Lisinopril side effects
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Lisinopril Side Effects: A Comprehensive Overview
Common Side Effects of Lisinopril
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is widely used for treating hypertension and heart failure. However, like all medications, it comes with potential side effects. The most frequently reported side effects in hypertensive patients include headache, dizziness, cough, nausea, diarrhea, and fatigue. These side effects are generally mild and do not always necessitate discontinuation of the medication.
Serious Side Effects and Discontinuation Rates
While serious side effects are rare, they can occur. In a large study involving 3,270 patients, 6.1% of hypertensive patients discontinued lisinopril due to adverse clinical events, most commonly cough and nausea. In patients with congestive heart failure (CHF), the discontinuation rate was higher at 9.6%, with hypotension, dizziness, diarrhea, and rash being the most frequent reasons. Notably, three CHF patients' deaths were considered related to lisinopril therapy.
Metabolic and Laboratory Effects
Lisinopril can also affect metabolic parameters. For instance, in a study comparing lisinopril with hydrochlorothiazide, it was found that serum potassium levels were lower and serum glucose levels were higher in patients taking higher doses of hydrochlorothiazide combined with lisinopril. However, changes in laboratory parameters were generally minor and seldom resulted in discontinuation of therapy.
Specific Side Effects in Different Patient Populations
Hypertensive Patients
In hypertensive patients, lisinopril effectively lowers blood pressure without major side effects. However, the incidence of side effects such as dizziness and fatigue is similar whether lisinopril is used alone or in combination with hydrochlorothiazide. Additionally, the antihypertensive effect of lisinopril is sustained throughout a 24-hour period without significantly affecting heart rate .
Patients with Heart Failure
For patients with heart failure, lisinopril has been shown to improve peak oxygen consumption and attenuate adrenergic drive during exercise. However, it is associated with a higher incidence of adverse events such as hypotension and worsening renal function, especially at higher doses. Despite these side effects, the benefits of high-dose lisinopril in reducing the risk of major clinical events outweigh the risks.
Renal Transplant Recipients
In renal transplant recipients, lisinopril is effective in treating hypertension but does not improve kidney transplant function as effectively as nifedipine over a two-year period. Both medications were found to be safe, but nifedipine showed a more significant improvement in glomerular filtration rates.
Conclusion
Lisinopril is a well-tolerated and effective medication for treating hypertension and heart failure, but it is not without side effects. Common side effects include headache, dizziness, and cough, while more serious side effects like hypotension and renal function deterioration are less frequent but noteworthy. The decision to use lisinopril should be based on a careful consideration of its benefits and potential risks, tailored to the specific needs of the patient.
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