Lisinopril 10mg Dosing Frequency
Lisinopril 10mg should be taken once daily. 1
Dosing Guidelines for Lisinopril
Standard Dosing
- Lisinopril is administered once daily regardless of indication 1, 2
- For hypertension, the recommended initial dose is 10mg once daily, with a usual dosage range of 20-40mg per day as a single daily dose 1
- For heart failure, the recommended starting dose is 5mg once daily, which can be titrated up to a maximum of 40mg once daily 1, 3
- The long duration of action (24+ hours) allows for once-daily dosing 2, 4
Target Dosing
- For heart failure with reduced ejection fraction (HFrEF), the target dose of lisinopril is 20mg once daily 3
- At least 50% of the target dose (10mg daily) should be achieved for optimal clinical benefit in heart failure patients 3
Dose Adjustments
- In patients taking diuretics, a lower initial dose of 5mg once daily is recommended 1
- For patients with renal impairment (creatinine clearance ≤30 mL/min), the initial dose should be reduced to half the usual recommended dose 1
- For elderly patients, lower starting doses may be necessary (2.5-5mg once daily) 2, 5
Clinical Considerations
Pharmacokinetics Supporting Once-Daily Dosing
- Peak serum concentration occurs 6-8 hours after administration 2
- Effects last for at least 24 hours after a single dose 2, 4
- Elimination half-life is 12.6 hours in patients with normal renal function 2, 4
Titration
- Dose should be adjusted according to blood pressure response 1
- When titrating, increase the dose at intervals of not less than 2 weeks 3
- Aim for target dose or, if not tolerated, the highest tolerated dose 3
Monitoring
- Monitor blood chemistry (urea, creatinine, potassium) and blood pressure during initiation and dose adjustments 3
- An increase in creatinine of up to 50% above baseline is acceptable when initiating therapy 3
Common Pitfalls and Caveats
- Renal function: Dosage adjustment is required in patients with impaired renal function 1
- Hypotension: Initial doses may cause symptomatic hypotension, particularly in volume-depleted patients or those on diuretics 3, 1
- Hyperkalemia: Monitor potassium levels, especially when combined with potassium-sparing diuretics or supplements 3
- Cough: ACE inhibitor-induced cough is common (up to 20% of patients) but rarely requires discontinuation 3
- Angioedema: Though rare (<1%), this is a potentially life-threatening reaction that warrants permanent discontinuation of all ACE inhibitors 3
Remember that once-daily dosing of lisinopril provides 24-hour blood pressure control and improves medication adherence compared to medications requiring multiple daily doses 4, 5.