Zestril contains Lisinopril and it is produced by Searl Company Limited under license of AstraZeneca and marketing by ICI Pakistan Limited. It is being used to treat hypertension high blood pressure and heart failure-related diseases. Secondly, it is also being used to treat acute myocardial infarction, renal complications of diabetes mellitus and kidney problems, and heart attacks. It is an oral medication, which affects within few days. It actually relaxes blood vessels which reduce high blood pressure and also help prevent heart strokes.
Starting Dose
The starting dose for hypertension patients is usually recommended 10mg but those patients who are facing strong activated renin-angiotensin-aldosterone system particularly renovascular hypertension or those patients whose blood pressure fall down can use a starting dose of 2.5mg to 5mg daily. If desired therapeutic effects cannot be achieved within 2 weeks, the dose can be increased with medical supervision.
Dosage for Renal Impairment
| Creatinine Clearance (ml/min) | Starting dose (mg/day) |
| Less than 10ml/min | 2.5mg |
| 10-30ml/min | 2.5 to 5mg |
| 31-80ml/min | 5 to 10mg |
Heart Failure
The initial dose in heart failure is 2.5mg once daily but it is highly recommended to keep that patient in medical supervision to check blood pressure and heart strokes. To treat heart failure patients you need to keep these three things in your mind.
- Do not give Lisinopril more than 10mg
- An interval of no less than 2 weeks
- The highest dose within 24hours should be less than 35mg
Secondly, dose adjustment should be based on the clinical response of that patient.
Acute Myocardial Infarction
The recommended dose for acute myocardial infarction should be 5mg within 24 hours. Do not give Lisinopril to patients whose blood pressure is less than 100 mmHg.
Renal Complications of Diabetes Mellitus
In normotensive insulin-dependent diabetes mellitus patients, the recommended dose is 10mg Lisinopril once daily. After medical supervision, this dose can be increased to 20mg once daily if necessary.
Use in Kidney Transplant Patients
There are no adequate studies have been done regarding the administration of Zestril in kidney transplantation patients. Therefore it is not recommended to use Lisinopril after kidney transplantation.
Side Effects of Zestril
From clinical studies, it has been known that Lisinopril is well tolerated but when it becomes severe it can cause the following undesirable effects have been observed during treatment with Zestril.
| Very Common | ≥10% |
| Common | ≥1%<10% |
| Uncommon | ≥0.1<1% |
| Rare | ≥0.01<0.1% |
| Very Rare | <0.01% |
Blood and the Lymphatic System Disorders: In rare cases, it will decrease in haemoglobin and haematocrit. While in very rare cases Lisinopril can cause bone marrow depression, neutropenia, anemia, leucopenia, and agranulocytosis.
Cardiac and Vascular Disorders: In cardiac and vascular disorders you will find some common side effects of orthostatic and hypotension effects. While in uncommon effects it can cause myocardial infarction and cerebrovascular accident etc.
Nervous System and Psychiatric Disorder: Common side effects of Zestril on the nervous system include dizziness, headache, vertigo, and fatigue etc. While uncommon it can cause mood alterations, tension, taste disturbance, sleep disturbance and mental confusion etc.
Gastrointestinal Disorders: Common side effects include vomiting and diarrhea while uncommon effects include nausea, abdominal pain, dry mouth, and indigestion, etc. Very rare effects include pancreatitis, hepatitis, intestinal angioedema and cholestatic, etc.
Renal and Urinary Disorders: Common side effects include renal dysfunction while rare and very rare effects include uremia, acute renal failure and anuria etc.
Investigations: Some uncommon side effects include increase in blood urea and serum creatinine. While rare effects include increase serum bilirubin and hyponatraemia etc.
Respiratory System and Breast Disorder: Uncommon effects include impotence while rare contain gynaecomastia etc.
General Disorders and Administration site conditions: These uncommon side effects include fatigue and asthenia etc.
Endocrine Disorders: In endocrine disorder patients feel an unknown and inappropriate antidiuretic hormone secretion etc.
Respiratory Thoracic and Mediastinal Disorders: Common respiratory side effects include cough and sneezing while uncommon effects include rhinitis etc. In very rare cases it can cause bronchospasm and allergic alveolitis etc.
Skin and Subcutaneous Tissue Disorder: Uncommon effects include rash, angioneurotic edema of lips, tongue, glottis, and pruritus, etc, while rare side effects include urticaria, psoriasis, and alopecia, etc. Very rare effects include diaphoresis, toxic epidermal and pemphigus, etc.
Metabolism and Nutrition Disorders: In rare cases, it can cause hypoglycemia
Pregnancy and Lactation
Zestril should not be used within the first trimester of pregnancy. It is also contraindicated in the second and third trimester of pregnancy as well; therefore do not use Lisinopril in pregnancy.
Lactation: There is no adequate research or not known either Lisinopril is secreted in breast milk or not. In a study, Lisinopril is excreted into rat’s milk.
Contraindications
Zestril is contraindicated in patients who are hypersensitive to ACE Inhibitor drugs
History of angioedema associated therapy
Hereditary or idiopathic angioedema
Second or third trimesters of pregnancy
Frequently Asked Questions
What is Zestril used for?
Zestril contains Lisinopril and it is being used to treat high blood pressure (Hypertension)
Is Zestril a blood thinner or it only reduces blood pressure?
Zestril is known as ACE Inhibitor, which relaxes blood vessels due to which blood flows easily in the vessels. Secondly, in some countries, hydrochlorothiazide is also being added along with Lisinopril, which causes frequent urination, through which toxic salt and water can be excreted from the body. To thinner your blood you can use Aspirin also.
When should I take Zestril: before or after a meal?
It can be taken with or without food. While taking Zestril, try to drink plenty of water.
When should you not take Lisinopril?
You should not take Zestril if you are hypersensitive to the following diseases
History of angioedema associated therapy
Hereditary or idiopathic angioedema
Second or third trimesters of pregnancy
Zestril 5mg Tablets
Zestril 5mg Tablets Lisinopril
Composition Each 5mg tablet contains Lisinopril Dihydrate equivalent to 5mg Anhydrous Lisinopril
Symptoms Hypertension
Company AstraZeneca
Per tablet price Rs9
Zestril 10mg Tablets
Zestril 10mg Tablets Lisinopril
Composition Each 10mg tablet contains Lisinopril Dihydrate equivalent to 5mg Anhydrous Lisinopril
Symptoms Hypertension
Company AstraZeneca
Per tablet price Rs 17.5
Zestril 20mg Tablets
Zestril 20mg Tablets Lisinopril
Composition Each 20mg tablet contains Lisinopril Dihydrate equivalent to 5mg Anhydrous Lisinopril
Symptoms Hypertension
Company AstraZeneca
Per tablet price Rs27.8