Inside, regardless of food intake. With arterial hypertension, patients who do not receive other antihypertensives are prescribed 5 mg once a day. In the absence of effect, 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 a preliminary treatment with diuretics, then the medication should be stopped 2-3 days before Lysigamma is started. If this is not feasible, the initial dose of Lysigamma 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.
In the case of renovascular hypertension or other conditions with an 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 (blood pressure control, kidney function, potassium concentration in blood serum). The maintenance dose, continuing strict medical control, should be determined depending on the dynamics of blood pressure.
With renal failure 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 of mg / day |
| 30-70 | 5-10 |
| 10-30 | 2,5-5 |
| less than 10 | 2,5 |
(including patients treated with hemodialysis)
With persistent arterial hypertension, prolonged maintenance therapy of 10-15 mg / day is shown.
In 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, maintaining a daily dose of 5-20 mg. The dose should not exceed 20 mg per day.
In elderly people, a more pronounced prolonged hypotensive effect is often observed, 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 dose of 2.5 mg should be given. 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 for more than 1 hour), treatment with Lysigamma should be discontinued.
Diabetic Nephropathy
In patients with insulin-dependent diabetes mellitus, 10 mg of Lysigamma is applied once a day. The dose may, if necessary, be increased to 20 mg once daily to achieve diastolic blood pressure values below 75 mm Hg. Art. in the sitting position. In patients with insulin-dependent diabetes mellitus, the dosage is the same, in order to achieve diastolic blood pressure values below 90 mm Hg. Art. in the sitting position.