Lisinopril dosage
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Lisinopril Dosage: A Comprehensive Review
Introduction to Lisinopril Dosage
Lisinopril is a long-acting angiotensin-converting enzyme (ACE) inhibitor commonly used to treat hypertension, congestive heart failure, and acute myocardial infarction. The appropriate dosage of lisinopril can vary significantly based on patient age, renal function, and specific medical conditions.
Lisinopril Dosage in Elderly Patients
In elderly patients, lisinopril is effective in reducing blood pressure, with dosages typically ranging from 2.5 to 40 mg/day. Clinical trials have shown that 68.2% to 89.1% of elderly patients responded to treatment within 8 weeks, achieving a diastolic pressure of ≤90 mm Hg. For those with significant renal impairment, lower dosages are recommended to avoid drug accumulation and potential adverse effects.
Lisinopril Dosage in Pediatric Patients
For hypertensive children aged 6 to 16 years, lisinopril has been shown to be effective and well-tolerated. The initial recommended dose is 0.07 mg/kg once daily, with blood pressure reductions observed in a dose-dependent manner. This dosage can be adjusted based on the child's weight and response to treatment.
Dose-Response Relationship in Essential Hypertension
Studies have demonstrated a clear dose-response relationship for lisinopril in patients with mild to moderate essential hypertension. Dosages ranging from 2.5 to 80 mg/day have been evaluated, with higher doses providing greater antihypertensive effects. Specifically, 10 and 20 mg/day doses produced similar peak effects, which were greater than those achieved with 2.5 mg/day but less than those with 80 mg/day .
Optimal Dosage for Renoprotection in Diabetic Nephropathy
In type 1 diabetic patients with diabetic nephropathy, lisinopril dosages of 20, 40, and 60 mg/day were compared. The study found that 40 mg/day provided the optimal balance of efficacy and safety, significantly reducing urinary albumin excretion rate (UAER) and blood pressure without additional benefits at 60 mg/day.
Lisinopril in Patients with Impaired Renal Function
For patients with hypertension and impaired renal function, lisinopril is effective at dosages adjusted for renal clearance. Starting doses of 2.5 mg for those with a glomerular filtration rate (GFR) of less than 30 ml/min and 5 mg for others are recommended, with titration up to 40 mg/day based on blood pressure response. This approach helps manage hypertension while minimizing the risk of drug accumulation.
Pharmacokinetics in Pediatric Patients
In pediatric patients, lisinopril pharmacokinetics are influenced by body weight and renal function. Dosages ranging from 0.05 to 0.2 mg/kg once daily have been studied, with adjustments based on estimated glomerular filtration rate (eGFR) to ensure safe and effective treatment.
Lisinopril in Acute Ischemic Stroke
Lisinopril has also been studied for its effects on blood pressure in patients with acute ischemic stroke. Administering 5 mg within 24 hours of stroke onset, with an increase to 10 mg if necessary, has been shown to effectively reduce blood pressure without significant adverse effects.
Conclusion
Lisinopril is a versatile ACE inhibitor with a wide range of effective dosages tailored to specific patient populations and conditions. From elderly patients to children, and those with renal impairment or diabetic nephropathy, careful dosage adjustments ensure optimal therapeutic outcomes while minimizing risks.
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