Lisinopril how long does it last
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Duration and Effects of Lisinopril: A Comprehensive Overview
Pharmacokinetics and Duration of Action
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, exhibits a unique pharmacokinetic profile. After oral administration, peak serum concentrations are achieved within 6 to 8 hours, and the drug's effects can last for 12 to 24 hours . The drug is not metabolized and is excreted unchanged via the kidneys, with an accumulation half-life averaging 12.6 hours despite a terminal serum half-life of approximately 40 hours . Steady-state concentrations are typically reached after two daily doses in healthy individuals.
Clinical Efficacy in Acute Myocardial Infarction
Lisinopril has been extensively studied for its benefits in patients with acute myocardial infarction (AMI). The GISSI-3 trial demonstrated that a 6-week course of lisinopril, initiated within 24 hours of symptom onset, significantly reduced mortality and severe left ventricular dysfunction at 6 months, even after the treatment was discontinued . Specifically, 18.1% of patients treated with lisinopril died or developed severe ventricular dysfunction compared to 19.3% of those who did not receive the drug, indicating a sustained benefit beyond the treatment period .
Long-Term Benefits in Heart Failure
In patients with congestive heart failure, high doses of lisinopril (32.5 to 35 mg daily) have shown significant advantages over lower doses (2.5 to 5 mg daily) in reducing the risk of major clinical events over a period of 39 to 58 months. These benefits include an 8% lower risk of all-cause mortality and a 24% reduction in hospitalizations for heart failure, demonstrating the drug's long-term efficacy.
Impact on Diabetic Patients with Myocardial Infarction
Diabetic patients with AMI also benefit significantly from early treatment with lisinopril. The GISSI-3 study found that lisinopril reduced 6-week mortality in diabetic patients from 12.4% to 8.7%, with the survival benefit largely maintained at 6 months despite the cessation of treatment at 6 weeks. This highlights the drug's potential to provide lasting benefits in high-risk populations.
Conclusion
Lisinopril is a potent ACE inhibitor with a duration of action that extends well beyond its administration period. Its pharmacokinetic properties ensure sustained therapeutic effects, making it effective in managing conditions like acute myocardial infarction and congestive heart failure. The drug's benefits, particularly in reducing mortality and severe ventricular dysfunction, persist even after treatment discontinuation, underscoring its long-term efficacy.
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