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These studies suggest that lisinopril remains effective for up to 6 months after acute myocardial infarction and has a terminal serum half-life of approximately 40 hours.
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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 .
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 .
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 .
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.
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.
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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