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Lisinopril Dosage: How Much Zestril Can Be Taken Daily?

pile of Lisinopril pills fell out from jar

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Lisinopril doses, also known under the brand names Zestril and Prinivil, are used to treat health conditions such as high blood pressure, congestive heart failure, diabetic nephropathy, hypertension, and post-myocardial infarction.
Zestril classification is a long-lasting, oral ACE inhibitor. Zestril dosage is available in different forms and strengths. The variation found here makes it important for one to be able to identify the differences – however minute they may be – among the various brands sold on the market, and the right amount of doses of Lisinopril to be used in the treatment of any health conditions.

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Table Of Contents:

Lisinopril Dosage Forms And Strengths

What is Lisinopril dosage form? It is supplied in the form of tablets and an oral solution. The tablets are white and oval-shaped, with an “LSN” inscription on one side alongside the corresponding dosage strength of each pill. For instance, Lisinopril 2.5mg tablet has an “LSN 2.5” inscription on one side and no inscription on the other side. Other dosage strengths of the tablet form include:

  • Zestril 5mg
  • Zestril 10mg
  • Zestril 20mg
  • Zestril 30mg
  • Zestril 40mg

Alternatively, Lisinopril oral solution has a dosage strength of 1.09 mg per milliliter.

A healthcare provider may recommend either one of these two Lisinopril dosage forms, depending on the health condition and other possible interactions that the patient may have.

Lisinopril Dosage For Adult And Pediatric Patients

As mentioned earlier, the appropriate Lisinopril dosage recommended for a patient will vary according to a number of factors. Some of these factors are the age of the patient, the health condition that the patient is dealing with, and any possible drug interactions that other medications may have on the use of Prinivil for that person. The dosage tables below address the appropriate doses for several conditions that Lisinopril is used for.

Lisinopril Adult Dosage

A schedule of the normal doses of Lisinopril  for adult patients is as follows:

ConditionInitial DoseFrequencyMaximum Daily Dose
Hypertension10 mgOnce a day80 mg
Heart Failure2.5 mg to 5 mgOnce a dayLisinopril 40 mg
Post-myocardial infraction for hemodynamically stable patientsLisinopril 5 mg tabOnce a day10 mg
Post-myocardial infraction for patients with low systolic blood pressure (<= 120 mmHg)2.5 mg if the patient is hypotensive before therapy. 5 mg if the patient is not hypotensive before therapyOnce a day5 mg
Persistent albuminuriaZestril 5 mgOnce a day10 mg for normotensive diabetic patients 20 mg for nondiabetic hypertensive patients
Diabetic retinopathyLisinopril 10 mgOnce a day20 mg
Migraine prophylaxis10 mgOnce a day20 mg

Recommended Geriatric Zestril Dosage

The recommended dosing schedule for Geriatric adults using Lisinopril is as follows:

ConditionInitial DoseFrequencyMaximum Daily Dose
Post-myocardial infraction2.5 mgOnce a day5 mg
Diabetic retinopathy10 mgOnce a day10 mg

Pediatric Lisinopril Dosage

The recommended dosing schedule for pediatric patients is as follows:

ConditionInitial DoseFrequencyMaximum Daily Dose
Hypertension0.07mg per kgOnce a day0.6 mg/kg/day or 40 mg/day
Proteinuria0.2mg per kgOnce a day10 mg

Dosage Adjustments When Using Lisinopril

In line with the Lisinopril dosage administration schedule described above, a health care provider may recommend dose adjustments in specific situations to increase the efficacy of treatment. Some of the possible scenarios that may require Zestril dose adjustments are as follows:

  • For adults with hypertension, patients receiving diuretics and patients with impaired renal function may be recommended for dose adjustments. Lisinopril starting dose here is reduced to less than 10 mg once a day.
  • For adults with hypertension and a creatinine clearance of below 30 ml per minute, the initial dose is adjusted to 5 mg once a day.
  • For adults receiving treatment for heart failure, a lower Zestril dose may be recommended for patients that are undergoing concomitant diuretic therapy – to minimize hypovolemia. Patients with hyponatremia may also be advised for a lower initial dose of Lisinopril 2.5 mg. This initial dose can then be titrated according to the tolerance of the patient. A titration rate of 10mg (or less) per day is recommended until the maximum Lisinopril dose of 40mg is reached.
  • For hemodynamically stable patients with postmyocardial infarction, after the Linisopril starting dose of 5 mg, another subsequent dose of 5 mg after 24 hours, the dose should be adjusted to 10mg once a day.

