Drug interactions with lisinopril
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Drug Interactions with Lisinopril
Lisinopril and Diclofenac Sodium: Impact on Blood Pressure and Renal Function
Concomitant administration of lisinopril and diclofenac sodium can significantly reduce the antihypertensive efficacy of lisinopril. This interaction was observed in both non-diabetic and diabetic hypertensive patients with osteoarthritis. The study found that diclofenac sodium reduced blood pressure control achieved by lisinopril (SBP: p=0.00002; DBP: p=0.000008 in non-diabetics; SBP: p=0.002; DBP: p=0.001 in diabetics) . Additionally, the combination treatment led to increased serum creatinine levels and altered renal function markers such as creatinine clearance and blood urea nitrogen in both diabetic and non-diabetic patients . These findings suggest that the combination of lisinopril and diclofenac sodium requires careful monitoring of blood pressure and renal function.
Lisinopril and Nifedipine: No Acute Interaction
A study investigating the interaction between lisinopril and nifedipine in normotensive subjects found no significant pharmacokinetic or pharmacodynamic interactions. Both drugs lowered blood pressure, with nifedipine having a short-term effect and lisinopril a longer-term effect. The combination of the two drugs showed additive effects on blood pressure reduction without altering the pharmacokinetics of either drug . This suggests that lisinopril and nifedipine can be co-administered without significant interaction concerns.
Lisinopril and Gliclazide: Enhanced Antidiabetic Effect
In experimental animal studies, the combination of lisinopril and gliclazide, a sulfonylurea used in type II diabetes, showed a significant interaction. Chronic use of lisinopril enhanced the blood glucose-lowering effect of gliclazide in both normal and diabetic rats . This suggests that when used together, there may be a need for dose adjustment to avoid hypoglycemia.
Lisinopril and Metformin: Altered Dissolution Profiles
In vitro studies have shown that lisinopril can affect the dissolution profile of metformin, a common antidiabetic drug. The presence of lisinopril decreased the percentage of metformin released at various pH levels (pH 1.2, 4.5, and 6.8), while metformin increased the release of lisinopril at pH 1.2 and 6.8 . These findings indicate that co-administration of these drugs could potentially alter their absorption and efficacy.
Lisinopril and JBP485: Intestinal and Renal Transporter Interactions
The interaction between lisinopril and JBP485, a dipeptide with antihepatitis activity, involves shared transporters in the intestine and kidneys. Co-administration of these drugs reduced their plasma concentrations due to competition for the peptide cotransporter 1 (PEPT1) in the intestine and organic anion transporters (OATs) in the kidneys . This suggests that the pharmacokinetic interaction is primarily due to inhibition of the same transporters, affecting drug absorption and excretion.
Lisinopril and Hydralazine: Increased Bioavailability
A study comparing the pharmacokinetics of lisinopril and enalapril, another ACE inhibitor, found that co-administration with hydralazine significantly increased the bioavailability of lisinopril but not enalapril . This interaction may be due to enhanced absorption of lisinopril when combined with hydralazine, indicating a need for careful dose management when these drugs are used together.
Lisinopril and Hydrochlorothiazide: Effective Combination Therapy
The combination of lisinopril with hydrochlorothiazide, a thiazide diuretic, has been shown to be effective in managing hypertension. The combination therapy provided greater blood pressure reduction compared to monotherapy with either drug alone, without significant pharmacokinetic interactions 78. This combination is well-tolerated and offers a synergistic effect in lowering blood pressure.
Conclusion
Lisinopril interacts with various drugs, affecting their pharmacokinetics and pharmacodynamics. These interactions can alter the efficacy and safety of the treatments, necessitating careful monitoring and potential dose adjustments. Understanding these interactions is crucial for optimizing therapeutic outcomes and minimizing adverse effects in patients receiving lisinopril in combination with other medications.
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