >30% rise or K >5.5
Source and review
- SOLVD Trial; 2017 ACC/AHA Hypertension Guidelines. Last reviewed: 2024-11-01