Prinivil (lisinopril) is an ACE (Angiotensin Converting Enzyme) inhibitor. Prinivil is used to treat high blood pressure (hypertension) in adults and children who are at least 5 years old. Prinivil is also used to treat congestive heart failure in adults, or to improve survival after a heart attack.

Precautions

  • Prinivil precautionsDo not use Prinivil if one is pregnant. It could harm the unborn baby. Seek advice from the doctor and use effective birth control while taking Prinivil.
  • Do not use Prinivil if one has hereditary angioedema.
  • If one has diabetes, do not use Prinivil together with any medication that contains aliskiren (such as Amturnide, Tekturna, Tekamlo).
  • Do not use Prinivil if allergic to lisinopril or to any other ACE inhibitor, such as benazepril captopril, fosinopril, enalapril, moexipril, perindopril, quinapril, ramipril, or trandolapril.
  • If one has diabetes, do not use Prinivil together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo).
  • Avoid taking Prinivilwith aliskiren if you have kidney disease.
  • Do not use Prinivil if one has hereditary angioedema.

It is not known whether lisinopril passes into breast milk or if it could harm a nursing baby. Do not breast-feed while using lisinopril.

If one needs surgery, tell the surgeon ahead of time that Prinivil is currently being used. One may need to stop using the medicine for a short time.

To make sure Prinivil is safe for one’s use, tell the doctor if there is:

  • kidney disease (or if one is on dialysis);
  • liver disease;
  • diabetes; or
  • high levels of potassium in the blood.

How should I take Prinivil?

  • Take Prinivil exactly as prescribed by the doctor. Follow all directions on prescription label. The doctor may occasionally change dose to make sure one gets the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.
  • Drink plenty of water each day while taking this medicine.
  • Prinivil can be taken with or without food.

Blood pressure will need to be checked often, and one may need frequent blood tests. Call the doctor if there is ongoing vomiting or diarrhea, or if one is sweating more than usual. One can easily become dehydrated while taking this medicine. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while taking Prinivil.

If one is being treated for high blood pressure, keep using this medication even if one is feeling well. High blood pressure often has no symptoms. One may need to use blood pressure medication for the rest of life. Store at room temperature away from moisture and heat.

LISINOPRIL

Prinivil (Lisinopril)Lisinopril belongs to a class of medications called Angiotensin Converting Enzyme (ACE) inhibitors. It is used to treat high blood pressure and congestive heart failure. It works by relaxing blood vessels and helping the heart to pump blood that carries oxygen to the different parts of the body more efficiently. It is also used immediately after a heart attack in order to reduce the risk of having another heart attack.

Precautions

  • Do not stop taking this medication without consulting the doctor.
  • Do not give this medication to anyone else, even if they have the same symptoms. It can be harmful for people to take this medication if their doctor has not prescribed it.

FORMS

5mg

Each white, oval-shaped, compressed tablet, with code “MSD 19” on one side and scored on the other, contains lisinopril 5 mg. Non-medicinal ingredients: calcium phosphate, cornstarch, magnesium stearate, and mannitol. The splitting of Prinivil tablets is not advised.

10 mg

Each light yellow, oval-shaped, compressed tablet, engraved “MSD 106” on one side and scored on the other, contains lisinopril 10 mg. Non-medicinal ingredients: calcium phosphate, cornstarch, iron oxide, magnesium stearate, and mannitol. The splitting of Prinivil tablets is not advised.

20 mg

Each peach, oval-shaped, compressed tablet, engraved “MSD 207” on one side and scored on the other, contains lisinopril 20 mg. Non-medicinal ingredients: calcium phosphate, cornstarch, iron oxide, magnesium stearate, and mannitol. The splitting of Prinivil tablets is not advised.

SIDE EFFECTS

Contact the doctor if experiencing these side effects and they are severe or bothersome: cough (dry, persistent), diarrhea, mild dizziness, headache, nausea, unusual tiredness, chest pain, signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools), signs of low blood pressure (e.g., dizziness, lightheadedness, or fainting), signs of too much potassium in the body (e.g., confusion; irregular heartbeat; nervousness; numbness or tingling in hands, feet, or lips; shortness of breath or difficulty breathing; weakness or heaviness of legs), signs of angioedema (e.9., swelling of face, mouth, hands, or feet), trouble in swallowing or breathing (sudden).

Some people may experience side effects other than those listed. Check with the doctor if there are notices of any symptom that worries while taking this medication.

