Inside, regardless of food intake.
In the treatment of hypertension patients who do not receive other antihypertensive drugs, the initial dose is 5 mg once a day. If the effect is insufficient, the dose is increased every 2-3 days by 5 mg to an average therapeutic dose of 20-40 mg / day (increasing the dose above 40 mg / day usually does not lead to a further decrease in blood pressure). The usual daily maintenance dose is 20 mg. The maximum daily dose is 40 mg.
The full effect usually develops in 2-4 weeks from the start of treatment, which should be taken into account when increasing the dose. With insufficient clinical effect, it is possible to combine the drug with other antihypertensive drugs.
If the patient received prior treatment with diuretics, then the use of such drugs should be stopped 2-3 days before the application of Dapril®.If this is not feasible, the initial dose of Dapril® should not exceed 5 mg per day. In this case, after taking the first dose, medical supervision is recommended for several hours (maximum effect is achieved after about 6 hours), since there may be a pronounced decrease in blood pressure.
With Renovascular Hypertension or other conditions with increased activity of the renin-angiotensin-aldosterone system, it is also advisable to prescribe a low initial dose of 2.5-5 mg per day, under enhanced medical supervision (control of blood pressure, kidney function, potassium concentration in serum). The maintenance dose, continuing strict medical control, should be determined depending on the dynamics of blood pressure.
With renal insufficiency due to the fact that lisinopril is released through the kidneys, the initial dose should be determined depending on the creatinine clearance, then, in accordance with the reaction, a maintenance dose should be established in conditions of frequent monitoring of kidney function, potassium level, sodium in the blood serum.
| Creatinine clearance, ml / min | Initial dose, mg / day |
| 30-70 | 5-10 |
| 10-30 | 2,5-5 |
| less than 10 | 2,5 |
(including patients receiving hemodialysis treatment)
With persistent arterial hypertension, prolonged maintenance therapy at a dose of 10-15 mg / day is indicated.
Chronic heart failure: begin with 2.5 mg 1 time per day, followed by an increase in the dose of 2.5 mg 3-5 days before the usual, supporting a daily dose of 5-20 mg. The dose should not exceed 20 mg per day.
In elderly people often more pronounced prolonged hypotensive effect, which is associated with a decrease in the rate of excretion of lisinopril (it is recommended to begin treatment with 2.5 mg / day).
Acute myocardial infarction (as part of combination therapy)
On the first day - 5 mg orally, then 5 mg every other day, 10 mg after two days and then 10 mg once a day. In patients with acute myocardial infarction, the drug should be applied for at least 6 weeks.
At the beginning of treatment or within the first 3 days after an acute myocardial infarction in patients with low systolic blood pressure (120 mm Hg or lower), a smaller a dose of 2.5 mg. In the case of a decrease in blood pressure (systolic blood pressure is less than or equal to 100 mm Hg), a daily dose of 5 mg is possible if it is necessary to temporarily reduce to 2.5 mg. In the case of a long pronounced decrease in blood pressure (systolic blood pressure below 90 mm Hg.more than 1 hour), treatment with Dapril® should be stopped.
Diabetic Nephropathy
In patients with insulin-dependent diabetes mellitus, 10 mg of lisinopril is administered once a day. The dose may, if necessary, be increased to 20 mg once a day in order to achieve diastolic blood pressure values below 75 mmHg. in the sitting position. In patients with non-insulin dependent diabetes mellitus, the dosage is the same, in order to achieve diastolic blood pressure values below 90 mm Hg. in the sitting position.