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Safety Advices
বাংলা
English
UNSAFE
It is unsafe to consume alcohol with Zestril.
CONSULT YOUR DOCTOR
Zestril is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
SAFE IF PRESCRIBED
Zestril is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.
UNSAFE
Zestril may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
CAUTION
Zestril should be used with caution in patients with kidney disease. Dose adjustment of Zestril may be needed. Please consult your doctor.
Regular monitoring of blood pressure is recommended for better dose adjustment.
CAUTION
Zestril should be used with caution in patients with liver disease. Dose adjustment of Zestril may be needed. Please consult your doctor.
Inform your doctor if you develop any signs and symptoms of jaundice while taking this medicine.
Medicine Overview of Zestril 20mg Tablet
Introduction
Zestril belongs to a group of medicines known as angiotensin converting enzyme (ACE) inhibitor. It is widely used to treat high blood pressure and heart failure and may be prescribed after a heart attack. It also lowers the chances of having a heart attack or stroke. Zestril can be prescribed either alone or in combination with other medicines. It should be taken on an empty stomach. This medicine should be taken at the same time each day to get the most benefit. It is important to continue taking it regularly even if you feel well or even if your blood...
... Show moreUses of Zestril
- Hypertension (high blood pressure)
- Prevention of heart attack and stroke
- Heart failure
Side effects of Zestril
Common
- Decreased blood pressure
- Cough
- Increased potassium level in blood
- Fatigue
- Weakness
- Dizziness
How to use Zestril
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Zestril may be taken with or without food, but it is better to take it at a fixed time.
How Zestril works
Zestril is an angiotensin converting enzyme (ACE) inhibitor. It works by reducing stress on the heart and relaxing blood vessel so that blood flows more smoothly and the heart can pump blood more efficiently.
What if you forget to take Zestril?
If you miss a dose of Zestril, skip it and continue with your normal schedule. Do not double the dose.
Quick Tips
- Zestril can make you feel dizzy for the first few days, so rise slowly if you have been sitting or lying down. You can also prefer taking it at bedtime to avoid dizziness throughout the day.
- Let your doctor know about any cough, or throat irritation that does not go away.
- It may increase the level of potassium in blood. Avoid taking potassium supplements and potassium-rich foods such as banana and broccoli.
- Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.
Brief Description
Indication
Heart failure, Myocardial infarction, Diabetic nephropathy, Hypertension
Administration
May be taken with or without food.
Adult Dose
Oral Hypertension Adult: Initially, 10 mg/day, 1st dose given preferably at bedtime to avoid precipitous fall in BP. Patient w/ renovascular HTN, volume depletion, severe HTN: Initially, 2.5-5 mg once daily. Patient on diuretic: Initially, 5 mg once daily. Maintenance: 20 mg once daily, up to 80 mg/day may be given if needed. Heart failure Adult: As adjunct: Initially, 2.5 or 5 mg/day, increased by increments of >10 mg at intervals of at least 2 wk to max maintenance dose of 40 mg/day. Post myocardial infarction Adult: Initially, 5 mg once daily for 2 days started w/in 24 hr of...
... Show moreChild Dose
Oral
Hypertension
Child: >6 yr Initially, 0.07 mg/kg, up to 5 mg once daily.
Renal Dose
Hypertension
Renal impairment: Adult: CrCl <10 mL/min or on dialysis: Initially, 2.5 mg once daily. CrCl 10-30 mL/min: Initially, 2.5-5 mg once daily. CrCl 31-80 mL/min: Initially, 5-10 mg once daily. Dose can be adjusted up to max 40 mg once daily based on patient's response. Child: Do not give if GFR <30 mL/min/1.73 m2.
CrCl (ml/min)
<10 Initially, 2.5 mg once daily.
10-30 Initially 2.5-5 mg once daily.
31-80 Initially, 5-10 mg once daily.
Contraindication
History of angioedema related to previous treatment with ACE inhibitors, hereditary or idiopathic angioedema. Bilateral renal artery stenosis. Pregnancy (2nd or 3rd trimester), lactation.
Mode of Action
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.
Precaution
Hypovolaemia, hyperkalaemia, collagen vascular disease, valvular stenosis; before, during or immediately after anaesthesia, preexisting renal insufficiency, unilateral renal artery stenosis. Children <6 yr. Assess renal function. May impair ability to drive or operate machinery.
Lactation: Not known if excreted into breast milk; not recommended
Side Effect
>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%
Immune hypersensitivity reaction,Psoriasis,Angioedema of the face, lips, throat; intestinal angioedema,Anuria,Atrial tachycardia,Acute renal failure,Arthralgia,Alopecia,Atrial fibrillation,Bone marrow suppression,Cutaneous pseudolymphoma,Hypersomnia,Leukopenia,Mood changes,Pancreatitis,Skin infections
Potentially Fatal: Severe hypotension, angioedema.
Interaction
May enhance hypotensive effect w/ diuretics. May increase risk of renal function deterioration and decrease antihypertensive effect w/ NSAIDs. May increase serum levels and toxicity of lithium. Increased risk of hyperkalaemia w/ K-sparing diuretics and K supplements. May increase nitritoid reactions of gold Na thiomalate.
Potentially Fatal: Increased risk of hypotension, hyperkalaemia and changes in renal function w/ aliskiren in patients w/ diabetes or renal impairment.