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Hypersensitivity to lisinopril; – angioedema (local edema of the skin, subcutaneous tissue and/or mucous membranes in combination with or without urticaria) in the anamnesis, including when using ACE inhibitors; – simultaneous use of angiotensin converting enzyme inhibitors or ATII receptor blockers with aliskiren in patients with diabetes mellitus or moderate / severe renal insufficiency (GFR < 60 ml/min / 1.73 m2) is contraindicated; – hereditary Quincke’s edema; – children under 6 years of age; – pregnancy; – breastfeeding.
Method of administration and dosage
Lisinopril is recommended to be administered orally 1 time a day, approximately at the same time. Food intake does not affect the absorption of lisinopril tablets. The dose should be determined individually according to the patient’s reaction and blood pressure. Arterial hypertension Lisinopril can be used as monotherapy and in combination with other antihypertensive drugs. The initial dose. For patients with arterial hypertension, the recommended initial dose is 10 mg. Patients with a very active renin-angiotensin-aldosterone system (in particular, with renovascular hypertension, increased salt excretion from the body and / or reduced volume of intercellular fluid, heart failure or severe arterial hypertension) may feel a significant decrease in blood pressure after taking the initial dose. For such patients, the recommended dose is 2.5-5 mg, the beginning of treatment should take place under the direct supervision of a doctor. Reducing the initial dose is also recommended for renal insufficiency (see the table below). Maintenance dose. The usual recommended maintenance dose is 20 mg once a day. If the administration of this dose does not give sufficient therapeutic effect within 2-4 weeks, it can be increased. The maximum daily dose is 80 mg. Treatment of arterial hypertension in children aged 6-16 years The recommended starting dose is 2.5 mg once a day in patients with a body weight of 20 to <50 kg and 5 mg for patients with a body weight of ≥ 50 kg. The dosage should be selected individually up to a maximum daily dose of 20 mg for children with a body weight of 20 to <50 kg and a maximum daily dose of 40 mg for patients with a body weight of ≥50 kg. There are no data on the use of doses higher than 0.61 mg/ kg (above 40 mg) in children. In children with reduced renal function, a lower initial dose and an increase in the interval between doses of the drug are required. Patients taking diuretic medications Symptomatic hypotension may occur after the start of treatment with Lisinopril. This is likely for patients taking diuretics when treated with Lisinopril. Such patients are advised to take the drug with caution due to the likelihood of increased salt excretion from the body and / or a decrease in the volume of intercellular fluid. If there is such a possibility, it is necessary to stop treatment with diuretics 2-3 days before the start of Lisinopril therapy. For patients with arterial hypertension who cannot stop treatment with diuretics, therapy should begin with a dose of 5 mg. It is necessary to monitor kidney function and serum potassium levels. Subsequent doses of Lisinopril should be selected in accordance with the reaction of blood pressure. If necessary, diuretic therapy can be resumed.