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Prinivil (lisinopril) is an ACE inhibitor. ACE stands for angiotensin converting enzyme.
Prinivil is used to treat high blood pressure (hypertension) in adults and children who are at least 6 years old.
Prinivil is also used to treat congestive heart failure in adults, or to improve survival after a heart attack.
Do not use Prinivil if you are pregnant. It could harm the unborn baby. Stop using this medicine and tell your doctor right away if you become pregnant.
You should not use Prinivil if you have ever had angioedema. Do not take Prinivil within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).
If you have diabetes, do not use lisinopril together with any medication that contains aliskiren (such as Tekturna or Tekamlo).
You may also need to avoid taking Prinivil with aliskiren if you have kidney disease.
You should not use Prinivil if you are allergic to lisinopril, or if you:
have a history of angioedema;
recently took a heart medicine called sacubitril; or
are allergic to any other ACE inhibitor, such as benazepril, captopril, enalapril, fosinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril.
Do not take Prinivil within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).
You may also need to avoid taking Prinivil with aliskiren if you have kidney disease.
To make sure this medicine is safe for you, tell your doctor if you have ever had:
kidney disease (or if you are on dialysis);
liver disease; or
high levels of potassium in your blood.
Do not use Prinivil if you are pregnant, and tell your doctor right away if you become pregnant. Lisinopril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.
You should not breastfeed while using lisinopril.
Take Prinivil exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Drink plenty of water each day while you are taking this medicine.
Prinivil can be taken with or without food.
Your blood pressure will need to be checked often. Your kidney function and electrolytes may also need to be checked.
Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking lisinopril. This can lead to very low blood pressure, a serious electrolyte imbalance, or kidney failure.
If you need surgery, tell the surgeon ahead of time that you are using Prinivil.
If you have high blood pressure, keep using this medication 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 at room temperature away from moisture and heat.
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.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Drinking alcohol can further lower your blood pressure and may increase certain side effects of Prinivil.
Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Prinivil can decrease sweating and you may be more prone to heat stroke.
Do not use salt substitutes or potassium supplements while taking lisinopril, 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.
Get emergency medical help if you have signs of an allergic reaction to lisinopril: hives; severe stomach pain, difficult breathing; swelling of your face, lips, tongue, or throat. You may be more likely to have an allergic reaction if you are African-American.
Call your doctor at once if you have:
a light-headed feeling, like you might pass out;
fever, sore throat;
high potassium - nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement;
kidney problems - little or no urination, swelling in your feet or ankles, feeling tired or short of breath; or
liver problems - nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Common Prinivil side effects may include:
headache, dizziness;
cough; or
chest pain.
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.
Usual Adult Dose for Hypertension:
Initial dose: 10 mg orally once a day; 5 mg orally once a day
Maintenance dose: 20 to 40 mg orally once a day
Maximum dose: 80 mg orally once a day
Comments:
-The initial dose is 5 mg orally once a day in patients receiving a diuretic.
-The 80 mg dose is used but does not appear to give greater effect.
-If blood pressure is not controlled with Prinivil alone, a low dose of a diuretic may be added (e.g., hydrochlorothiazide, 12.5 mg). After the addition of a diuretic, it may be possible to reduce the dose of Prinivil.
Usual Adult Dose for Congestive Heart Failure:
Initial dose: 2.5 to 5 mg orally once a day
Maintenance dose: Dosage should be increased as tolerated
Maximum dose: 40 mg orally once a day
Comments:
-The diuretic dose may need to be adjusted to help minimize hypovolemia, which may contribute to hypotension. The appearance of hypotension after the initial dose of Prinivil does not preclude subsequent careful dose titration with the drug.
Usual Adult 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, then 10 mg orally after 48 hours.
Maintenance dose: 10 mg orally once a day. Dosing should continue for at least 6 weeks.
Comments:
-Therapy should be initiated at 2.5 mg in patients with a low systolic blood pressure (less than or equal to 120 mm Hg and greater than 100 mmHg) during the first 3 days after the infarct. If prolonged hypotension occurs (systolic blood pressure less than 90 mmHg for more than 1 hour) therapy should be withdrawn.
Uses: Reduction of mortality in acute myocardial infarction
Usual Adult Dose for Diabetic Nephropathy:
Initial dose: 10 to 20 mg orally once a day
Maintenance dose: 20 to 40 mg orally once a day
Dosage may be titrated upward every 3 days
Comments:
-Not an approved indication.
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 mg to 5 mg per day at 1 to 2 week intervals.
Maximum dose: 40 mg orally once a day
Usual Pediatric Dose for Hypertension:
Pediatric patients greater than or equal to 6 years of age:
Initial dose: 0.07 mg/kg orally once a day (Maximum initial dose is 5 mg once a day)
Maintenance dose: Dosage should be adjusted according to blood pressure response at 1 to 2 week intervals.