Maximum Recommended Dose for Lisinopril

How much Lisinopril is too much? The maximum recommended dosage varies per indication, meaning that the health condition that the patient is receiving treatment for determines what the maximum recommended dose will be. The half-life of Lisinopril for each patient here would depend on the dosage strength used.

Young woman with Lisinopril pills at home.
Maximum recommended doses of Zestril are as follows:

Zestril Max Dose For Adults

The maximum recommended dose of Lisinopril for hypertension treatment with Lisinopril is 80 mg per day, while the one for heart failure is 40 mg per day. The same applies to geriatric adults.

Zestril Max Dose For Pediatric Patients

The safety and efficacy of Lisinopril dosage have not been established with infants and neonates.

For children aged between 12 months to 23 months, the recommendation from clinical guidelines is 0.6 mg/kg/day.
For children aged 2 to 12 years, the recommendation from clinical guidelines is also 0.6 mg/kg/day, maxing out at a limit of 40mg per day. The same applies to adolescents.

What is the lethal dose (LD50) of Lisinopril?

This has been tested with rats and mice. For rats, the oral LD50 for Lisinopril is 8500 mg/kg. For mice, it is 9100 mg/kg.

Zestril Overdose: Can One Overdose On The Drug?

Overdosed man is lying on table.

Can one overdose on Lisinopril? Considering the fact that a qualified health care provider is the proper person to prescribe doses of Lisinopril, any dose intake that is higher than the recommendation of the health care provider is an overdose. Consequently, the severity of side effects experienced from a Lisinopril overdose would depend on how much the dose taken is.
If one takes more than the prescribed dose of Zestril on a single occasion, it would be an acute overdose. Prinivil side effects such as a drop in blood pressure and dizziness are commonly associated with acute overdose. These side effects are not significantly harmful individually, but the impact that the side effects have on the person could lead to life-threatening situations. For instance, if one is dizzy, it is possible to fall over and break a bone or rip a muscle. If one is dizzy while driving a car, an accident could occur.
If an individual takes more than the prescribed dose of Lisinopril for an extended period of time, the result would be a chronic overdose, and the side effects of Lisinopril would be even more severe. These side effects could become severe enough to lead to organ failure, which would require immediate, extensive medical attention.

Using Lisinopril Safely

Here are a few tips for taking Prinivil safely:

  • Pregnant and breastfeeding mothers must consult with a doctor before using any dose of Lisinopril.
  • If one is using any other medication at the same time, provide the health care provider with a list of these medications to make sure that there are no interactions with Lisinopril dosage.
  • One must ensure that there are no allergies to ACE inhibitors before using the medication.
  • Anybody with a history of angioneurotic oedema is advised not to use the drug.
  • Zestril abuse can happen to some patients who take this medication for prolonged durations. Addiction treatment psychiatrists can help to diagnose the abuse and to consult about rehab options available in the area.

Smiling doctor at the clinic gives advice.

People with the following health conditions should inform the doctor before beginning to use Lisinopril:

  • Diarrhea or Vomiting
  • On a low-salt diet
  • Kidney problems
  • Insufficient blood supply to the brain or heart
  • Liver disease
  • Aortic stenosis
  • Collagen vascular disease
  • Recent heart attack
  • Congestive heart failure
  • Low blood pressure

Storage and Handling

The drug should be kept away from the reach of children. It should be left in its original container and stored at a temperature of 77 F (25 C) and below. If the medicine is no longer required, it should not be disposed of via household waste or water waste.
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Sources
  1. Trilli LE, Johnson KA., Lisinopril overdose and management with intravenous angiotensin II, 1994, https://www.ncbi.nlm.nih.gov/pubmed/7841571
  2. Belay TW, Nusair AR. Apparent lisinopril overdose requiring hemodialysis, 2013, https://www.ncbi.nlm.nih.gov/pubmed/23820459
  3. Tsai T, Kroehl ME, Smith SM, Thompson AM, Dai IY, Trinkley KE. Efficacy and safety of twice- vs once-daily dosing of lisinopril for hypertension, 2017, https://www.ncbi.nlm.nih.gov/pubmed/28439946

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