TM Owner Merck & Co.
Prinivil 20mg Tablet
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Indications & Clinical Uses
- Prinivil 20 mg tablets contain lisinopril, an angiotensin-converting enzyme (ACE) inhibitor.
- Prinivil is used to treat high blood pressure (hypertension) in adults and in children aged 6 years and older, as add-on treatment for heart failure alongside diuretics and, where appropriate, digoxin and beta-blockers, and to improve survival in haemodynamically stable adults within 24 hours of a heart attack (acute myocardial infarction).
- Lisinopril lowers blood pressure by relaxing blood vessels and reduces the heart's workload in heart failure.
- Prinivil is taken by mouth, usually once daily, and may be used alone or together with other blood-pressure-lowering medicines such as thiazide diuretics.
- It is marketed by Merck & Co. in the United States; the same active ingredient is sold under other brand names, including Zestril, in various markets.
Side Effects
- Prinivil carries a boxed warning for fetal toxicity: ACE inhibitors like lisinopril can injure or cause the death of an unborn baby when used during pregnancy, so Prinivil must be stopped as soon as pregnancy is detected.
- Common side effects include headache (about 6%), dizziness (about 5%) and a persistent dry cough (about 4%), which can develop weeks into treatment; report a bothersome cough so your prescriber can consider an alternative.
- In heart failure and after a heart attack, low blood pressure and chest pain are common.
- Get urgent medical help for swelling of the face, lips, tongue or throat, or difficulty breathing (angioedema), as this is a rare but serious and sometimes delayed reaction.
- Also report signs of high potassium such as muscle weakness or an irregular heartbeat.
Precautions & Warnings
- Prinivil must be stopped as soon as pregnancy is confirmed because of the boxed warning for fetal toxicity; it should not be used by women trying to become pregnant.
- It is contraindicated in people with a history of angioedema related to any ACE inhibitor, hereditary or idiopathic angioedema, and in people with diabetes taking aliskiren; it must not be combined with a neprilysin inhibitor such as sacubitril, and there must be a 36-hour gap after switching from or to such a medicine.
- Kidney function, blood pressure and blood potassium should be checked before starting and periodically during treatment, particularly in people with kidney disease, heart failure, or those on potassium-sparing diuretics or supplements.
- Prinivil can cause dizziness or light-headedness, especially after the first dose or a dose increase, so caution is needed when driving or operating machinery until you know how it affects you.
Avoid Interactions
- Combining Prinivil with potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium, or trimethoprim can raise blood potassium to dangerous levels.
- NSAIDs, including selective COX-2 inhibitors, may reduce Prinivil's blood-pressure-lowering effect and increase the risk of kidney problems, particularly in older adults, people who are dehydrated, or those with existing kidney disease.
- Combining Prinivil with other drugs that act on the renin-angiotensin system, such as angiotensin receptor blockers or aliskiren, increases the risk of low blood pressure, high potassium and kidney impairment and is generally not recommended.
- Lithium levels can rise when taken with Prinivil, increasing the risk of lithium toxicity, so levels should be monitored.
- Tell your healthcare provider and pharmacist about every medicine and supplement you take, including over-the-counter painkillers, before starting Prinivil.
References
Frequently Asked Questions
Prinivil (lisinopril) is an ACE inhibitor used to treat high blood pressure in adults and children aged 6 and over, to treat heart failure alongside other medicines, and to improve survival after a heart attack. It works by relaxing blood vessels so the heart pumps more easily.
Prinivil is taken by mouth once daily, with or without food, usually at the same time each day. Your doctor starts at a low dose and increases it gradually based on your blood pressure response. Swallow the tablet whole; do not stop suddenly without medical advice.
Common Prinivil side effects are headache, dizziness and a dry, persistent cough. Its boxed warning covers fetal toxicity: ACE inhibitors can harm an unborn baby. Get urgent help for facial or throat swelling and breathing difficulty (angioedema), which can occur even after months of use.
Avoid potassium supplements, salt substitutes and potassium-sparing diuretics with Prinivil, as they can raise potassium to unsafe levels. NSAIDs can reduce its effect and stress the kidneys. Do not combine it with aliskiren if you have diabetes, and stop Prinivil immediately if you become pregnant.
No. Prinivil has a boxed warning because ACE inhibitors like lisinopril can injure or cause the death of an unborn baby, especially in the second and third trimesters. Stop Prinivil as soon as pregnancy is confirmed and tell your doctor immediately so an alternative can be started.
Your doctor checks kidney function and blood potassium before starting Prinivil and periodically afterward, since ACE inhibitors can raise potassium and affect kidney function. Blood pressure is also monitored regularly, especially when starting treatment or increasing your dose.
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