Lisinopril Drug Interactions

Lisinopril Drug Interactions: A Comprehensive Overview

Introduction to Lisinopril Drug Interactions

Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is commonly prescribed for hypertension and heart failure. However, its interaction with other drugs can significantly impact its efficacy and safety. This article synthesizes research findings on lisinopril's interactions with various drugs, highlighting the pharmacokinetic and pharmacodynamic implications.

Lisinopril and Nifedipine: No Acute Interaction

A study investigating the interaction between lisinopril and nifedipine in normotensive subjects found no significant pharmacokinetic or pharmacodynamic interactions. Both drugs lowered blood pressure independently, and their combination showed additive effects without altering each other's pharmacokinetics. This suggests that co-administration of these drugs is generally safe and effective for blood pressure management.

Lisinopril and Diclofenac: Reduced Antihypertensive Efficacy

The combination of lisinopril and diclofenac sodium in hypertensive osteoarthritic patients, both diabetic and non-diabetic, resulted in reduced blood pressure control compared to lisinopril alone. Additionally, this combination adversely affected renal function, as indicated by increased serum creatinine levels and altered creatinine clearance and blood urea nitrogen levels. These findings underscore the need for careful monitoring and potential dose adjustments when these drugs are used together.

Lisinopril and Gliclazide: Enhanced Hypoglycemic Effect

In diabetic patients, the combination of lisinopril and gliclazide, a sulfonylurea, showed a significant enhancement in the hypoglycemic effect of gliclazide. This interaction was more pronounced with chronic use, suggesting that dose adjustments may be necessary to avoid hypoglycemia. This highlights the importance of monitoring blood glucose levels when these drugs are co-administered.

Lisinopril and JBP485: Transporter-Mediated Interaction

Research on the interaction between lisinopril and JBP485, a dipeptide with antihepatitis activity, revealed that both drugs inhibit the same transporters in the intestine (PEPT1) and kidneys (OATs). This interaction led to decreased plasma concentrations and altered renal excretion of both drugs, indicating a significant pharmacokinetic interaction. This suggests that co-administration may require dose adjustments to maintain therapeutic efficacy.

Lisinopril and Metformin: Altered Dissolution Profiles

An in vitro study on the interaction between lisinopril and metformin found that lisinopril significantly altered the dissolution profile of metformin at various pH levels, and vice versa. This interaction could potentially affect the bioavailability of both drugs when co-administered. Therefore, clinicians should consider the timing of administration to minimize interaction effects.

Lisinopril and Hydrochlorothiazide: No Significant Interaction

The co-administration of lisinopril and hydrochlorothiazide, a diuretic, showed no clinically relevant pharmacokinetic interactions. Both drugs maintained their pharmacokinetic profiles when administered together, either as separate tablets or in a fixed-dose combination. This combination is effective and well-tolerated for hypertension management.

Conclusion

Lisinopril interacts with various drugs, affecting their pharmacokinetic and pharmacodynamic profiles. While some combinations, like with nifedipine and hydrochlorothiazide, are generally safe, others, such as with diclofenac and gliclazide, require careful monitoring and potential dose adjustments. Understanding these interactions is crucial for optimizing therapeutic outcomes and minimizing adverse effects.

Summary

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