ACE inhibitor
Lisinopril
Brand names: Zestril, Carace
Adult dose
Dose: Initial 2.5–10mg OD; usual maintenance 10–40mg OD; max 80mg OD
Route: PO
Frequency: OD
Dose adjustments
Renal
Reduce in CKD; close U&E monitoring
Clinical pearls
- Hypertension, heart failure, post-MI, diabetic nephropathy
- Once-daily, no metabolite, useful in hepatic impairment
Contraindications
- History of angioedema
- Bilateral renal artery stenosis
- Pregnancy
- Concurrent sacubitril/valsartan
- Concurrent aliskiren in diabetes/CKD
Side effects
- Cough
- Hyperkalaemia
- Renal impairment
- Angioedema
- First-dose hypotension
- Rash
Interactions
- NSAIDs
- Potassium-sparing diuretics
- Lithium
- Sacubitril/valsartan (avoid concurrent)
Monitoring
- U&E (1–2 weeks after start, with dose changes)
- BP
Reference: BNF; NICE NG136/NG106; https://bnf.nice.org.uk/drugs/lisinopril/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Drugs
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines