Lisinopril discontinuation effects
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Lisinopril Discontinuation Effects: Common and Rare Outcomes
Discontinuation Due to Adverse Effects in Hypertension and Heart Failure
Lisinopril is generally well tolerated, but a notable percentage of patients discontinue it due to side effects. In studies of patients with hypertension, about 5–6.1% stopped taking lisinopril, most often because of cough, dizziness, or nausea. In patients with congestive heart failure (CHF), discontinuation rates were slightly higher, ranging from 7.4% to 9.6%, with hypotension, dizziness, diarrhea, and renal impairment being the most common reasons for stopping the medication. Most adverse effects were mild to moderate and did not require stopping the drug, but some patients did need to discontinue due to these symptoms 14.
Cough and Ethnic Differences in Discontinuation
Cough is a well-known side effect of lisinopril and other ACE inhibitors. It is a leading cause of discontinuation, especially among certain populations. For example, Chinese-Americans are more than twice as likely as the general population to stop taking lisinopril due to cough, even after accounting for age, sex, and smoking status . This highlights the importance of monitoring for cough and considering alternative therapies in patients who develop this symptom.
Resolution of Rare and Serious Adverse Effects After Discontinuation
Some rare but serious side effects of lisinopril resolve quickly after the drug is stopped. For instance, cases of angioedema affecting the intestine or mouth have been reported. Symptoms such as abdominal pain, swelling, and burning sensations in the mouth (sometimes called "scalded mouth syndrome") typically subside after discontinuing lisinopril 357. Similarly, a case of presumed lisinopril-induced liver injury showed rapid improvement in liver function and symptoms after the medication was stopped, with full normalization of liver enzymes within two months .
Time Course of Symptom Resolution
For most adverse effects, symptoms improve within days to weeks after stopping lisinopril. Intestinal angioedema, for example, often resolves within 24–48 hours, while liver-related side effects may take several weeks to fully normalize 235. Oral symptoms like burning mouth also subside after discontinuation .
Conclusion
Discontinuing lisinopril is most often prompted by side effects such as cough, dizziness, or hypotension, with certain populations at higher risk for specific reactions. Rare but serious adverse effects, including angioedema and liver injury, typically resolve after stopping the drug. Most symptoms improve rapidly, but some may take longer to fully resolve. Monitoring for side effects and timely discontinuation when necessary can help prevent complications and improve patient outcomes 1234567.
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