Reduction of angiotensin II leads to a direct reduction in allocation aldoserona. It reduces the degradation of bradykinin and increases the synthesis of prostaglandin. It reduces the total peripheral vascular resistance, blood pressure (BP), preload, pressure in the pulmonary capillaries, causing an increase in cardiac output and increase tolerance to myocardial stress in patients with heart failure. Artery expands to a greater extent than veins. Some effects are explained by the influence on the tissue renin-angiotensin system. With anadrol dosage prolonged use reduces myocardial hypertrophy and arterial wall of the resistive type. It improves blood flow to ischemic myocardium. ACE inhibitors prolong the life expectancy of patients with heart failure, slow the progression of left ventricular dysfunction in patients with myocardial infarction without clinical manifestations of heart failure. Valid – after 1 hour. The maximum effect is determined in 6-7 hours duration – 24 hours. When hypertension effect noted in the first days after the start of treatment, stable effect develops in 1-2 months.
The bioavailability of the drug is 25-50%, weakly bound to plasma proteins. The maximum serum concentration achieved after 7 hours. Food intake has no effect on absorption. Lisores is not metabolized and is excreted unchanged in the urine. The main part of it is released during the initial phase (poluvyvedeniya- effective period of 12 hours), followed by the remote terminal phase (half-life approximately 30 hours). Permeability through the blood brain barrier and the placental – low.
- hypertension (in monotherapy or in combination with other agents);
- chronic heart failure (in a combination therapy for the treatment of patients taking drugs digitalis and / or diuretics);Contraindications
: Hypersensitivity to lisinopril other ACE inhibitors, expressed violations kidney function, bilateral renal artery stenosis or stenosis of the artery only kidneys with progressive azotemia, condition after kidney transplantation, azotemia, primary aldosteronism, aortic stenosis (and similar obstructions to blood flow), hereditary edema angioedema, pregnancy, lactation, age 18 years (effectiveness and safety have been established)
Be wary –
hypotension, inhibition of bone marrow hematopoiesis, hyponatremia (increased risk of hypotension in patients who are at malosolevoy or salt-free diet), systemic connective tissue disease, diabetes, gout, hyperuricemia, coronary heart disease, cerebrovascular disease, severe chronic heart failure, hyperkalemia, old age.
Side effect On the part of the cardiovascular system: reduction of blood pressure, chest pain, rarely -ortostaticheskaya hypotension, tachycardia, bradycardia, the emergence of symptoms of heart failure, violation of atrioventricular conduction. From the nervous system: dizziness, headache, fatigue, drowsiness, convulsive twitching of the limbs and lips, rare – asthenic syndrome, mood lability, anadrol dosage confusion. on the part of the gastrointestinal tract: nausea, dyspepsia, anorexia, changes in taste, abdominal pain, diarrhea, dry mouth. From the side of hematopoiesis: leukopenia, thrombocytopenia, neutropenia, agranulocytosis, anemia (decreased hemoglobin, erythropenia). The respiratory system: dyspnea, bronchospasm, apnea. Allergic reactions: angioedema, skin rash, itching. Laboratory indicators:hyperkalemia, hyperuricemia, rarely – increased activity of “liver “transaminases, hyperbilirubinemia. Others: dry cough, decreased potency, rarely – acute renal failure, arthralgia, myalgia, fever, swelling (tongue, lips, limbs), violation of fetal kidney.
Interaction with other drugs
There was no significant interaction with propranalolom Lisinopril, hydrochlorothiazide, digoxin. Perhaps the reduction in the antihypertensive effect of Lisinopril while taking a nonsteroidal anti-inflammatory drugs, estrogens, sympathomimetics. Hydrochlorothiazide may potentiate the antihypertensive effect of Lisinopril. Combined use of beta-blockers, blockers “slow” calcium channel blockers and diuretics increases the antihypertensive effect of Lisinopril. While the use of potassium-sparing diuretics (spironolactone, triamterene, amiloride), potassium salt substitutes containing potassium, increases the risk of hyperkalemia, especially in patients with impaired renal function. Lisinopril reduces potassium loss caused by thiazide diuretics type. When coadministered with drugs lithium Lisinopril may slow excretion of lithium from the body. Antacids and cholestyramine reduce the absorption of Lisinopril in the gastrointestinal tract.
During treatment requires regular medical supervision. For patients with impaired renal function the dose should be reduced or reduce the frequency of administration Lisores. Patients taking Lisores, reported on the development of angioedema face, lips, tongue, glottis and / or larynx. In such cases, you must immediately stop anadrol dosage taking Lisores.