Drugs that interact with lisinopril
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Drug Interactions with Lisinopril: A Comprehensive Overview
Introduction to Lisinopril and Its Uses
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor commonly prescribed to treat high blood pressure, protect kidney function in diabetic patients, and reduce mortality risk during heart attacks. It is marketed under various names, including Prinivil®, Qbrelis®, and Zestril®, and is also available in combination with the diuretic hydrochlorothiazide (Zestoretic®).
Interaction with 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 has been observed in both non-diabetic and diabetic hypertensive patients, leading to less effective blood pressure control. Additionally, this combination can worsen renal function, as indicated by increased serum creatinine levels and altered creatinine clearance and blood urea nitrogen (BUN) levels.
Interaction with Gliclazide
Effects on Blood Glucose Levels
Lisinopril can interact with gliclazide, a sulfonylurea used to manage type II diabetes. Chronic use of lisinopril enhances the blood glucose-lowering effect of gliclazide in both normal and diabetic rats, suggesting that dose adjustments may be necessary when these drugs are used together.
Interaction with Metformin
Dissolution Profile Alterations
In vitro studies have shown that lisinopril can affect the dissolution profile of metformin, a common antidiabetic medication. Specifically, lisinopril increases the release of metformin at various pH levels, which could potentially alter its therapeutic efficacy.
Interaction with JBP485
Pharmacokinetic Mechanisms
Lisinopril interacts with JBP485, a dipeptide with antihepatitis activity, by inhibiting the same transporters in the intestinal mucosa (PEPT1) and kidneys (OATs). This interaction leads to decreased plasma concentrations of both drugs when administered orally, highlighting the importance of considering transporter-mediated interactions.
Interaction with Nifedipine
Additive Effects on Blood Pressure
Studies have shown that the combination of lisinopril and nifedipine, a calcium channel blocker, results in additive effects on blood pressure reduction without significant pharmacokinetic interactions. This combination also leads to an increased heart rate and additive side effects .
Interaction with Hydrochlorothiazide
Enhanced Antihypertensive Effect
Combining lisinopril with hydrochlorothiazide, a diuretic, enhances the antihypertensive effect compared to monotherapy with either drug. This combination is effective and well-tolerated, with minimal metabolic side effects, making it a viable option for managing hypertension.
Conclusion
Lisinopril interacts with various drugs, including diclofenac sodium, gliclazide, metformin, JBP485, nifedipine, and hydrochlorothiazide. These interactions can affect blood pressure control, renal function, blood glucose levels, and drug dissolution profiles. Understanding these interactions is crucial for optimizing therapeutic outcomes and minimizing adverse effects. Close monitoring and potential dose adjustments are recommended when lisinopril is used concomitantly with these medications.
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