PRINIVIL SIDE EFFECTS

Major Side Effects and more common: blurred vision, cloudy urine, confusion, decrease in urine output or decrease in urine-concentrating ability; dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position, sweating, unusual tiredness or weakness Major side effects and less common: abdominal or stomach pain, body aches or pain, chest pain Chills, common cold, cough, diarrhea, difficulty breathing, ear congestion, fever, headache, loss of voice, nasal congestion, nausea, runny nose, sneezing, sore throat, vomiting, Major side effects but rare: arm, back, or jaw pain; chest discomfort, tightness, or heaviness; fast or irregular heartbeat; general feeling of discomfort or illness; joint pain; loss of appetite; muscle aches and pains; shivering; trouble sleeping;

Minor Side Effects

Less common: decreased interest in sexual intercourse, inability to have or keep an erection, lack or loss of strength, loss in sexual ability, desire, drive, or performance; rash. Rare: Acid or sour stomach, belching, burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings, feeling of constant movement of self or surroundings, heartburn, indigestion, muscle cramps, sensation of spinning, stomach discomfort or upset, swelling

PRINIVIL ZESTRIL

This drug is being marketed by both Merck and Zeneca. The Merck product is called Prinivil; Zeneca’s product is called Zestril. Prinivil is indicated for the treatment of hypertension, heart failure, and acute myocardial infarction. It may be used alone as initial therapy or concomitantly with other classes of antihypertensive agents. It is indicated as adjunctive therapy in the management of heart failure in subjects who are not responding adequately to diuretics and digitalis. It is also indicated for the treatment of hemodynamically stable subjects within 24 hours of acute myocardial infarction, to improve survival. The effects of Prinivil in hypertension and heart failure appear to result primarily from suppression of the renin-angiotensin-aldosterone system. Inhibition of ACE results in decreased plasma angiotensin II, which leads to decreased vasopressor activity and to decrease aldosterone secretion.

Prinivil for blood pressureIn most hypertensive subjects studied, onset of antihypertensive activity was seen at one hour after oral administration of an individual dose of Prinivil, with peak reduction of blood pressure achieved by six hours. Although an antihypertensive effect was observed 24 hours after dosing with recommended single daily doses, the effect was more consistent and the mean effect was considerably larger in doses of 20 mg or more than with lower doses. However, at all doses studied, the mean antihypertensive effect was substantially smaller 24 hours after dosing than it was six hours after dosing. During baseline-controlled clinical trials in subjects receiving digitalis and diuretics, single doses of Prinivil resulted in decreases in pulmonary capillary wedge pressure, systemic vascular resistance, and blood pressure accompanied by an increase in cardiac output and no change in heart rate.

A multicenter, controlled, randomized, unblinded clinical trial was conducted in 19,394 subjects with acute myocardial infarction admitted to a coronary care unit. The trial was designed to examine the effects of short-term (6-week) treatment with Prinivil, nitrates, their combination, or no therapy. Subjects receiving Prinivil alone or with nitrates had an LIYI lower risk of death compared to patients receiving no Prinivil at 5 weeks. Prinivil was found to be generally well tolerated in controlled clinical trials. For the most part, the following adverse effects were mild and transient: fatigue, diarrhea, nausea, headache, and dizziness.

Adverse Effects

<10%: Dizziness (5-12%)

1-10%: Cough (4-9%), Headache (4-6%), Hyperkalemia (2-5%), Diarrhea (3-4%), Hypotension (1-4%), Chest pain (3%), Fatigue (3%), Nausea/vomiting (2%), Kidney disease, of AMI patients (2%), Rash (1-2%)

<1%: lmmune hypersensitivity reaction, Psoriasis, Angioedema of the face, lips, throat; intestinal angioedema, Anuria, Atrialtachycardia, Acute renal failure, Arthralgia, Alopecia, Atrial fibrillation, Bone marrow suppressiori, Cutaneous pseudolymphoma, Hypersomnia, Leukopenia, Mood changes, Pancreatitis, Skin infections.

What other drugs will affect Prinivil?

Inform the doctor about all current medicines and any start or stop using, especially: lithium; a diuretic or “water pill”; gold injections to treat arthritis; insulin or oral diabetes medicine; a potassium supplemen| medicine to prevent organ transplant rejection – everolimus, sirolimus, tacrolimus, temsirolimus; or NSAIDs (nonsteroidal anti-inflammatory drugs) – aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

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