From the Guidelines
The maximum recommended dose of Lisinopril for adults with hypertension is 40 mg once daily. This dose is based on the most recent and highest quality study available, which prioritizes morbidity, mortality, and quality of life as the outcome 1. Treatment typically starts at a lower dose of 10 mg once daily, which can be gradually increased by your healthcare provider based on blood pressure response. For patients already taking diuretics, an initial dose of 5 mg is recommended to avoid excessive blood pressure reduction. Lisinopril works by inhibiting angiotensin-converting enzyme (ACE), which prevents the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This leads to decreased peripheral resistance, reduced sodium and water retention, and ultimately lower blood pressure. Some key points to consider when prescribing Lisinopril include:
- Starting dose: 10 mg once daily
- Goal dose: 20-40 mg daily
- Maximum dose: 40 mg once daily
- Dose adjustment for patients with kidney impairment: lower doses may be necessary
- Common side effects: dry cough, dizziness, and headache
- Serious adverse effects: angioedema, and patients should seek immediate medical attention if experiencing swelling of the face, lips, tongue, or throat. Other studies, such as 1 and 1, also support the use of Lisinopril for hypertension, but the dose recommendations may vary. However, based on the most recent and highest quality study, the maximum recommended dose of Lisinopril for adults with hypertension is 40 mg once daily.
From the FDA Drug Label
The usual dosage range is 20 mg to 40 mg per day administered in a single daily dose. Doses up to 80 mg have been used but do not appear to give greater effect
- The maximum recommended dose of Lisinopril for adults with hypertension is 80 mg per day.
- However, doses above 40 mg do not appear to give greater effect, and the usual dosage range is 20 mg to 40 mg per day 2
From the Research
Maximum Recommended Dose of Lisinopril
The maximum recommended dose of Lisinopril for adults with hypertension is:
- 80 mg once daily, as reported in studies 3, 4
- However, in some studies, the maximum dose used was 40 mg daily, as seen in studies 5, 6, 7
Dosage Titration
Dosage titration is often used to achieve the desired blood pressure response, with the dose being increased weekly to a maximum of 40 mg once daily, as reported in study 6
Special Considerations
In patients with impaired renal function, the starting dose may be lower, such as 2.5 mg in patients with glomerular filtration rate (GFR) of less than 30 ml/min, as reported in study 5 In elderly patients, the starting dose may also be lower, such as 5 mg in patients with GFR of 30-60 ml/min, as reported in study 7
Key Points
- Lisinopril is an effective treatment for essential hypertension, with a maximum recommended dose of 80 mg once daily
- Dosage titration is often used to achieve the desired blood pressure response
- Special considerations are needed in patients with impaired renal function and elderly patients, with lower starting doses recommended