Lopril - Use | Dose | Side Effects
Lopril is a medicine that contains the active substance known as lisinopril. It belongs to a group of medicines called angiotensin-converting enzyme (abbreviated to the ACE inhibitors). It inhibits the enzyme called peptidyl dipeptidase which is responsible for conversion of angiotensin I to angiotensin II - a strong vasoconstrictor. By preventing the formation of angiotensin II, Lopril lowers blood pressure and improves blood flow through the blood vessels.
Lopril is used in the treatment of the following conditions:
- Heart failure
- Acute myocardial infarction
- Renal complications of diabetes mellitus
Precautions and contraindications
Contraindications to the use of the Lopril are:
- In patients with a history of ACE inhibitor-induced angioedema
- Hereditary or idiopathic angioedema
Lopril should be administered cautiously in the following situations:
- Aortic stenosis
- Hypertrophic cardiomyopathy
- Impaired renal function
- Impaired liver function
- Neutropenia or agranulocytosis
A common side effect of Lopril is cough. Cough usually goes away on its own after couple of weeks, and it is not necessary to stop the treatment because of this adverse effect. If the cough does not stop after 30-60 days, then consult your doctor about changing your treatment.
If you notice signs of angioneurotic edema (e.g. facial swelling, swelling of the tongue or swelling of the larynx), immediately stop taking this drug and contact your doctor. Angioneurotic edema caused by Lopril occurs very rare but is one of the serious side effect that can have a fatal outcome. Researches showed that Lopril cause angioedema more frequently than other ACE inhibitors (e.g. captopril or enalapril).1
If taken in high doses, Lopril increase a risk for hyperkalemia (also a potentially fatal side effect).2 If you notice an irregular heartbeat, contact your doctor, because it is a sign of hyperkalemia.
Neutropenia caused by Lopril is a side effect that occurs significantly less than with other ACE inhibitors.3 If you notice that your immunity is decreased and you're catching colds often, tell your doctor about it.
Lopril, pregnancy and breastfeeding
Lopril should never be used during pregnancy because there is a high risk for neonatal mortality and morbidity. Lopril leads to kidney failure in the fetus that threatens its life. Lopril is absolutely contraindicated for application during pregnancy.
Stop breastfeeding while using Lopril.
How to use
Lopril is administered once daily and the dose depends on the patient's condition. Food has no effect on the absorption of this drug, and this medication can be taken with or without food.
The usual initial dose in the treatment of hypertension is 10 mg once a day. In patients who have a more pronounced activation of the renin-angiotensin-aldosterone system, the initial dose should be 2.5 mg per day. This helps avoiding the risk of a sudden drop in blood pressure.
The usual maintenance dose is 20 mg once a day.
Lopril can be combined with other medications (e.g. diuretics), and in these situations, your doctor will determine the dose that is best for you.
It should not be used in children younger than 6 years.
Lopril enter major interactions with the following drugs:
- Potassium sparing diuretics, such as: spironolactone, triamterene and amiloride. Concomitant use of Lopril with these drugs can increase potassium levels in the blood (hyperkalemia), which can lead to the heart disorder.
- Aliskiren (also a drug used in the treatment of hypertension). Co-administration of these two drugs increases the risk of kidney damage and hyperkalemia.
- Angiotensin-receptor blockers (ARB), such as: valsartan, telmisartan, olmesartan and candesartan). These drugs increase levels of potassium in the blood and may cause kidney damage, as well as Lopril, so concomitant use is not recommended.
- Leflunomide (immunomodulatory drug). Co-administration of these two drugs increases the risk of liver damage.
- Bactrim (actually one of its active substances - trimethoprim). Bactrim can increase potassium levels in the blood, and concomitant use with Lopril is therefore contraindicated.
- Sodium biphosphate. Concomitant use increases the risk of kidney damage.
- Potassium preparations
- Gold preparations
Side effects of the Lopril include:
- Neutropenia and agranulocytosis
- Decreased levels of hemoglobin in the blood
- Taste disturbances
- Dry mouth
- Renal impairment
- Disorders of antidiuretic hormone secretion