Maximum dose: Doses above 0.61 mg/kg or greater than 40 mg have not been studied in pediatric patients
Comments:
-This drug is not recommended in pediatric patients less than 6 years old or in pediatric patients with glomerular filtration rate less than 30 mL/min.
Tell your doctor about all your other medicines, especially:
a diuretic or "water pill";
lithium;
gold injections to treat arthritis;
insulin or oral diabetes medicine;
a potassium supplement;
medicine to prevent organ transplant rejection - everolimus, sirolimus, tacrolimus, temsirolimus; or
NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.
This list is not complete. Other drugs may interact with lisinopril, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Prinivil only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Prinivil (www.drugs.com/prinivil.html).
Note: This document contains side effect information about lisinopril. Some of the dosage forms listed on this page may not apply to the brand name Prinivil.
Common side effects of Prinivil include: dizziness, hypotension, hyperkalemia, increased blood urea nitrogen, and increased serum creatinine. Other side effects include: headache. See below for a comprehensive list of adverse effects.
Applies to lisinopril: oral solution, oral tablet
Oral route (Tablet; Solution)
Discontinue lisinopril as soon as possible when pregnancy is detected, as drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.
Along with its needed effects, lisinopril (the active ingredient contained in Prinivil) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking lisinopril:
More common
Less common
Rare
Some side effects of lisinopril may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Rare
Applies to lisinopril: oral solution, oral tablet
Hypotension is most likely in patients who are sodium and intravascular volume depleted. In large studies, patients have reported "heart pounding" and chest pain, although the relationship to lisinopril (the active ingredient contained in Prinivil) is questionable.
Very common (10% or more): Hypotension (11%)
Common (1% to 10%): Chest pain, angina pectoris, orthostatic hypotension, palpitations
Uncommon (0.1% to 1%): Angioneurotic edema, myocardial infarction or cerebrovascular accident, palpitations, tachycardia, Raynaud's phenomenon
Common (1% to 10%): Creatinine increased (10%)
Very rare (less than 0.01%): Renal insufficiency
Very common (10% or more): Dizziness (19%)
Common (1% to 10%): Headache, syncope
Uncommon (0.1% to 1%): Paresthesias
A study has revealed a significantly higher incidence of discontinuation of angiotensin converting enzyme inhibitor therapy due to cough among black patients compared with nonblack patients (9.6% vs. 2.4%).
Common (1% to 10%): Creatinine increased (10%)
Uncommon (0.1% to 1%): Rhinitis
Very rare (less than 0.01%): Bronchospasm, sinusitis, allergic alveolitis/eosinophilic pneumonia
Common (1% to 10%): Hyperkalemia
Frequency not reported: Gout, hypoglycemia in diabetic patients receiving ACE inhibitors when concurrently treated with oral antidiabetic agents or insulin
Common (1% to 10%): Diarrhea, nausea, vomiting
Frequency not reported: Pancreatitis, constipation, flatulence, dry mouth, taste disturbance
Uncommon (0.1% to 1%): Angioedema
Uncommon (0.1% to 1%): Rash, pruritus, erythema
Rare (0.01% to 0.1%): Alopecia, urticaria, psoriasis, hypersensitivity/angioedema, angioneurotic edema of the face, extremities, lips, tongue, glottis, and/or larynx
Very rare (less than 0.01%): Sweating, skin lesions, skin infections, pemphigus, toxic epidermal necrolysis, Stevens-Johnson Syndrome, erythema multiforme, cutaneous pseudolymphoma
Frequency not reported: Photosensitivity, flushing, diaphoresis
Very rare (less than 0.01%): Bone marrow depression, hemolytic anemia, leukopenia/neutropenia, thrombocytopenia, decreases in hemoglobin, decreases in hematocrit
Rare (0.01% to 0.1%): Memory impairment, confusion, somnolence, irritability, nervousness, hallucinations
Very rare (less than 0.01%): Mania
Common (1% to 10%): Creatinine increased
Very rare (less than 0.01%): Cholestatic jaundice that progresses to fulminant hepatic necrosis and sometimes death (discontinue of therapy if jaundice or markedly elevated hepatic serum enzymes develop)
Very rare (less than 0.01%): Diabetes, syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Common (1% to 10%): Cough
Frequency not reported: Fatigue, asthenia, orthostatic effects, tinnitus, olfactory disturbance
Uncommon (0.1% to 1%): Impotence
Rare (less than 0.1%): Gynecomastia
Frequency not reported: Proteinuria
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Prinivil (www.drugs.com/prinivil.html).
April 30, 2020
February 12, 2020
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June 26, 2020
