Lipril

Acepril is indicated for all grades of essential hypertension and renovascular hypertension. Acepril can be used alone or with other anti-hypertensive agents.

Treatment should be started with 2.5 mg once daily. In patients with uncomplicated essential hypertension, not on diuretic therapy, the recommended initial dose is 10 mg once daily. Dosage should be adjusted according to blood pressure response. The usual dosage range is 10-20 mg once daily. Maximum dose is 40 mg per day as a single dose or as directed by the physician.
Diuretic treated patients
: In hypertensive patients who are currently being treated with a diuretic, symptomatic hypotension may occur, occasionally following the initial dose of Lisinopril. If the diuretic can not be discontinued, and initial dose of 10 mg should be used under medical supervision for at least two hours and until blood pressure has stabilised for at least an additional hour.

Chest discomfort, flushing, hypotension, tachycardia, abdominal pain, anorexia, constipation, flatulence, joint pain, depression, insomnia, bronchitis, cough may occur.

Evaluation of the patient should include assessment of renal function prior to initiation of therapy and during
treatment. Acepril should be used with caution in patients with renal insufficiency, as they may require reduced doses.
Severe hypotension has been reported with ACE inhibitors, mainly in patients with severe heart failure and also in patients with surgery.
Acepril should not be used in patients with aortic stenosis, corpulmonale or outflow tract obstruction.
As it is not known whether Acepril is excreted in human milk, caution should be exercised if Acepril is given to nursing mothers.

Lisinopril competitively inhibits ACE from converting angiotensin I to angiotensin II (a potent vasoconstrictor) resulting in increased plasma renin activity and reduced aldosterone (a hormone that causes water and Na retention) secretion. This promotes vasodilation and BP reduction.