Lisinopril onset peak duration

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Lisinopril: Onset, Peak, and Duration of Action

Onset of Action

Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is commonly used to manage hypertension and heart failure. The onset of its antihypertensive effect begins within approximately 2 hours after oral administration . This rapid onset makes lisinopril a suitable option for patients requiring prompt blood pressure control.

Peak Effect

The peak serum concentration of lisinopril occurs between 6 to 8 hours post-dosing . This peak effect is crucial for understanding the timing of maximum therapeutic benefit. Studies have shown that the antihypertensive effect of lisinopril peaks around 6 hours after administration, providing significant blood pressure reduction during this period .

Duration of Action

Lisinopril has a prolonged duration of action, maintaining its antihypertensive effects for at least 24 hours . This extended duration allows for once-daily dosing, which can improve patient compliance. The smoothness index (SI), trough: peak ratio (TPR), and morning: evening home blood pressure ratio (MER) all indicate that lisinopril provides a consistent and sustained antihypertensive effect throughout the day 24.

Clinical Implications

The dose-response relationship of lisinopril indicates that higher doses produce greater antihypertensive effects. For instance, doses of 10 and 20 mg/day have been shown to produce similar peak effects, which are more pronounced than those achieved with a 2.5 mg/day dose but less than those with an 80 mg/day dose . This information is vital for clinicians when titrating doses to achieve optimal blood pressure control without increasing the risk of adverse effects such as first-dose hypotension .

Conclusion

Lisinopril is an effective antihypertensive agent with a rapid onset of action within 2 hours, a peak effect at around 6 hours, and a duration of action lasting at least 24 hours. These pharmacokinetic properties support its use in once-daily dosing regimens, enhancing patient adherence and providing consistent blood pressure control.

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Most relevant research papers on this topic

Lisinopril: dose-peak effect relationship in essential hypertension.

Lisinopril 10 and 20 mg doses have similar peak antihypertensive effects, but less than 80 mg doses, with no greater risk of first-dose symptomatic hypotension.

RCT

1988·

30citations

·VJ Cirillo et al.

Comparison of the smoothness index, the trough: peak ratio and the morning evening ratio in assessing the features of the antihypertensive drug effect

Lisinopril provides better trough-peak ratio and morning-evening ratio than losartan, but the smoothness index provides different information on homogeneity and magnitude, but not duration, of antihypertensive effects.

RCT

2003·

50citations

·G. Stergiou et al.

The Clinical Pharmacology of Lisinopril

Lisinopril effectively reduces blood pressure in hypertensive patients without affecting heart rate or cardiovascular reflexes, and is well-tolerated and has a good safety profile.

Highly Cited

1987·

77citations

·H. Gomez et al.

Comparison of the smoothness index, the trough : peak ratio and the morning

The smoothness index (SI) complements the trough : peak ratio (TPR) and morning : evening home blood pressure ratio (MER) in assessing the features of antihypertensive drugs, providing information on homogeneity and magnitude but not duration.

RCT

2003·

29citations

·G. Stergiou et al.

Lisinopril-Mediated Regression of Myocardial Fibrosis in Patients With Hypertensive Heart Disease

Lisinopril can regress myocardial fibrosis and improve LV diastolic function in patients with hypertensive heart disease, regardless of left ventricular hypertrophy regression.

RCTHighly Cited

2000·

636citations

·C. Brilla et al.

Pharmacokinetic profiles of single and repeat doses of lisinopril and enalapril in congestive heart failure.

Congestive heart failure alters absorption, firstpass metabolism, and drug elimination, leading to different pharmacokinetic profiles for lisinopril and enalapril.

Non-RCT

1992·

12citations

·D. Johnston et al.

Lisinopril: A New Angiotensin‐Converting Enzyme Inhibitor

Lisinopril effectively lowers blood pressure and improves heart function in patients with essential and renovascular hypertension, with potential for combination with hydrochlorothiazide for greater blood pressure reduction.

1989·

14citations

·S. Chase et al.

Effect of the ACE inhibitor lisinopril on mortality in diabetic patients with acute myocardial infarction: data from the GISSI-3 study.

Early treatment with lisinopril in diabetic patients with acute MI is associated with a decreased 6-week mortality.

RCTLarge Human TrialHighly Cited

1997·

230citations

·G. Zuanetti et al.

Blood Pressure- and Pulse Pressure-Lowering Effects, Trough:Peak Ratio and Smoothness Index of Telmisartan Compared with Lisinopril

Telmisartan and lisinopril both effectively reduce blood pressure and pulse pressure, with both providing smooth and sustained effects throughout the 24-hour period.

RCT

2003·

24citations

·G. Stergiou et al.

Short- and long-acting angiotensin-converting enzyme inhibitors: A randomized trial of lisinopril versus captopril in the treatment of congestive heart failure

Lisinopril is superior to captopril in improving exercise duration and quality of life in congestive heart failure patients, particularly in those with renal impairment.

RCTHighly Cited

1989·

117citations

·T. Giles et al.

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