Lisinopril acetaminophen
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Lisinopril and Acetaminophen: Interactions and Effects
Protective Effects of Lisinopril Against Acetaminophen-Induced Hepatotoxicity
Keywords: Lisinopril, Acetaminophen, Hepatotoxicity, Liver Protection
Research has shown that lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, can offer protective effects against acetaminophen-induced liver damage. In a study involving rats, pre-treatment with lisinopril significantly reduced markers of liver injury, such as serum transaminases, and oxidative stress markers like hepatic malondialdehyde. Additionally, lisinopril increased beneficial antioxidants like hepatic glutathione and catalase. These findings suggest that lisinopril can mitigate the hepatotoxic effects of acetaminophen, potentially through mechanisms involving the regulation of angiotensin II and oxidative stress1.
Lisinopril and Hypotension: Interaction with Other Medications
Keywords: Lisinopril, Hypotension, Drug Interaction, Tizanidine
While lisinopril has beneficial effects, it can also interact with other medications, leading to adverse effects. A case study highlighted severe hypotension and bradycardia in a patient taking both lisinopril and tizanidine. The patient experienced a significant drop in blood pressure and heart rate after starting tizanidine, which was resolved upon discontinuation of the drug. This case underscores the importance of monitoring blood pressure and heart rate when lisinopril is used in combination with other medications that can lower blood pressure2.
Lisinopril in Diabetic Patients with Acute Myocardial Infarction
Keywords: Lisinopril, Diabetic Patients, Myocardial Infarction, Mortality Reduction
Lisinopril has been shown to reduce mortality in diabetic patients who suffer from acute myocardial infarction (MI). Data from the GISSI-3 study indicated that early treatment with lisinopril significantly decreased 6-week mortality rates in diabetic patients compared to those who did not receive the treatment. This effect was more pronounced in diabetic patients than in non-diabetic patients, suggesting that lisinopril is particularly beneficial in this high-risk group3.
Long-Term Effects of Lisinopril on Kidney Function in Diabetic Nephropathy
Keywords: Lisinopril, Kidney Function, Diabetic Nephropathy, Hypertension
In patients with hypertensive non-insulin-dependent diabetes mellitus (NIDDM) and diabetic nephropathy, lisinopril has been found to be effective in reducing the decline in kidney function. A long-term study comparing lisinopril with atenolol showed that both medications were equally effective in slowing the progression of kidney disease. However, lisinopril had a more significant effect on reducing urinary albumin excretion, indicating a potential advantage in preserving kidney function4.
Lisinopril and ACE2 Expression: Implications for COVID-19
Keywords: Lisinopril, ACE2, SARS-CoV-2, COVID-19
Lisinopril has been found to increase the expression of ACE2, the receptor for SARS-CoV-2, in various tissues. This increase was observed in the small intestine, lung, kidney, and brain of healthy mice. Interestingly, the combination of lisinopril with losartan, an angiotensin receptor blocker, prevented this increase. These findings suggest that while lisinopril alone can raise ACE2 levels, its combination with losartan can modulate this effect, which may have implications for the transmission and pathogenesis of COVID-195.
Conclusion
Lisinopril demonstrates a range of effects, from protecting against acetaminophen-induced liver damage to reducing mortality in diabetic patients with acute MI. However, its interactions with other medications and its impact on ACE2 expression warrant careful consideration. These findings highlight the importance of personalized medical approaches when using lisinopril, especially in patients with complex medical histories or those at risk for COVID-19.
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Most relevant research papers on this topic
Effect of amlodipine, lisinopril and allopurinol on acetaminophen-induced hepatotoxicity in rats
Amlodipine, lisinopril, and allopurinol can protect against acetaminophen-induced hepatotoxicity, with calcium channels, angiotensin converting enzyme, and xanthine oxidase playing roles in the injury.
RCT
Animal StudyHypotension and bradycardia associated with concomitant tizanidine and lisinopril therapy.
Concomitant tizanidine and lisinopril therapy can cause severe hypotension and bradycardia in patients with pre-existing medical conditions.
Case ReportEffect of the ACE inhibitor lisinopril on mortality in diabetic patients with acute myocardial infarction: data from the GISSI-3 study.
Early treatment with lisinopril in diabetic patients with acute MI is associated with a decreased 6-week mortality.
RCT
Large Human Trial
Highly CitedLong-Term Effect of Lisinopril and Atenolol on Kidney Function in Hypertensive NIDDM Subjects With Diabetic Nephropathy
Both lisinopril and atenolol effectively reduce kidney function decline in hypertensive NIDDM patients with diabetic nephropathy.
RCTHighly CitedOral Lisinopril Raises Tissue Levels of ACE2, the SARS-CoV-2 Receptor, in Healthy Male and Female Mice
Oral lisinopril increases ACE2 in tissues relevant to COVID-19 transmission and pathogenesis, but the addition of losartan prevents these increases in ACE2 levels.
RCTAnimal StudyEffect of Lisinopril on the progression of renal insufficiency in mild proteinuric non-diabetic nephropathies.
Lisinopril has a specific renoprotective effect in addition to blood pressure control in patients with mild proteinuria, slowing the progression of non-diabetic chronic renal diseases.
RCTBeneficial effect of lisinopril plus telmisartan in patients with type 2 diabetes, microalbuminuria and hypertension.
Lisinopril plus telmisartan provides superior blood pressure and albumin excretion rate control than either drug alone, potentially preventing diabetic nephropathy in patients with type 2 diabetes, hypertension, and microalbuminuria.
RCTHighly CitedLisinopril attenuates acute hypoxic pulmonary vasoconstriction in humans.
Lisinopril significantly reduces the pulmonary pressor response to hypoxemia without decreasing baseline mean arterial pressure or total pulmonary vascular resistance, suggesting it may be a useful adjunctive treatment for hypoxemic pulmonary hypertension.
RCTComparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. ATLAS Study Group.
High doses of ACE inhibitors are generally recommended for patients with heart failure, as they reduce morbidity and mortality, while very low doses may be tolerated but have limited benefits.
RCTLarge Human TrialHighly CitedEffect of angiotensin-converting enzyme (ACE) gene polymorphism on progression of renal disease and the influence of ACE inhibition in IDDM patients: findings from the EUCLID Randomized Controlled Trial. EURODIAB Controlled Trial of Lisinopril in IDDM.
ACE inhibitor treatment can slow renal disease progression in type II diabetes mellitus patients, with lisinopril showing the most significant benefit for this group.
RCTLarge Human TrialHighly Cited