Lisinopril dosage chart
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Lisinopril Dosage Chart: A Comprehensive Overview
Introduction to Lisinopril Dosage
Lisinopril is a long-acting angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension, congestive heart failure, and acute myocardial infarction. It is administered orally once daily and is known for its efficacy in both younger and elderly populations. This article provides a detailed overview of the recommended dosages of lisinopril for various conditions and patient demographics.
Dosage for Hypertension
General Population
For the general population with mild to moderate essential hypertension, lisinopril is typically prescribed in doses ranging from 10 to 80 mg per day. Studies have shown that 10 and 20 mg doses produce similar peak antihypertensive effects, which are greater than those produced by a 2.5 mg dose but less than those of an 80 mg dose. The antihypertensive response is dose-related across the 2.5 to 80 mg/day range.
Elderly Patients
In elderly patients, the effective dosage of lisinopril ranges from 2.5 to 40 mg/day. Age-related differences in antihypertensive efficacy are not clinically significant, but dosages may need to be lower in patients with significant renal impairment.
Patients with Impaired Renal Function
For patients with impaired renal function (glomerular filtration rate (GFR) ≤ 60 ml/min), the starting dose is typically 2.5 mg for those with a GFR of less than 30 ml/min and 5 mg for others. The dosage can be titrated upward to 40 mg daily based on blood pressure response.
Dosage for Congestive Heart Failure
In patients with congestive heart failure, lisinopril is administered in doses ranging from 2.5 to 20 mg/day. This dosage has been shown to increase exercise duration, improve left ventricular ejection fraction, and is well tolerated when combined with digoxin and diuretics .
Dosage for Acute Myocardial Infarction
Lisinopril has been shown to reduce mortality and left ventricular dysfunction when administered within 24 hours of the onset of infarction symptoms. The typical dosage in such cases follows the GISSI-3 protocol, which involves administering lisinopril for 42 days.
Pediatric Dosage
Children and Adolescents
For hypertensive children aged 6 to 16 years, the initial dose of lisinopril is 0.07 mg/kg once daily. This dosage effectively lowers blood pressure within two weeks and is well tolerated. In a dose-escalation study, doses ranged from 0.05 mg/kg to 0.2 mg/kg, and adjustments were made based on body weight and estimated glomerular filtration rate (eGFR).
Special Considerations
Renal Impairment
Lisinopril is primarily eliminated by the kidneys, and its elimination half-life is prolonged in patients with renal impairment. Therefore, lower dosages are recommended for patients with significant renal impairment to avoid drug accumulation.
Post-Stroke Hypertension
In patients with acute ischemic stroke, lisinopril administered within 24 hours has been shown to be effective in gradually reducing blood pressure. The initial dose is typically 5 mg, which can be increased to 10 mg if necessary.
Conclusion
Lisinopril is a versatile and effective ACE inhibitor with a wide range of dosages suitable for various conditions and patient demographics. Dosage adjustments are crucial for patients with renal impairment and for pediatric patients to ensure optimal therapeutic outcomes. Always consult a healthcare provider for personalized dosage recommendations.
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