Side effects of stopping lisinopril

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How Long Does Lisinopril Stay in Your System?

Published: 01/16/20

Do you take lisinopril for congestive heart failure, high blood pressure, or another cardiac condition?

This common ACE inhibitor drug was prescribed over 104,000 times in 2017, so you’re not alone if you’re wondering how long lisinopril stays in your system.

It’s not a typical “drug of abuse” but you might be wondering if it can show up on a drug screening. Millions of Americans take drug tests for work every year, so it’s a common concern with prescription drugs.

Here’s what you should know about lisinopril’s effects and whether it’s detectable on a lab test:

How Long Do Lisinopril Effects Last?

If you’re taking lisinopril to reduce your blood pressure, then its body and brain effects can start within hours.

Your blood pressure should stabilize within hours of starting lisinopril. The side effects start quickly and can include:

  • Cough
  • Diarrhea
  • Dizziness
  • Headache
  • Sleepiness

The effects start to wane within 12 hours or so. You may be asked to take lisinopril twice a day to keep enough of it in your system. Always take lisinopril according to your doctor’s directions.

For heart failure, the effects of lisinopril can take a few weeks to begin. It’s important to be patient and keep taking the medication even if it doesn’t work right away.

Lisinopril causes pre-birth injury. Never take lisinopril if you’re pregnant.

How Long Does Lisinopril Stay in Your System?

The length of time it takes for a drug to leave your system depends on its half-life.

Lisinopril has a half-life of 12.6 hours. That means it takes 12.6 hours to get half of the drug out of your system.

It takes five half-lives to get the drug out of your system, so you can expect the drug to stick around for about two and a half days.

This varies from person to person. It’s possible for lisinopril to stay in your system longer if you have kidney disease or have trouble excreting drugs.

How Long Does Lisinopril Stay in Lab Tests?

The amount of time lisinopril shows up on a lab test depends on:

  • The type of test, e.g. hair, urine, blood, or saliva testing
  • Your metabolism, which can include your genetics, age, and weight
  • Lisinopril usage, including dosage, the last time it was taken, and how often

This is not the same for everyone. The length of time you can detect lisinopril varies from person to person and from test to test.

How Long Does Lisinopril Stay in Your Urine?

Lisinopril can stay in your urine for up to 3 days after use. A urine test can’t detect amounts of lisinopril. However, it can tell whether you’ve taken the drug recently or not.

Some doctors use urine testing to find out if their patients are taking their medication as directed. Lisinopril isn’t part of a standard urine panel for illicit drug use.

How Long Does Lisinopril Stay in Your Hair?

In theory, lisinopril could stay in your hair for at least a month. Your hair can show evidence of many kinds of drug use within 30 days of use.

In reality, you’re not likely to receive a hair test for lisinopril. The drug is considered to have low potential for abuse. It doesn’t cause euphoria and it’s not part of most standard drug panels.

How Long Does Lisinopril Stay in Your Blood?

Like urine tests, blood tests can detect lisinopril for up to 3 days after use. This isn’t an exact figure and it can vary based on factors like metabolism and dosage.

You’re unlikely to have a blood test that checks for lisinopril. Your doctor may check lisinopril levels with a blood serum test if they need to know your levels. But even that is unlikely.

How Long Does Lisinopril Stay in Your Saliva?

Lisinopril stays in your saliva for the same amount of time as your blood serum. That means lisinopril and its byproducts can stay in your saliva for up to 3 days.

However, you probably won’t ever have a saliva test or a buccal swab test for lisinopril. That’s because lisinopril isn’t part of most routine drug screening panels.

Can You Detox From Lisinopril Faster?

You can’t make your body detox from lisinopril or any drug faster. That’s because detox is controlled by many factors. They can include your:

  • Drug use patterns, including the frequency of use
  • Genetics
  • Health
  • Lifestyle
  • Metabolism

You can control some of these factors but definitely not all of them! The best way to detox from lisinopril is to abstain from the drug completely. A drug rehab center can help you recover from lisinopril abuse.

You should never stop taking lisinopril without talking to your doctor! Stopping cardiac medication suddenly can be dangerous to your health.

Most people don’t develop a withdrawal syndrome from stopping lisinopril. But you can still experience rebound hypertension if you stop lisinopril too fast. This is high blood pressure caused by stopping your medication abruptly.

