Normopril-5 Tab

Side Effects of Normopril-5 Tab

Headache, fatigue, persistent and non-productive cough, chest and abdominal pain, dizziness, nausea, vomiting, diarrhoea, upper resp tract infection, asthenia, rash, orthostatic effects, hypotension, renal dysfunction, hyperkalaemia, intestinal angioedema; increased BUN and serum creatinine levels. Potentially Fatal: Anaphylactic reactions, angioedema, severe hypotension. Rarely, hepatic necrosis.

Drug Interactions

May enhance hypotensive effect w/ diuretics. May increase risk of renal function deterioration and decrease antihypertensive effect w/ NSAIDs. May increase serum levels and toxicity of lithium. Increased risk of hyperkalaemia w/ K-sparing diuretics and K supplements. May increase nitritoid reactions of gold Na thiomalate. Potentially Fatal: Increased risk of hypotension, hyperkalaemia and changes in renal function w/ aliskiren in patients w/ diabetes or renal impairment.

Contraindications

History of angioedema related to previous ACE inhibitor treatment, hereditary or idiopathic angioedema. Concomitant use w/ aliskiren in patients w/ diabetes or renal impairment. Pregnancy. Childn w/ GFR <30 mL/min/1.73 m2.

Mechanism of Action

Lisinopril competitively inhibits ACE from converting angiotensin I to angiotensin II (a potent vasoconstrictor) resulting in increased plasma renin activity and reduced aldosterone (a hormone that causes water and Na retention) secretion. This promotes vasodilation and BP reduction. Onset: 1-2 hr. Duration: 24 hr. Absorption: Absorbed slowly and incompletely from the GI tract. Absolute bioavailability: Decreased by approx 16% w/ heart failure. Time to peak plasma concentration: Approx 7 hr. Distribution: It crosses the placenta. Plasma protein binding: Not significantly bound (25%). Excretion: Via urine (as unchanged drug). Elimination half-life: 12 hr.

Special Precautions

Bilateral renal artery stenosis or a single kidney w/ unilateral renal artery stenosis. Patients w/ collagen vascular disease, acute MI at risk of further haemodynamic deterioration, angioedema unrelated to ACE inhibitor therapy, aortic stenosis and hypertrophic cardiomyopathy. Increased risk of angioedema in black patients. Renal impairment. Lactation. Childn <6 yr. Patient Counselling Patients should be informed to refrain from activities involving mental alertness and physical coordination after drug intake. Monitoring Parameters Monitor vital signs, serum electrolytes and creatinine levels frequently. Correct volume and/or salt depletion prior to treatment. Monitor renal function during the 1st few wk of treatment and periodically thereafter.

How to Use

Take orally with food and water, as directed by your physician.

How to Store

Keep in a cool, dry place away from sunlight and moisture.

Safety Concerns

• Alcohol: Avoid during treatment.
• Breastfeeding: Not recommended.
• Pregnancy: Contraindicated.
• Liver/Kidney: Use with caution.

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