Side effects of stopping lisinopril
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Side Effects of Stopping Lisinopril
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is commonly prescribed for managing hypertension and congestive heart failure (CHF). While its efficacy and tolerability are well-documented, discontinuing lisinopril can lead to various side effects and clinical implications.
Common Side Effects of Lisinopril Discontinuation
Rebound Hypertension
One of the primary concerns when stopping lisinopril is the potential for rebound hypertension. This occurs when blood pressure rises significantly after discontinuing antihypertensive medication. Patients who stop taking lisinopril may experience a return of high blood pressure, which can increase the risk of cardiovascular events .
Dizziness and Fatigue
Patients discontinuing lisinopril may also experience dizziness and fatigue. These symptoms are commonly reported during the initial phase of stopping the medication, as the body adjusts to the absence of the drug's effects on blood pressure regulation.
Cough and Nausea
Although cough and nausea are more frequently associated with the initiation of lisinopril therapy, some patients may continue to experience these symptoms even after stopping the medication. This can be due to the body's lingering response to the drug.
Specific Considerations for CHF Patients
Increased Risk of Heart Failure Symptoms
For patients with congestive heart failure, stopping lisinopril can lead to a worsening of heart failure symptoms. This includes increased dyspnea (difficulty breathing), fatigue, and fluid retention. These symptoms can significantly impact the quality of life and may necessitate the reintroduction of the medication or alternative therapies.
Hypotension and Orthostatic Effects
While hypotension (low blood pressure) and orthostatic dizziness are more commonly reported during the initiation of lisinopril, these effects can also occur upon discontinuation, particularly in CHF patients. This is due to the body's adjustment to the absence of the drug's vasodilatory effects.
Laboratory and Metabolic Changes
Potassium and Glucose Levels
Discontinuing lisinopril can lead to changes in laboratory parameters, although these are generally minor. For instance, serum potassium levels may decrease, and serum glucose levels may increase, particularly if the patient was on a combination therapy with hydrochlorothiazide. These changes are usually not severe but should be monitored to prevent potential complications.
Conclusion
Stopping lisinopril can lead to several side effects, including rebound hypertension, dizziness, fatigue, and potential worsening of heart failure symptoms in CHF patients. It is crucial for patients to consult their healthcare provider before discontinuing the medication to manage these risks effectively. Monitoring and gradual tapering of the dose may help mitigate some of these adverse effects.
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