Get Help for Prescription Drug Addiction

Even though lisinopril isn’t considered a “drug of abuse” you can still become addicted to it. You can develop addiction anytime you misuse a substance.

If you’re worried about prescription drugs taking over your life, you’re not alone. At Recovering Champions, we provide compassionate, non-judgmental addiction care.

Your treatment plan for prescription drug abuse can include:

  • Cognitive-behavioral therapy: This treatment is known as CBT. It helps you explore the reasons you use drugs so you can change that behavior.
  • Dialectical behavior therapy: DBT helps you learn mindfulness techniques and apply them to stressful situations. This can help you learn healthy coping methods—no drugs involved!
  • Group therapy: It’s common for someone living with an addiction to feel alone, but that couldn’t be farther from the truth. Group therapy helps you realize that you can get through this struggle.
  • Medication-assisted treatment: MAT is the use of drugs such as Suboxone to control cravings. This can increase the odds of success in alcohol or opioid treatment.

Now’s the time to start your recovery journey—and we’re here to help. Call Recovering Champions today to schedule your intake appointment!

1. What is lisinopril?

Lisinopril belongs to a class of drugs known as angiotensin-converting enzyme (ACE) inhibitors. It works by relaxing blood vessels, allowing blood to flow more easily. Other ACE inhibitors include:

  • Ramipril
  • Fosinopril
  • Enalapril
  • Captopril
  • Benazepril
  • Quinapril
  • Monopril

The angiotensin-converting enzyme is responsible for producing the chemical, angiotensin II. Angiotensin II causes muscles surrounding blood vessels to contract, causing them to narrow. This can cause blood pressure to increase and means the heart has to work harder to pump blood around the body.

ACE inhibitors like lisinopril counteract this mechanism and reduce blood pressure.

Zestril, Prinivil, and Qbrelis are some of the brand names for lisinopril.

2. What is lisinopril/HCTZ?

When ACE inhibitors alone are not able to sufficiently lower blood pressure, they will often be combined with another treatment. Lisinopril can be combined with hydrochlorothiazide (HCTZ), a diuretic medicine commonly known as a water pill. Lisinopril/HCTZ is sold under the brand names Prinzide and Zestoretic.

Manage Your Blood Pressure Treatment with MyTherapy

Lisinopril/HCTZ may be used to treat high blood pressure after other medicines have not worked effectively or have caused unwanted side effects.

Diuretics are also a first-line treatment for high blood pressure. Diuretics help treat high blood pressure by stopping the reabsorption of electrolytes such as sodium, chloride, magnesium, and potassium, which are then flushed out through urine along with excess water.

The removal of excess water and electrolytes from blood vessels helps blood flow and lowers your blood pressure.

3. What is lisinopril used for?

isinopril is a drug that is used as a first-line treatment for high blood pressure. This helps prevent heart attacks, strokes, and kidney diseases. Lisinopril is used to treat heart failure and helps prevent future strokes and heart attacks.

Lisinopril is also prescribed after a heart attack and to prevent the progression of renal disease in hypertensive patients with diabetes mellitus and kidney problems.

Other first-line treatments for high blood pressure include:

  • Angiotensin II receptor blockers (ARBs)
  • Diuretics
  • Calcium channel blockers

Your doctor will take factors such as your age, sex, race, blood pressure level, and other conditions into consideration when deciding the most suitable treatment options.

ACE Inhibitors are sometimes prescribed in combination with other blood pressure medicines, such as diuretics.

If you do not respond to one type of treatment or have an adverse or allergic reaction, your doctor may try a different medication or a combination of two drugs.

However, some types of drugs are not routinely used in combination, such as ARBs and ACE inhibitors.

Treatment for hypertension will usually come with recommendations for healthy lifestyle changes, such as adopting a diet that is low in fat and salt, maintaining a healthy weight, exercising (within one’s capabilities), not smoking, and moderating the amount of alcohol you drink (or abstaining completely).

4. How does lisinopril work?

The angiotensin-converting enzyme converts angiotensin I to angiotensin II, which regulates blood pressure by constricting the arterial muscles.

