How Genes Affect The Breakdown Of Lisinopril?

What Is Lisinopril?

Lisinopril is a medication that treats high blood pressure and heart failure. It is used in adults and children aged six and above.

Lisinopril is an Angiotensin-Converting Enzyme (ACE) inhibitor.

ACE inhibitors reduce blood volume in the arteries and veins and relax blood vessels.

Lisinopril makes to the World Health Organization’s List of Essential Medicines for 2021.

It is available in brand names Zestril, Qbrelis, Prinivil, and Dapril.

Image: Action of ACE Inhibitors

Is Lisinopril A Beta-Blocker?

Lisinopril is an ACE inhibitor and not a beta-blocker.

Both these medicines work differently in reducing blood pressure levels.

What Is Lisinopril Used For?

Lisinopril treats high blood pressure by relaxing the blood vessels and reducing blood flow volume.

Doctors may also use it along with other medications to treat heart failure.

In people with uncontrolled type II diabetes, lisinopril can also be used to prevent kidney conditions.

How Does Lisinopril Work?

ACE inhibitors work by controlling the action of the Angiotensin-Converting Enzyme (ACE).

ACE converts a hormone called angiotensin I into another substance called angiotensin II.

Angiotensin II is a vasoconstrictor.

It leads to the constriction of the blood vessels, increasing blood pressure levels.

Lisinopril works by reducing angiotensin II levels and increasing the levels of bradykinin.

Bradykinins are small proteins that cause inflammation and help dilate the blood vessels.

How Long Does Lisinopril Stay In Your System?

The half-life of lisinopril is about 12.6 hours, and it can stay in the blood for an average of 46.7 hours before getting eliminated.

Side Effects Of Lisinopril

Some of the common side effects of lisinopril are:

Lightheadedness
Sore throat
Fever and chills
Weakness and tiredness
Headaches

Some of the more severe side effects of lisinopril are:

Breathing difficulties
Chest pain
High potassium levels in the body, causing irregular heartbeat, tingling sensation in the body, nausea, and weakness
Kidney problems
Liver problems

Does Lisinopril Cause Weight Gain?

No, most ACE inhibitors don’t cause weight gain.

Some studies show that long-term use of ACE inhibitors may help reduce body weight.

What Is Lisinopril Angioedema

Angioedema is a condition that causes swelling beneath the skin. Lisinopril may lead to angioedema, and in some cases, the side effects may be fatal.

If you experience shortness of breath or swelling in the tongue, face, lips, or any other part of the body after using the drug, rush to the nearest ER or dial 911.

Does Lisinopril Cause ED (Erectile Dysfunction)?

Erectile Dysfunction is a rare side effect of lisinopril.

Studies show that when compared to other ACE inhibitors, lisinopril causes only a temporary decline in sexual desire.

What Is Lisinopril Hyponatremia

Hyponatremia is a condition that causes low blood sodium levels. Lisinopril-induced hyponatremia may be a rare yet severe side-effect of this drug.

What Is Lisinopril Cough?

Lisinopril cough is a chronic condition that is one of this drug’s more common side effects.

Up to one-third of all people on ACE-inhibitor drugs may develop this condition.

What Does A Lisinopril Cough Sound Like?

A lisinopril-induced cough is dry, hacking, and has a barking sound to it.

It occurs consistently and continues for as long as you are on the drug.

Interactions With Other Drugs

Lisinopril may interact with other medications and lead to changes in drug efficacy or worsen the side effects.

Notify your doctor if you use the below drugs with lisinopril.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Diuretics (water pills used to reduce water retention in the body)
Diabetic medications
Potassium supplements
Renin-inhibitors like aliskiren (used to treat high blood pressure)
Drugs that prevent rejection after organ transplants like tacrolimus, sirolimus, and everolimus

Amlodipine And Lisinopril

Amlodipine is a calcium-channel blocker used to treat high blood pressure and heart conditions.

According to studies, a combination of amlodipine and lisinopril can improve blood pressure reduction rate compared to using just one of these medicines.

Lisinopril And Metoprolol

Metoprolol is a beta-blocker and treats high blood pressure.

Combining lisinopril and metoprolol may lead to very low blood pressure levels and cause conditions like dizziness, weakness, and fainting episodes.

Make sure you talk to your doctor about the effect of this combination.

Lisinopril And Metformin

Metformin is a common drug to bring down blood sugar levels.

