From the Guidelines
Lisinopril, an Angiotensin-Converting Enzyme (ACE) Inhibitor, is contraindicated in patients with pregnancy, renovascular disease, and bilateral renal artery stenosis.
Contraindications for Lisinopril
- Pregnancy: ACE inhibitors, including Lisinopril, are contraindicated in pregnancy due to the risk of fetal harm 1.
- Renovascular disease: Patients with renovascular disease, such as bilateral renal artery stenosis, should not be treated with Lisinopril due to the risk of worsening renal function 1.
- Bilateral renal artery stenosis: This is a specific type of renovascular disease where the arteries that supply blood to the kidneys are narrowed, and ACE inhibitors like Lisinopril can exacerbate the condition 1.
Additional Considerations
- Caution in patients with renal impairment: While not an absolute contraindication, Lisinopril should be used with caution in patients with significant renal impairment, as it may worsen renal function 1.
- Monitor potassium levels: ACE inhibitors like Lisinopril can increase potassium levels, so patients with hyperkalemia or those at risk of developing it should be monitored closely 1.
From the FDA Drug Label
Lisinopril is contraindicated in patients with:
- a history of angioedema or hypersensitivity related to previous treatment with an angiotensin converting enzyme inhibitor
- hereditary or idiopathic angioedema Do not co-administer aliskiren with lisinopril in patients with diabetes
The contraindications for Lisinopril are:
- A history of angioedema or hypersensitivity related to previous treatment with an angiotensin converting enzyme inhibitor
- Hereditary or idiopathic angioedema Additionally, Lisinopril should not be co-administered with aliskiren in patients with diabetes 2
From the Research
Contraindications for Lisinopril
The provided studies do not directly address the contraindications for Lisinopril. However, some information can be inferred from the potential adverse effects and interactions mentioned:
- The studies mention that Lisinopril can cause hypotension, renal dysfunction, and hyperkalemia 3, 4, 5, 6.
- Lisinopril is also known to cause angioedema, which can be a serious and potentially life-threatening side effect 5.
- The GISSI-3 trial reported an increased incidence of persistent hypotension and renal dysfunction in patients receiving Lisinopril, particularly in those with pre-existing renal impairment 6.
- The ATLAS study found that high doses of Lisinopril were associated with a higher incidence of adverse events, including hypotension and worsening renal function 7.
Potential Contraindications
Based on the available information, potential contraindications for Lisinopril may include:
- Hypersensitivity to ACE inhibitors or any component of the formulation
- History of angioedema
- Severe renal impairment (creatinine clearance < 30 mL/min)
- Hyperkalemia
- Pregnancy or breastfeeding (although not explicitly mentioned in the studies, ACE inhibitors are generally contraindicated in these populations due to potential fetal or infant harm)
Important Considerations
It is essential to note that the provided studies do not comprehensively address the contraindications for Lisinopril. A thorough review of the prescribing information, clinical guidelines, and other relevant resources is necessary to determine the complete list of contraindications and precautions for Lisinopril use.