ACE inhibitors like lisinopril work by reducing the activity of the enzyme and thus reducing the production of angiotensin II, therefore relaxing the arterial muscle and expanding blood vessels. This helps lower blood pressure and means the heart does not have to work too hard to pump blood around the body.

This improves the symptoms of heart failure and can help protect the kidney in people with diabetic kidney disease by slowing down the disease.

5. How long does it take for lisinopril to work?

Lisinopril starts to work within a few hours after taking it, but may take two to four weeks before you get the full benefit of this medication.

If you’re taking lisinopril to treat high blood pressure, you may not feel any different, but this doesn’t mean that the drug isn’t working.

It is important to keep taking it because, like most blood pressure lowering medications, lisinopril is often required for the rest of your life, even if it has successfully lowered your blood pressure.

Continued use will help keep your blood pressure under control and may help mitigate the risk of heart failure.

Tell your doctor if your condition does not get better or if it gets worse.

6. What are the most common side effects of lisinopril?

The most common side effects of lisinopril occur when you begin treatment and your body adjusts. Dizziness or lightheadedness, particularly when you stand or sit up quickly, is common in the first few days of your treatment. Other common side effects include:

  • A dry cough
  • Headaches
  • Nausea
  • Sexual dysfunction
  • Mild itching or rash
  • Tiredness and fatigue
  • Drowsiness
  • Diarrhea
  • Blurred vision

You should speak to your doctor if these symptoms are severe, persistent, or you have any other concerns.

More serious side effects, although rare, can include:

  • Signs of liver problems, such as yellowing of the skin and eyes
  • Signs of kidney problems, such as blood in your urine, passing little or no urine, or swollen ankles
  • Signs of heart problems, such as rapid or irregular heartbeat, chest pain, or chest tightness
  • Signs of lung problems, such as shortness of breath or wheezing
  • Signs of high potassium, such as muscle weakness, slow or irregular heartbeat, or tingly feeling

If you experience any of these serious side effects, you should contact a doctor immediately.

Allergic reactions to lisinopril are rare. A serious allergic reaction should be treated as an emergency; signs of a serious allergic reaction include:

  • Swelling of your face, lips, tongue, or throat
  • A skin rash that may include itchy, red, swollen, blistering, or peeling skin
  • Tightness in your chest or throat
  • Wheezing or trouble breathing

If you believe you or someone else is having a serious allergic reaction, seek immediate medical attention or call the emergency services. You should never take an ACE inhibitor again after having a serious allergic reaction.

Although this covers the most common and serious side effects of lisinopril, please check the information leaflet for an extensive list.

7. What is the correct dosage of lisinopril?

Lisinopril comes in the form of tablets (2.5, 5, 10, 20, 30 and 40 mg), taken orally, usually once a day, with a starting daily dose of 10 mg for adults.

The dose of lisinopril will be different for different patients. Your doctor may check your blood pressure and ask of any side effects in deciding your dose.

The usual dose range for adults is 20-40 mg daily. Your doctor may start you on a lower dose and gradually increase it as necessary.

For children aged 6 years old and over, the dosage is usually based on weight. The starting dose is usually 0.07 mg per kilogram (kg) of body weight per day, which may be increased as needed. However, the dose is usually not more than 0.61 mg per kg of body weight or 40 mg per day.

It is important to follow your doctor’s instructions. If you have any concerns regarding your dosage of lisinopril, please speak to your doctor.

8. Who can take lisinopril?

Lisinopril can be taken by adults and children over 6 years old.

Lisinopril isn’t suitable for everyone; you should discuss all past or present medical conditions with your doctor. If you have a history of heart, liver, or kidney problems, diabetes, or low blood pressure, lisinopril may not be the most suitable medication. Other conditions may also influence your doctor’s choice of medication.

It is also important to discuss other medications – both over the counter and prescription – or supplements that you take.

Other lifestyle factors, such as your diet, may also be relevant (particularly if you have a low-salt diet). If you have diabetes, you may need to take additional care regarding your blood sugar levels, which can be lowered by lisinopril.

9. How long does lisinopril stay in your system?

A drug stays in your body for approximately 5.5 x the elimination half-life of that particular drug.

Lisinopril has a half-life of about 12 hours.

It will therefore take approximately 66 hours (about 3 days) for lisinopril to be cleared from your system.

10. What time should I take lisinopril?

Although there’s no conclusive evidence that taking lisinopril either in the morning, afternoon, or evening leads to better or worse results, it is advisable to take lisinopril around the same time every day.

It could also be important to schedule when you take lisinopril and when you take other medications or supplements, to avoid interactions.

Lisinopril may also make you dizzy, so your doctor may suggest you take your first dose before going to bed. After the first dose, you can decide which time of day suits you best and aim to take it consistently.

11. Is lisinopril safe during pregnancy or when breastfeeding?

Lisinopril is not recommended for use during pregnancy or when breastfeeding as it may possibly cause fatal harm to fetuses and neonates.

Small amounts of lisinopril may pass into breast milk and might cause low blood pressure in the baby.

Talk to your doctor immediately if you plan on becoming pregnant, are pregnant or before/while breastfeeding as other medications might be a better alternative.

12. Can I take other drugs with lisinopril?

There are many drugs that may interact with lisinopril, which may reduce the effectiveness of your treatment or cause harmful side effects.

It is not recommended that lisinopril is taken together with:

  • Sacubitril
  • Aliskiren

Lisinopril is not usually recommended in combination with potassium, diuretics that conserve potassium (such as spironolactone), drugs that may increase the level of potassium in the blood (such as ARBs including losartan and valsartan), or birth control pills containing drospirenone, as these combinations may raise your potassium levels to dangerous levels.

Other medications, including aspirin, NSAIDS (such as ibuprofen), indomethacin, and naproxen can raise your blood pressure, worsen your heart failure or reduce the effects of ACE inhibitors.
Drugs used to treat asthma, heart failure, or allergies (such as ephedrine and noradrenaline), and drugs that suppress your immune system (e.g. ciclosporin) may interact with the way lisinopril works.

This is not an extensive list of drugs with which lisinopril may interact. It is important you discuss all medications you take with your doctor.

Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

13. What foods shouldn’t I eat while taking lisinopril?

ACE inhibitors are designed to lower blood pressure, but they also elevate potassium levels in the body. Therefore, potassium-rich foods can be problematic for people taking ACE inhibitors. Some of these foods include:

  • Bananas, oranges, and green, leafy vegetables
  • Mushrooms
  • Avocadoes
  • Peas
  • Tomatoes
  • Potatoes and sweet potatoes

As a result, people taking ACE inhibitors like benazepril (sold under the brand name Lotensin, among others), captopril (Capoten), and lisinopril may develop dangerous heart tremors if they eat too much food that is high in potassium.

Grapefruit and grapefruit juice have also shown to reduce your ability to absorb drugs like lisinopril and should therefore be avoided while taking it. It slows down how quickly the body is able to break down the medication, which could cause lisinopril levels in the blood to rise.

Talk to your doctor before using salt substitutes because they often contain potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

14. Can I drink alcohol while taking lisinopril?

Although alcohol does not interact with lisinopril directly, it is recommended that you avoid alcohol for at least a few days when you start taking lisinopril or when your dose is increased.

Some of the side effects of lisinopril, such as dizziness, are caused by the blood pressure-lowering effect of the drug. Alcohol also lowers your blood pressure, so the combination can exacerbate the symptoms.

If you live with other conditions, such as heart failure, it is important to discuss your alcohol consumption with your doctor and follow the advice you are given.

15. What else should I know about taking lisinopril?

  • Angioedema (swelling of the airways and facial areas) is one of the signs of an allergic reaction. As mentioned, allergic reactions to lisinopril are rare, but it is believed that if you have experiences angioedema (unrelated to ACE inhibitors) in the past you are at greater risk. People of African American descent also appear to be at a greater risk than the general population.
  • High daily doses of lisinopril (80 mg) have shown only modest benefits over moderate doses (20 mg). Accordingly, your doctor may try combining lisinopril with another type of medication (such as a diuretic) or prescribe a different medication altogether (such as valsartan) should lisinopril prove ineffective.
  • It does not matter whether you take lisinopril with food or not, so meals do not need to be taken into consideration.
  • Lisinopril should be stored at room temperature, away from moisture and heat.
  • If you miss a dose, take it as soon as you realize. If it is almost time for your next dose, skip the missed dose and stick to your usual schedule. Do not take a double dose to make up for the one you’ve missed.