Combining lisinopril and metformin may increase the efficacy of metformin and cause abnormally low blood sugar levels.

Meloxicam And Lisinopril

Meloxicam is an NSAID used to treat pain and inflammation in people with arthritis.

Meloxicam can increase blood pressure levels and, as a result, decrease the efficacy of lisinopril.

If you are on NSAIDs, mention this to your doctor to plan the dose of blood pressure medications.

Lisinopril: Gene-Drug Interactions

The AGT Gene

The angiotensinogen gene (AGT gene) provides instruction for making the angiotensinogen protein.

This protein controls fluid balance in the body and regulates blood pressure levels.

rs11122576 is a Single Nucleotide Polymorphism (SNP) in the AGT gene.

Compared to patients treated with amlodipine (a calcium channel blocker drug), patients of the CC and CT genotypes of this SNP treated with lisinopril have an increased risk of developing coronary diseases.

Genotype	Implications
CC	Increased risk of coronary disease when treated with lisinopril
CT	Increased risk of coronary disease when treated with lisinopril
TT	No such relationship found

Recommendations To Use Lisinopril

Lisinopril Allergy Implications

Lisinopril may increase the risk of developing angioedema (swelling underneath the skin).

If you have a history of allergies, mention this to your doctor before using lisinopril.

The drug may worsen swelling and breathing difficulties.

Lisinopril Geriatric Implications

The side effects of lisinopril may be severe in the elderly, especially in large doses.

Studies show that 5 mg was a safe dose to start with in geriatric patients.

The value can be slowly increased to up to 40 mg, depending on individual cases.

Lisinopril And Pregnancy

Most ACE inhibitors are risky to be used during pregnancy, especially during the second and third trimesters.

Lisinopril may cause kidney damage in the fetus.

Recent studies show that using the drug may not be safe even during the first trimester.

A study was conducted on 29,507 children born between 1985 and 2000 to study the effects of ACE inhibitors.

Out of these, mothers of 209 infants had used ACE inhibitors in the first trimester, and mothers of 202 infants were exposed to other antihypertensive drugs.

The remaining mothers did not use any hypertension medication.

The study reports that usage of ACE inhibitors caused an increased risk of congenital malformations in the heart and Central Nervous System (CNS) in infants.

Lisinopril Nursing Implications

Lisinopril is more favorable than other ACE inhibitors because it does not have an active metabolite and has a shorter half-life.

However, there is no clear evidence of how much lisinopril may get passed on in breast milk.

If you are on the drug and are nursing, talk to your doctor and weigh the risks and benefits before making a decision.

Lisinopril And Electrolyte Imbalance

Some of the side effects of lisinopril, like vomiting, sweating, and frequent urination, can increase the risk of dehydration and electrolyte imbalance.

A minor electrolyte imbalance may be corrected by diet changes.

Should I Drink More Water When Taking Lisinopril?

Lisinopril may lead to excess water loss from the body by making you urinate more.

Therefore, it is recommended you increase your water intake while on lisinopril.

Can I Have A Glass Of Wine With Lisinopril?

Alcohol may cause changes in blood pressure levels and dizziness.

As a result, it may worsen the side effects of lisinopril.

Talk to your doctor to understand safe alcohol doses while on this drug.

Genetic Testing

Genetic testing can help understand how effective lisinopril will be in reducing blood pressure levels in individual patients.

It can also predict the risk of side effects and help take preventive actions if needed.

Analyze Your Genetic Response to Lisinopril

Summary

Lisinopril is an Angiotensin-Converting Enzyme (ACE) inhibitor drug used to treat high blood pressure and symptoms of heart failure.
Lisinopril works by dilating blood vessels and reducing blood volume flow. As a result, it brings down blood pressure levels.
Some of the side effects of lisinopril are nausea, headaches, sore throat, tiredness, lightheadedness, chest pain, angioedema, and liver and kidney problems..
Changes in the AGT gene can increase the risk of coronary diseases in people treated with lisinopril.
The side effects of lisinopril may be severe in older patients. They have to start with minimal doses and be monitored throughout the treatment process.
Using lisinopril during pregnancy may cause congenital malformations in infants. Since it is not sure if lisinopril is excreted in breastmilk, discuss with your doctor if you are breastfeeding while on the drug.
Genetic testing can help understand the efficiency, risk of side effects, and correct doses of lisinopril in individual cases.