What is the recommended dose and frequency of Lisinopril?

From the Guidelines

The recommended dose and frequency of Lisinopril is 2.5-5 mg once daily, with a target dose of 20-40 mg once daily.

Key Points

• The initial daily dose of Lisinopril is 2.5-5 mg once daily 1
• The target dose of Lisinopril is 20-40 mg once daily 1
• Lisinopril is typically administered once daily, with the goal of achieving a total daily dose of 20-40 mg 1
• The mean dose achieved in clinical trials was 32.5-35.0 mg total daily 1

Clinical Considerations

• Lisinopril is an angiotensin-converting enzyme inhibitor (ACEI) commonly used in the treatment of heart failure with reduced ejection fraction (HFrEF) 1
• The use of ACEIs, including Lisinopril, has been shown to reduce morbidity and mortality in patients with HFrEF 1
• The dose of Lisinopril should be individualized based on patient tolerance and clinical response 1

From the FDA Drug Label

DOSAGE & ADMINISTRATION 2. 1 Hypertension Initial Therapy in adults: The recommended initial dose is 10 mg once a day. Dosage should be adjusted according to blood pressure response. The usual dosage range is 20 mg to 40 mg per day administered in a single daily dose. 2. 2 Heart Failure The recommended starting dose for lisinopril tablets, when used with diuretics and (usually) digitalis as adjunctive therapy for systolic heart failure, is 5 mg once daily. 2. 3 Reduction of Mortality in Acute Myocardial Infarction In hemodynamically stable patients within 24 hours of the onset of symptoms of acute myocardial infarction, give lisinopril tablets 5 mg orally, followed by 5 mg after 24 hours, 10 mg after 48 hours and then 10 mg once daily.

The recommended dose and frequency of Lisinopril are:

• Hypertension: 10 mg once daily, with a usual dosage range of 20 mg to 40 mg per day
• Heart Failure: 5 mg once daily
• Acute Myocardial Infarction: 5 mg orally, followed by 5 mg after 24 hours, 10 mg after 48 hours, and then 10 mg once daily 2

From the Research

Recommended Dose and Frequency of Lisinopril

The recommended dose and frequency of Lisinopril vary depending on the condition being treated.

• For patients with heart failure, high doses (32.5 to 35mg, administered once daily) of lisinopril have been shown to be more effective than low doses (2.5 to 5mg, administered once daily) in reducing the risk of major clinical events 3.
• For essential hypertension, lisinopril is effective at dosages of 20 to 80 mg once daily 4, 5.
• For congestive heart failure, doses of 2.5-20 mg/d appear to provide hemodynamic effects comparable to those of captopril 4, 5.
• In elderly patients with hypertension, dosages effective tend to range from 2.5 to 40 mg/day, with lower dosages needed in patients with significant renal impairment 6.

Administration and Pharmacokinetics

• Lisinopril is administered once daily by mouth 5, 6.
• The onset of action occurs one to two hours after administration, with effects still present 24 hours later 5.
• The major route of elimination is through renal excretion, with an elimination half-life of 12.6 hours reported in normotensive individuals 5.

Special Considerations

• In patients with impaired renal function, a longer half-life and accumulation have been observed, requiring dose adjustments 5.
• Lisinopril is well tolerated, with a profile of adverse events typical of ACE inhibitors as a class 3, 4, 5, 6, 7.