The content on this page is provided for informational purposes only. If you have any questions or concerns about your treatment, you should talk to your doctor, pharmacist, or healthcare professional. This is particularly important if you are taking multiple medications or have any existing medical conditions.

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Is Lisinopril a Drug of Abuse?

Lisinopril is the generic name for an angiotensin-converting enzyme (ACE) inhibitor prescription medication, first approved as the brand name Prinivil by the Food and Drug Administration (FDA) in 1986. The current popular brand name for lisinopril is Zestril, but there are several other brand names associated with this medication, which was originally developed by Merck. The FDA approved generic lisinopril for prescription use in 2002.

ACE inhibitors like lisinopril lower blood pressure, reducing heart damage and the risk of heart disease associated with damage to the blood vessels. It is specifically prescribed after a heart attack to improve survival and reduce the risk of future heart attacks. When not treated, high blood pressure can cause damage to the heart, blood vessels, kidneys, brain, and many other organs in the body. Lisinopril, combined with lifestyle changes like eating a healthier diet and exercising regularly, will reduce the risk of heart disease.

Lisinopril Side Effects

Like any prescription drug, lisinopril can cause some side effects. If these are not monitored by a physician, they can become serious health risks, but typically, medications like lisinopril can be adjusted so side effects dissipate.

Common

Common side effects associated with lisinopril include:

  • Dizziness
  • Coughing
  • Headaches
  • Diarrhea
  • Weakness
  • Sneezing
  • Runny nose
  • Rash
  • Fatigue or extreme tiredness
  • Nausea, vomiting, or digestive issues

Long-Term

Long term side effects of lisinopril can occur, especially if someone takes too much for too long.
These include:

  • Swelling in the face, throat, hands, feet, ankles, or lower legs
  • Difficulty breathing or swallowing, which can indicate a serious allergic reaction
  • Hoarseness
  • Jaundice (yellowing of the skin and eyes due to liver damage)
  • Fainting or lightheadedness
  • Chest pain

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Health Risks from Lisinopril

People who already have diabetes are at risk for worsening symptoms due to rapid blood sugar changes, usually sudden drops in blood sugar, especially within the first month of use.

In rare cases, lisinopril is associated with liver damage. This may be more likely among people who have previously abused alcohol or drugs that damage the liver and kidneys, so taking a higher dose of lisinopril exacerbates existing problems.

Sometimes, a person who has struggled with addiction or substance abuse in the past will begin abusing their current prescriptions. Anyone with a history of drug abuse or addiction should report this condition to their physician when they get a new prescription medication. This will help the doctor monitor for signs of compulsive drug misuse or abuse.

Signs of prescription drug abuse include:

  • Stealing drugs
  • Forging prescriptions
  • Taking higher doses than prescribed or taking doses more often than prescribed
  • Mood swings, changes in sleeping and eating patterns, or appearing intoxicated
  • Becoming defensive or aggressive when questioned about substance abuse
  • Lying about how much of the drug is being consumed
  • Poor decision-making
  • Losing prescriptions frequently
  • Needing refills more often than necessary
  • Doctor shopping to get multiple prescriptions

Serious Health Issues Associated with Lisinopril Abuse

One report found that out of 179,015 people who experienced side effects from taking lisinopril, 195 people reported abusing this drug or experiencing compulsive behaviors. Most often, abuse of the drug was reported within the first month after receiving the prescription; however, 14.81% of people abused the drug after the first year, and the same percent abused the drug at 2–5 years after receiving a prescription for it. Of the people who abused the drug, 43.01% were women and 56.99% were men; 35.26% were 50–59 years old, 21.79% were 60 or older, and 28.85% were 40–49 years old. These age groups are more likely to develop heart disease and experience a heart attack, so they are more likely to receive a prescription for lisinopril.

Several conditions that are associated with an increased risk of drug abuse, including abusing prescription drugs, were reported in the 195 people who abused lisinopril: 38 people reported depression; 18 people reported insomnia or sleeplessness; 15 people reported stress and anxiety; 14 people reported drug dependence on previous substances; and 14 people reported chronic pain.

