How long does lisinopril last
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Duration and Effects of Lisinopril: A Comprehensive Overview
Pharmacokinetics of Lisinopril
Bioavailability and Absorption
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, has an oral bioavailability of approximately 25%, which is not affected by food intake . After oral administration, peak serum concentrations are typically reached within 6 to 8 hours .
Half-Life and Elimination
The drug has an accumulation half-life of about 12.6 hours, despite a terminal serum half-life of approximately 40 hours . Lisinopril is not metabolized and is primarily eliminated unchanged through the kidneys, involving processes such as glomerular filtration, tubular secretion, and reabsorption .
Clinical Efficacy and Duration of Effects
Immediate and Short-Term Effects
In patients with heart failure, the maximum pharmacodynamic effects of lisinopril are observed 6 to 8 hours after administration and can persist for 12 to 24 hours. This makes lisinopril effective for once-daily dosing in managing conditions like hypertension and heart failure .
Long-Term Benefits Post-Treatment
The GISSI-3 trial demonstrated that a 6-week course of lisinopril initiated within 24 hours of acute myocardial infarction (MI) significantly reduced mortality and severe left ventricular dysfunction at 6 months, even after the treatment was discontinued . This suggests that the benefits of lisinopril can extend well beyond the period of active treatment.
Effects in Specific Populations
In diabetic patients with acute MI, early treatment with lisinopril was associated with a significant reduction in 6-week mortality, and this benefit was largely maintained at 6 months post-treatment. This highlights the drug's prolonged protective effects in high-risk groups.
Conclusion
Lisinopril exhibits a rapid onset of action with peak effects occurring within 6 to 8 hours and a duration of action lasting up to 24 hours, making it suitable for once-daily dosing. The drug's benefits, particularly in reducing mortality and severe ventricular dysfunction post-MI, can persist for months after discontinuation, underscoring its long-term efficacy. These characteristics make lisinopril a valuable therapeutic option in the management of hypertension, heart failure, and acute myocardial infarction.
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