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| Initial Therapy:
| | #REDIRECT [[Lisinopril#Adult Indications and Dosage]] |
| In patients with uncomplicated essential hypertension not on diuretic therapy, the recommended initial dose is 10 mg once
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| a day. Dosage should be adjusted according to blood pressure response. The usual dosage range is 20 to 40 mg per day administered in a
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| single daily dose. The antihypertensive effect may diminish toward the end of the dosing interval regardless of the administered dose, but
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| most commonly with a dose of 10 mg daily. This can be evaluated by measuring blood pressure just prior to dosing to determine whether
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| satisfactory control is being maintained for 24 hours. If it is not, an increase in dose should be considered. Doses up to 80 mg have been used
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| but do not appear to give greater effect. If blood pressure is not controlled with ZESTRIL alone, a low dose of a diuretic may be added.
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| Hydrochlorothiazide, 12.5 mg has been shown to provide an additive effect. After the addition of a diuretic, it may be possible to reduce the
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| dose of ZESTRIL.
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| Diuretic Treated Patients:
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| In hypertensive patients who are currently being treated with a diuretic, symptomatic hypotension may occur
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| occasionally following the initial dose of ZESTRIL. The diuretic should be discontinued, if possible, for two to three days before beginning
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| therapy with ZESTRIL to reduce the likelihood of hypotension. (See WARNINGS.) The dosage of ZESTRIL should be adjusted according to
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| blood pressure response. If the patient’s blood pressure is not controlled with ZESTRIL alone, diuretic therapy may be resumed as described
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| above.
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| If the diuretic cannot be discontinued, an initial dose of 5 mg should be used under medical supervision for at least two hours and until
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| blood pressure has stabilized for at least an additional hour. (See WARNINGS and PRECAUTIONS, Drug Interactions.)
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| Concomitant administration of ZESTRIL with potassium supplements, potassium salt substitutes, or potassium-sparing diuretics may lead
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| to increases of serum potassium. (See PRECAUTIONS.)
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| Dosage Adjustment in Renal Impairment: | |
| The usual dose of ZESTRIL (10 mg) is recommended for patients with creatinine clearance
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| > 30 mL/min (serum creatinine of up to approximately 3 mg/dL). For patients with creatinine clearance ≥ 10 mL/min ≤ 30 mL/min (serum
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| creatinine ≥ 3 mg/dL), the first dose is 5 mg once daily. For patients with creatinine clearance < 10 mL/min (usually on hemodialysis) the recommended
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| initial dose is 2.5 mg. The dosage may be titrated upward until blood pressure is controlled or to a maximum of 40 mg daily.
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