Although lisinopril does not cause a high like typically addictive drugs, including prescription painkillers, sedative-hypnotics, benzodiazepines, and prescription stimulants, some people do abuse this medication. Prescription misuse includes drug abuse, but it also includes failure to follow the prescribing physician’s instructions, failing to take doses at appropriate times, adjusting the dose without consulting the physician, stealing the drug from loved ones, accidentally ingesting too much, or taking harmful, intoxicating drugs alongside lisinopril.

Abuse of a drug like lisinopril can indicate relapse in people who have struggled with addiction in the past. Anyone who has struggled with any kind of addiction has a chance of relapse. The National Institute on Drug Abuse (NIDA) reports that addiction is a chronic illness, and like other chronic illnesses such as hypertension, asthma, and diabetes, a relapse of symptoms will occur at some point for most people. About 40­–60% of people who struggle with addiction will relapse at some point, which simply means they should return to rehabilitation to manage their symptoms.

Abusing a prescription like lisinopril, which will not cause intoxication, can indicate that one is at risk of relapse back into substance abuse for more dangerous drugs.

The Danger of Mixing Lisinopril and Other Drugs

Because lisinopril treats blood pressure and heart disease, the medication can interact with several drugs that may change its effectiveness, prevent the medication from working, or lead to further heart damage. Stimulants like Adderall, Ritalin, cocaine, and bath salts can all spike blood pressure, making lisinopril less effective and cause further heart disease. Some sedative medications may lower blood pressure which, when combined with an ACE inhibitor, can lead to fainting, passing out, or changes in blood flow that can be dangerous.

Alcohol is one of the most common substances mixed with lisinopril, leading to harmful results. Although it is legal for adults in the United States to drink alcohol, it is a sedative substance, and it can rapidly lower blood pressure, which can increase the risk of lisinopril side effects.

Other drugs that interact with lisinopril include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, and acetaminophen
  • Diuretics
  • Potassium supplements
  • Diabetes medications, including insulin
  • Lithium
  • Other ACE inhibitors

Long-Term Harm from Abusing Lisinopril

Although lisinopril is a safe medication for people who need help lowering their blood pressure, it can cause side effects, which can lead to long-term harm when they are not addressed.

  • Low blood sugar:Lisinopril can change blood sugar levels and make hypoglycemia or diabetes symptoms worse.
  • Hypotension:This medication is designed to lower blood pressure, but taking too high a dose can dangerously lower blood pressure, leading to dizziness or fainting. This effect becomes worse when lisinopril is taken with a sedative like alcohol, opioids, or benzodiazepines.
  • Renal function impairment or kidney damage:Too much lisinopril can damage the kidneys.
  • Angioedema:Swelling of extremities like the hands, feet, or ankles, or swelling in the face, can be a side effect of lisinopril. When swelling occurs in sensitive areas like the throat, it can be dangerous.

When one takes lisinopril as prescribed with a doctor’s supervision, these side effects are less likely to occur, and they will be addressed if they do appear. Abusing lisinopril increases the risk of serious side effects, issues that lead to long-lasting harm, and even overdose.

Allergic reactions to lisinopril can lead to hospitalization. Taking too high a dose may lower blood pressure too much, leading to fainting and difficulty breathing. It is extremely important to call 911 if someone has passed out and appears to struggle to breathe.

Withdrawing from Lisinopril

For the most part, people who take lisinopril will continue to take this medication to maintain low blood pressure for the rest of their lives. In some cases, the person may switch to a different ACE inhibitor, which may require stopping lisinopril. In the best case, one can reduce their dose of lisinopril over time while making lifestyle changes because adjusting their diet and exercise is enough to manage blood pressure. It is rare, in these cases, to experience any withdrawal symptoms because the underlying blood pressure condition is being managed.

Some studies of ACE inhibitors, as a general group of medications, show that a very small group of people experience an increase in blood pressure to levels higher than before they took lisinopril when they attempt to quit “cold turkey.” However, this outcome is not well documented. While rebound hypertension or high blood pressure should be considered, it is a rare effect, and tapering off the medication, rather than simply stopping, is not likely to change this outcome.

Help to Overcome Prescription Drug Abuse, Including Misuse of Lisinopril

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in a 2014 survey of drug abuse in the United States, about 15 million people (ages 12 and older) abused prescription medications for nonmedical reasons in the prior year. While lisinopril is not a widely abused drug since it has no intoxicating effects, there are people who have misused or abused it.

