Lisinopril
- (all- S) -1 - [6- amino-2- (1 -carboxy -3-phenyl -propyl) amino- hexanoyl ] pyrrolidine-2 -carboxylic acid ( dihydrate)
- C21H31N3O5 (Lisinopril )
- C21H31N3O5 · 2H2O ( lisinopril dihydrate )
C09AA03
Inhibition of angiotensin converting enzyme
- 405.49 g · mol -1 ( lisinopril)
- 441.52 g · mol -1 ( lisinopril dihydrate )
Readily soluble in water ( 97 mg · ml -1) and methanol ( 14 mg · ml -1), poorly soluble (< 0.1 mg · ml -1, respectively ) in ethanol, acetone, acetonitrile, chloroform and dimethylformamide ( Lisinipril · dihydrate)
Dihydrate
3600 mg · kg -1 ( LD50, rat, oral)
Template: Infobox chemical / molecular formula search available
Lisinopril is a drug of the group of ACE inhibitors, in particular for the treatment of hypertension (high blood pressure ) and the treatment of heart failure is used. Its mechanism of action is based on inhibition of the angiotensin -converting enzyme ( ACE).
Chemistry
Lisinopril is an ACE inhibitor of the second generation. It has a Tripeptidstruktur consisting of the natural α - amino acids ( S)-proline and (S) -lysine and unnatural α - amino acid homologues of the (S)- phenylalanine.
Lisinopril next Captopril is one of the two substances from the group of medicines called ACE inhibitors, their zinc - chelating group acts directly and no prodrug ( with ethanol esterified carboxy group ) is. Against enalapril and ramipril, a further difference is that the alanine of the tripeptide was replaced by lysine.
Pharmacology
Areas of application
Lisinopril is used with diuretics or calcium antagonists for the treatment of hypertension as well as in monotherapy and dual combinations used in monotherapy and in two- or triple combinations preferably with diuretics for the treatment of symptomatic heart failure, where it comes in combinations synergistic effects of the substances. Furthermore, it has an efficacy in the Reinfarktprophylaxe for up to 6 weeks after a heart attack is shown. By nephroprotective properties ( kidney protection ) is also a use in patients with hypertension in diabetes mellitus type II and onset of kidney diseases (eg nephropathy) possible and appropriate.
Mechanism of Action
Lisinopril leads as an inhibitor of angiotensin converting enzyme in a reduced formation of angiotensin II from angiotensin I. This reduced formation of angiotensin II causes a decrease in the tonus of the blood vessels and thus a decrease in blood pressure. Also the decrease in angiotensin II levels leads to a reduction of aldosterone release from the adrenal cortex and thus to influence the water budget (see also the renin -angiotensin -aldosterone system ). At the cellular level, a decrease in the mitogenic effects mediated by angiotensin II on cells of the heart, especially the lead after a heart attack to adverse changes (remodeling ) are observed.
Side effects
Most side effects of lisinopril be associated with a conditional by ACE inhibitors slow degradation and the accumulation of bradykinin. These include skin reactions such as rashes and hives, and also angioneurotic edema. Severe allergic skin reactions are, however, only very rarely observed.
Among the side effects of the respiratory system include dry cough, hoarseness and sore throat. Asthma attacks and shortness of breath may also, though rarely, occur.
As a result, the main effect of lisinopril may result in an excessively high blood pressure. As a result, can be observed occasionally dizziness, headache and dizziness. From serious cardiovascular events such as angina pectoris, myocardial infarction, and syncope have been reported only in individual cases.
By intervening in the water and electrolyte balance functional renal dysfunction can be observed occasionally. Proteinuria ( excretion of proteins in urine ), however, was only rarely observed.
Because lisinopril can cause in pregnancy, among others growth and bone formation disorders associated with increased mortality in children, lisinopril should not be taken at this time and should be replaced with other suitable therapeutic measures.
Interactions
Lisinopril potentiates the blood glucose lowering effect of insulin and oral hypoglycemic agents, and the blood- changing effects of immunosuppressants.
By intervening in the water and Elektrolyhaushalt the excretion of electrolytes can be slowed down, which in therapy should be considered especially with lithium and potassium-sparing diuretics.
In combination with other antihypertensive drugs increased blood pressure reduction should be considered.
Potencies
Lisinopril is in the following dosage strengths are available:
- As a single agent - 2.5 mg, 5 mg, 10 mg and 20 mg
- In combination with hydrochlorothiazide - 10/ 12, 5 mg and 20/ 12, 5 mg
Trade names
Zestril (D), Acemin (A), acetic (A), Lisidigal (D), Lisigamma (D), Lisitril (CH), Lisopril (CH), Lisinostad (A), Prinil (CH), Zestril (CH), numerous generics (D, CH)
Acelisino (A), Acercomp (D, A), co- acetic (A), co- Lisinostad (A), Lisigamma HCT (D), Lisitril comp. (CH), Prinzide (CH), Zestoretic (CH ), various generics with the prefix "co- " and the suffix " comp", " HCT ", " mite" or " plus" (D, A, CH)