In addition to evidence-based treatment programs, peer-based support groups can also help to augment recovery. There are also several support groups that can help people stay sober, including SMART Recovery and Pills Anonymous.

“To everything there is a season, and a time to every purpose under heaven.”

That oft-quoted passage doesn’t apply just to rending and sewing, weeping and laughing, or gathering stones together. Your body has its own set of “seasons,” many of them following the turn of a complete day. Taking some medications at specific times of the day can help them work better. Some studies suggest that blood pressure pills taken at night might improve blood pressure and prevent more heart attacks and strokes than taking the same medications during the day.

In one study performed a few years ago, Spanish researchers tested the timing of blood pressure medicines in a 661 men and women with mild kidney disease, all of them taking one or more blood pressure medicines. Half were asked to take all of their blood pressure pills in the morning. The others took at least one of their blood pressure pills before going to bed.

After an average of 5½ years, study participants who took at least one blood pressure medicine at night had better blood pressure control. They also were about one-third as likely to have a heart attack or stroke or to develop heart failure, as those who took morning pills.

In most people, blood pressure begins to rise just before getting out of bed in the morning, and reaches its peak around mid-day. It falls during sleep, reaching its lowest point of day between midnight and 3:00 or 4:00 am. This drop is sometimes called “dipping.” But people with high blood pressure often have little or no decrease in their blood pressure at night. One possible reason for this is blood pressure medicines taken around breakfast time have worn off.

Based on this and other studies, it’s time to reconsider the best timing for blood pressure medicines.

In deciding when to take your blood pressure pills, the most important thing is to pick a time that ensures you will take your medicine every day.

If you take only one pill, ask your doctor whether taking it at night might be better for you. If you take more than one drug, then taking at least one of them at night before bed makes sense.

Don’t start doing this on your own. There might be specific reasons why your doctor prefers you take your medicine in the morning. For example, older people need to be careful about taking blood pressure pills at night. Standing up too quickly in the middle of the night can lead to a sudden blood pressure drop and a fall.

Lisinopril 10mg Tablet

ACE-inhibitors and angiotensin II receptor blockers should not be used concomitantly in patients with diabetic nephropathy.

Race

ACE inhibitors cause a higher rate of angioedema in black patients than in non-black patients. As with other ACE inhibitors, lisinopril may be less effective in lowering blood pressure in black patients than in non-blacks, possibly because of a higher prevalence of low-renin states in the black hypertensive population.

Cough

Cough has been reported with the use of ACE inhibitors. Characteristically, the cough is nonproductive, persistent and resolves after discontinuation of therapy. ACE inhibitor-induced cough should be considered as part of the differential diagnosis of cough.

Surgery/Anaesthesia

In patients undergoing major surgery or during anaesthesia with agents that produce hypotension, lisinopril may block angiotensin II formation secondary to compensatory renin release. If hypotension occurs and is considered to be due to this mechanism, it can be corrected by volume expansion.

Serum potassium

ACE inhibitors can cause hyperkalemia because they inhibit the release of aldosterone. The effect is usually not significant in patients with normal renal function. However, in patients with impaired renal function, diabetes mellitus and/or in patients taking potassium supplements (including salt substitutes), potassium-sparing diuretics (e.g. spironolactone, triamterene or amiloride), other drugs associated with increase in serum potassium (e.g. heparin, trimethoprim or co-trimoxazole also known as trimethoprim/sulfamethoxazole) and especially aldosterone antagonists or angiotensin-receptor blockers, hyperkalemia can occur. Potassium-sparing diuretics and angiotensin-receptor blockers should be used with caution in patients receiving ACE inhibitors, and serum potassium and renal function should be monitored (see section 4.5).

Diabetic patients

In diabetic patients treated with oral antidiabetic agents or insulin, glycaemic control should be closely monitored during the first month of treatment with an ACE inhibitor (see section 4.5).

Lithium

The combination of lithium and lisinopril is generally not recommended (see section 4.5).

Pregnancy and lactation

ACE inhibitors should not be initiated during pregnancy. Unless continued ACE inhibitor therapy is considered essential, patients planning pregnancy should be changed to alternative antihypertensive treatments which have an established safety profile for use in pregnancy. When pregnancy is diagnosed, treatment with ACE inhibitors should be stopped immediately, and, if appropriate, alternative therapy should be started (see sections 4.3 and 4.6).

Think your blood pressure is too high? Think again.

Been told that your blood pressure is too high? Already on meds to lower your pressure?

You should know that you might not have to reduce it as much as you thought. Many experts say that millions of Americans don’t have to aim quite as low when trying to manage their blood pressure. That means you might be able to delay or even avoid taking a blood pressure medication, thereby reducing the risk of side effects and lowering your costs.

The not-so-great news is that it has been more than a year since the advice, from experts convened by the National Heart, Lung, and Blood Institute, came out, but many doctors have not yet adopted the new blood pressure targets. Here’s why Consumer Reports thinks they should, and what it means for you.

How low should you go?

High blood pressure continues to be a serious health problem; it’s still a leading cause of heart attacks and strokes. The ideal levels remain the same: a systolic pressure of 120 millimeters of mercury or less (the top number) and a diastolic reading (the bottom number) of 80 or less.

Until recently, most experts agreed that medication was needed if a person’s systolic level (which reflects the pressure in arteries when the heart contracts) hit 140 or if the diastolic level (the pressure between heartbeats) reached 90. The goal was even lower — 130/80 — for people with diabetes or chronic kidney disease because they’re vulnerable to heart attacks and strokes.

But the independent group of experts suggested changing those cutoffs based on a review of the medical research. Contrary to long-held assumptions, they concluded that most people age 60 or older don’t need drugs until their levels hit 150/90 and that drugs aren’t necessary for most people with diabetes or chronic kidney disease until their systolic pressure reaches 140/90.

Consumer Reports’ medical experts think that the goal of 150/90 for most people age 60 or older and 140/90 for most people with diabetes or chronic kidney disease is reasonable. They point out that getting levels below 140/90 can require high doses of blood pressure drugs or multiple medications. That increases the risk of side effects, which can include persistent coughing, erectile dysfunction and frequent urination, depending on the medication. The drugs can also cause dizziness, which can lead to falls.

Take these two key steps

Even if your blood pressure is moderately elevated, Consumer Reports’ experts say that you might not need to start taking medications, at least not right away. Instead, do these two things first:

● Confirm the diagnosis. Blood pressure levels fluctuate depending on factors such as how you’re sitting and whether you’re feeling anxiety in a doctor’s office. If your levels are high in your doctor’s office, ask him or her to confirm the readings. The gold standard for that is 24-to-48-hour monitoring. But that kind of monitoring isn’t widely available, and insurance might not cover the cost. In that case, schedule several follow-up visits. It’s also wise to invest in a home monitor so that you can check levels on your own.

● Try lifestyle changes. There are a number of measures — including losing weight, exercising more, cutting back on sodium and drinking less alcohol — that can sometimes reduce or even eliminate your need for drugs. If your systolic level is moderately elevated (150 to 160 for people 60 and older, 140 to 150 for others), consider drugs only if your blood pressure hasn’t dropped enough after six months of serious attempts at diet and lifestyle changes.

Be medication-wise

If you do need a drug, choose carefully. Until recently, the standard advice for most people was to start with a “water pill,” a thiazide diuretic such as hydrochlorothiazide, either alone or with another drug. Diuretics are still a good choice for many people. But several other classes of drugs usually work just as well. And like diuretics, they’re available as low-cost generics, most of them costing less than $1 per day.

In some cases, other drugs are actually better choices than diuretics. For example, people with kidney disease may fare better on ACE inhibitors such as enalapril or lisinopril because those drugs can also help reduce complications of kidney disease.

Having a choice of blood pressure drugs can also help you minimize side effects. The medications are relatively safe, but some trigger side effects that can be severe enough to warrant switching to another drug.

If your doctor says that you need drugs, ask what numbers he or she is hoping to reach. Whether it’s with lifestyle changes alone or combined with drugs, the aim for most people is to keep blood pressure below 140/90 if they’re younger than age 60 or have diabetes or kidney disease, and below 150/90 if they’re older. The ideal remains below 120/80, but you don’t have to get your levels that low to substantially cut your risk of heart attack and stroke.

Copyright 2015. Consumers Union of United States Inc.

For further guidance, go to www.ConsumerReports.org/Health, where more detailed information, including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products, is available to subscribers.

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